Surgical Flow Disruptions, a Pilot Survey with Significant Clinical Outcome Implications
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OTHER PAIN (N VADIVELU AND AD KAYE, SECTION EDITORS)
Surgical Flow Disruptions, a Pilot Survey with Significant Clinical Outcome Implications David Silver 1 & Alan D. Kaye 2 & Douglas Slakey 3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Surgical flow disruptions (SFD) are deviations from the progression of a procedure which can be potentially compromising to the safety of the patient. Investigators have previously demonstrated that SFDs can increase the likelihood of error. To date, there has been no investigation into flow disruptions through the eyes of clinicians in the operating room. This study, therefore, attempted to better understand SFDs and their impact from the perspective of operating room team members. Recent Findings After Institutional Review Board approval, a survey was sent to operating room team members including surgeons, anesthesia providers, nurses, and surgical technologists. The survey was developed to assess the perceived frequency and consequences of SFDs, and the ability to report and perceive the efficacy of reporting to management. Among 111 survey participants, 65% reported that surgical flow disruptions happen either “several times a day” or “every procedure.” Forty percent ranked poor communication as the most frequent cause of SFDs. Ten percent reported equipment failure was the most frequent cause of SFDs. Respondents who identified as attending surgeons felt impacts on patient safety and staff burnout was the most likely consequence of SFDs. Scrub technicians and nurses felt that economic consequences were the most likely result. Forty-four percent did not feel reporting led to effective change. Thirty-five percent did not believe they could report issues without adverse consequences. Summary Flow disruptions represent patterns or accumulations of disruptions which may highlight weak points in surgical systems and potential causes of staff burnout and medical error. The data in the present investigation demonstrate that OR team members recognize surgical flow disruptions are an important issue and believe poor communication and equipment problems are a significant factor. Our data additionally suggest the groups surveyed do not feel safe or productive in reporting flow disruptions. Keywords Surgical flow disruptions . Operating room . Anesthesiologist . Surgeon . Nurse
This article is part of the Topical Collection on Other Pain * Alan D. Kaye [email protected]; [email protected] David Silver [email protected] Douglas Slakey [email protected] 1
Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
2
Department of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University School of Medicine, 1501 Kings Hwy, Shreveport, LA 71103, USA
3
Advocate Christ Medical Center, Advocate Aurora Health Care, Chicago, IL, USA
Introduction Psychologist Mihaly Csikszentmihalyi described flow with respect to complex work as a loss of consciousness of self
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