Title: 3 Human factors in the operating room: interpersonal determinants of safety, efficiency and morale
Abstract: The majority of accidents in technical professions have human error as a causal element. More critically, these errors tend to involve interpersonal issues: communications, leadership, conflict, flawed decision-making, etc. Aviation has responded by initiating formal instructions in the interpersonal aspects of human factors through programmes that are known as Crew Resource Management (CRM) training. Research into the interpersonal activities in the operating room has demonstrated similar problems in communication, conflict and situational awareness. To define the issues more sharply, an input-process-outcome model of operating room team performance was adapted from one developed in aviation. The model defines areas such as attitudes, organizational culture and group processes that are amenable to improvement through training and organizational interventions. It has also led to the development of formal human factors training programmes that, like that in aviation, involve simulation. Team-Oriented Medical Simulation (TOMS) at the University of Basel/Kantonsspital is a training programme that includes a full operating room simulator. Anaesthetists, surgeons, nurses and orderlies conduct scheduled surgery on an instrumented mannequin that allows both anaesthetic and laparoscopic simulation. Initial results from simulations show highly favourable reactions from participants. Human factors and quality assurance programmes need to be data-driven to have a positive impact. Survey and systematic observational methodologies have been used to define areas that may benefit from training. Results from three hospitals showed highly significant differences in attitudes regarding the interpersonal aspects of surgery between organizations and among subgroups (anaesthetists, surgeons, nurses) within organizations. We conclude that integrated quality assurance and human factors programmes have the potential to increase safety, efficiency and job satisfaction among medical personnel.
Publication Year: 1996
Publication Date: 1996-07-01
Language: en
Type: article
Indexed In: ['crossref']
Access and Citation
Cited By Count: 114
AI Researcher Chatbot
Get quick answers to your questions about the article from our AI researcher chatbot