Dynamic patterns of communication and workload during cardiac surgery: An explorative study

Area of Science:

• Cardiovascular Surgery
• Surgical Team Dynamics
• Human Factors Engineering

Background:

• Effective operating room (OR) communication is vital for patient safety and surgical outcomes.
• This study examines intraoperative communication in relation to physiological workload during cardiac surgery.
• The research explores links between team member workload, communication types, and surgical phase duration.

Purpose of the Study:

• To investigate the relationship between team members' workload and communication patterns in cardiac surgery.
• To determine how case-relevant and case-irrelevant communication correlate with physiological workload.
• To assess the association between workload, communication, and surgical phase length.

Main Methods:

• 24 cardiac surgeries were recorded, with communication annotated from incision to closure.
• Heart rate monitors assessed team members' physiological workload (HRV, RMSSD).
• Mixed-effects models analyzed workload's impact on communication frequency and surgical phase duration.

Main Results:

• Case-relevant communication peaked during bypass initiation/discontinuation; case-irrelevant communication was highest during final closure.
• Increased personal workload correlated with less case-irrelevant communication, but increased team workload correlated with more case-irrelevant communication from others.
• Both workload and case-relevant communication significantly influenced surgical phase length.

Conclusions:

• Intraoperative communication patterns are dynamically linked to physiological workload.
• Combining observational data with physiological workload indicators offers a promising method for studying OR team dynamics.
• Further research is needed to refine these methods for enhancing surgical team performance.