The cognition of dynamic evaluation of operating room environmental quality among medical staff: a qualitative study

This qualitative study, guided by the Donabedian three-dimensional quality model, aimed to explore the real perceptions of multidisciplinary healthcare professionals regarding the dynamic evaluation of the operating room environment quality. The ultimate goal was to identify current management deficiencies and propose evidence-based strategies for optimization.

Using a descriptive qualitative design with a hybrid analytic orientation, purposive sampling recruited 7 operating-room nurses, 6 surgeons, 5 anesthesiologists, and 2 infection-control specialists from 4 tertiary Grade A hospitals. After ethics approval, formal semi-structured interviews were conducted in March 2026. Interview data were transcribed, manually coded, and analyzed in NVivo 15.0 using Colaizzi's method. The Donabedian model informed the interview guide and later organization of evaluation-related categories.

Three core themes were extracted: (1) the four-dimensional connotation of operating-room environmental quality, comprising physical, chemical, biological, and humanistic dimensions; (2) nine preliminary candidate indicators for dynamic evaluation, grouped across structure, process, and outcome domains; and (3) healthcare professionals' perceptions of potential safety and health implications for staff and patients. These findings highlight a gap between current static monitoring practices and the dynamic nature of intraoperative environmental risks.

Participants' accounts suggest that a preliminary candidate framework for dynamic evaluation could incorporate structural conditions, process monitoring, and outcome-related feedback. Integrated management that considers both occupational health and patient safety represents a practice implication to be empirically evaluated. This study provides a qualitative foundation for subsequent Delphi consultation and psychometric or empirical validation of a dynamic OR environmental assessment framework.