Characterization of surgical flow disruptions in orthopedic surgery using a human factors approach

Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2025-04-05 DOI:10.1016/j.pcorm.2025.100488

Asfandyar Khan , Scott A. Shappell , Albert J. Boquet

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引用次数: 0

Abstract

Background

Efficient and safe perioperative care is critical to optimizing surgical outcomes and reducing preventable errors. Orthopedic procedures, ranging from minimally invasive techniques to complex surgeries, place significant cognitive and physical demands on surgical teams. Disruptions in workflow can compromise efficiency, coordination, and patient safety. This study aimed to systematically identify and categorize surgical flow disruptions to inform quality improvement efforts.

Method

Forty orthopedic surgeries were observed. A human factors taxonomy was used to classify disruptions, and descriptive statistical analysis was applied.

Result

Of the 2343 total disruptions observed, Interruptions (46.39 %) were the most frequent, followed by communication failures (33.25 %), coordination challenges (13.19 %), layout inefficiencies (5.25 %), equipment issues (1.20 %), and usability concerns (0.73 %). This translated into one disruption every 3.7 min for the 40 surgeries.

Conclusions

Addressing surgical flow disruptions proactively can enhance perioperative efficiency, safety, and team coordination. This study presents system vulnerabilities, enabling the possibility of shifting the focus from reactive error analysis to proactive mitigation strategies.

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.