Human factors application, decision making, team working and leadership in Surgical Oncology

As humans we are fallible, and make mistakes both at work and in our personal lives on a regular basis. The operating theatre is one of the most dangerous areas of the hospital with many preventable errors occurring in this setting. Understanding, recognising and applying human factors (HF) in surgical practice can help reduce the chances of error. While HF is gaining ever increasing traction and profile across healthcare, sadly some colleagues do not think these factors apply to them, and for example, feel able to operate for countless hours without taking a break. In this review, we explore some of the many human factors that are relevant to surgical oncology, gained from our experiences in the British National Health System (NHS). We focus on the sometimes overlooked factors that can be utilised to improve both personal performance and enhance team working. We also discuss decision making, thinking processes, situation awareness, surgical personality, leadership and other factors. The importance of a just culture in surgery is also discussed, whereby incidents are investigated to learn why something has happened, rather than who was to blame. Finally, the potential adverse effects of burnout on surgical error and patient safety are also considered.