Managing complexity in the operating room: a group interview study.

Area of Science:

• Healthcare Management
• Patient Safety
• Surgical Nursing

Background:

• Operating room (OR) clinical work is inherently complex, dynamic, and resource-constrained.
• Successful OR management requires adaptation and adaptive coordination for expected and unexpected events.
• Limited research explores how OR staff manage challenges and constraints to ensure safety.

Purpose of the Study:

• To explore how operating room nurses, nurse anesthetists, and surgeons manage complexity.
• To understand how OR professionals adapt to create safe patient care within constraints.

Main Methods:

• Qualitative explorative study using group interviews with OR nurses, nurse anesthetists, and surgeons.
• Verbatim transcription and inductive qualitative content analysis of interview data.

Main Results:

• Three generic categories for safe OR care: preconditions/resources, planning/preparation, and adapting to the unexpected.
• Common sub-categories across professions: information coordination, patient planning, mental preparation, and problem-solving.
• Identified strategies for managing complexity and ensuring safety.

Conclusions:

• Safe OR care is a process of planning and preparing for complex work.
• OR staff require resources, experience, and information coordination to navigate situations.
• Resilience theory principles are applied by OR staff to manage complexity and ensure safety.