World Journal of Surgery

, Volume 32, Issue 8, pp 1643–1650

Annoyances, Disruptions, and Interruptions in Surgery: The Disruptions in Surgery Index (DiSI)

  • Nick Sevdalis
  • Damien Forrest
  • Shabnam Undre
  • Ara Darzi
  • Charles Vincent
Article

DOI: 10.1007/s00268-008-9624-7

Cite this article as:
Sevdalis, N., Forrest, D., Undre, S. et al. World J Surg (2008) 32: 1643. doi:10.1007/s00268-008-9624-7

Abstract

Background

Recent studies have investigated disruptions to surgical process via observation. We developed the Disruptions in Surgery Index (DiSI) to assess operating room professionals’ self-perceptions of disruptions that affect surgical processes.

Materials

The DiSI assesses individual issues, operating room environment, communication, coordination/situational awareness, patient-related disruptions, team cohesion, and organizational issues. Sixteen surgeons, 26 nurses, and 20 anesthetists/operating departmental practitioners participated. Participants judged for themselves and for their colleagues how often each disruption occurs, its contribution to error, and obstruction of surgical goals.

Results

We combined the team cohesion and organizational disruptions to improve reliability. All participants judged that individual issues, operating room environment, and communication issues affect others more often and more severely than one’s self. Surgeons reported significantly fewer disruptions than nurses or anesthetists.

Conclusion

Although operating room professionals acknowledged disruptions and their impact, they attributed disruptions related to individual performance and attitudes more to their colleagues than to themselves. The cross-professional discrepancy in perceived disruptions (surgeons perceiving fewer than the other two groups) suggests that attempts to improve the surgical environment should always start with thorough assessment of the views of all its users. DiSI is useful in that it differentiates between the frequency and the severity of disruptions. Further research should explore correlations of DiSI-assessed perceptions and other observable measures.

Copyright information

© Société Internationale de Chirurgie 2008

Authors and Affiliations

  • Nick Sevdalis
    • 1
    • 2
  • Damien Forrest
    • 1
  • Shabnam Undre
    • 1
  • Ara Darzi
    • 1
  • Charles Vincent
    • 1
  1. 1.Clinical Safety Research Unit, Department of Bio-Surgery & Surgical TechnologyImperial CollegeLondonUK
  2. 2.National Patient Safety Agency LondonUK