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Relationships Between Expertise, Crew Familiarity and Surgical Workflow Disruptions: An Observational Study

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Abstract

Background

Teamwork is an essential factor in reducing workflow disruption (WD) in the operating room. Team familiarity (TF) has been recognized as an antecedent to surgical quality and safety. To date, no study has examined the link between team members’ role and expertise, TF and WD in surgical setting. This study aimed to examine the relationships between expertise, surgeon–scrub nurse familiarity and WD.

Methods

We observed a convenience sample of 12 elective neurosurgical procedures carried out by 4 surgeons and 11 SN with different levels of expertise and different degrees of familiarity between surgeons and SN. We calculated the number of WD per unit of coding time to control for the duration of operation. We explored the type and frequency of WD, and the differences between the surgeons and SN. We examined the relationships between duration of WD, staff expertise and surgeon–scrub nurse familiarity.

Results

9.91% of the coded surgical time concerned WD. The most frequent causes of WD were distractions (29.7%) and colleagues’ interruptions (25.2%). This proportion was seen for SN, whereas teaching moments and colleagues’ interruptions were the most frequent WD for surgeons. The WD was less high among expert surgeons and less frequent when surgeon was familiar with SN.

Conclusions

The frequency of WD during surgical time can compromise surgical quality and patient safety. WD seems to decrease in teams with high levels of surgeon–scrub nurse familiarity and with development of surgical expertise. Favoring TF and giving feedback to the team about WD issues could be interesting ways to improve teamwork.

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Authors and Affiliations

  1. Department of Neurosurgery, Rennes University Hospital, 2, rue Henri Le Guilloux, 35033, Rennes Cedex 9, France

    Pierre-Louis Henaux & Laurent Riffaud

  2. INSERM MediCIS, Unit U1099 LTSI, Faculty of Medicine, Rennes 1 University, 2 Avenue du Professeur Léon Bernard, 35043, Rennes Cedex, France

    Pierre-Louis Henaux, Pierre Jannin & Laurent Riffaud

  3. LP3C (Laboratoire de Psychologie : Cognition, Comportement, Communication) - EA 1285, Univ Rennes, 35000, Rennes, France

    Estelle Michinov, Julie Rochat & Brivael Hémon

Authors
  1. Pierre-Louis Henaux
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  2. Estelle Michinov
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  3. Julie Rochat
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  4. Brivael Hémon
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  5. Pierre Jannin
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  6. Laurent Riffaud
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Correspondence to Pierre-Louis Henaux.

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The authors declare that they have no conflict of interest.

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Henaux, PL., Michinov, E., Rochat, J. et al. Relationships Between Expertise, Crew Familiarity and Surgical Workflow Disruptions: An Observational Study. World J Surg 43, 431–438 (2019). https://doi.org/10.1007/s00268-018-4805-5

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  • DOI: https://doi.org/10.1007/s00268-018-4805-5

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