World Journal of Surgery

, Volume 43, Issue 2, pp 431–438 | Cite as

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

  • Pierre-Louis HenauxEmail author
  • Estelle Michinov
  • Julie Rochat
  • Brivael Hémon
  • Pierre Jannin
  • Laurent Riffaud
Original Scientific Report



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.


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.


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.


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.


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryRennes University HospitalRennes Cedex 9France
  2. 2.INSERM MediCIS, Unit U1099 LTSI, Faculty of MedicineRennes 1 UniversityRennes CedexFrance
  3. 3.LP3C (Laboratoire de Psychologie : Cognition, Comportement, Communication) - EA 1285Univ RennesRennesFrance

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