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Designing for Safety: the Importance of the Physical Space

  • Patient Safety in Anesthesia (A Barbeito, Section Editor)
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Abstract

Surgical adverse events have been linked to flow interruptions in the normal progression of the surgical procedure. Human factors engineering principles have been used to study the effects of the operating room environment on the performance of surgical team members. Flow disruptions can be caused by factors related to operating design, size, and layout, i.e., cluttered workspaces and inefficient personnel movements. Other causes of flow disruptions include distractions caused by traffic in the operating room and equipment failure. Continued research is needed to develop processes and procedures to minimize adverse events related to flow disruption.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. de Leval MR, Carthey J, Wright DJ, et al. Human factors and cardiac surgery: a multicenter study. J Thorac Cardiovasc Surg. 2000;119:661–72.

    Article  Google Scholar 

  2. Catchpole KR, Giddings AE, Wilkinson M, et al. Improving patient safety by identifying latent failures in successful operations. Surgery. 2007;142:102–10.

    Article  Google Scholar 

  3. Wiegmann DA, ElBardissi AW, Dearani JA, et al. Disruptions in surgical flow and their relationship to surgical errors: an exploratory investigation. Surgery. 2007;142:658–65.

    Article  Google Scholar 

  4. • Palmer G 2nd, Abernathy JH 3rd, Swinton G, et al. Realizing improved patient care through human-centered operating room design: a human factors methodology for observing flow disruptions in the cardiothoracic operating room. Anesthesiology. 2013;119:1066–77. First study to incorporate architectural diagrams to define the locations of flow disruptions in the OR.

    Article  Google Scholar 

  5. Ahmad N, Hussein AA, Cavuoto L, et al. Ambulatory movements, team dynamics and interactions during robot-assisted surgery. BJU Int. 2016;118:132–9.

    Article  Google Scholar 

  6. Cohen TN, Cabrera JS, Sisk OD, et al. Identifying workflow disruptions in the cardiovascular operating room. Anaesthesia. 2016;71:948–54.

    Article  CAS  Google Scholar 

  7. Cesarano FL, Piergeorge AR. The spaghetti syndrome. A new clinical entity. Crit Care Med. 1979;7:182–3.

    Article  CAS  Google Scholar 

  8. Brogmus G, Leone W, Butler L, et al. Best practices in OR suite layout and equipment choices to reduce slips, trips, and falls. AORN J. 2007;86:384–394; quiz 395-388.

    Article  Google Scholar 

  9. Ofek E, Pizov R, Bitterman N. From a radial operating theatre to a self-contained operating table. Anaesthesia. 2006;61:548–52.

    Article  CAS  Google Scholar 

  10. ElBardissi AW, Sundt TM. Human factors and operating room safety. Surg Clin North Am. 2012;92:21–35.

    Article  Google Scholar 

  11. Watkins N, Kobelja M, Peavey E, et al. An evaluation of operating room safety and efficiency: pilot utilization of a structured focus group format and three-dimensional video mock-up to inform design decision. HERD. 2011;5:6–22.

    Article  Google Scholar 

  12. Institute FG: Operating room requirements for 2014 and beyond2014.

  13. McNeer RR, Bennett CL, Horn DB, et al. Factors affecting acoustics and speech intelligibility in the operating room: size matters. Anesth Analg. 2017;124:1978–85.

    Article  Google Scholar 

  14. Wheelock A, Suliman A, Wharton R, et al. The impact of operating room distractions on stress, workload, and teamwork. Ann Surg. 2015;261:1079–84.

    Article  Google Scholar 

  15. Scaltriti S, Cencetti S, Rovesti S, et al. Risk factors for particulate and microbial contamination of air in operating theatres. J Hosp Infect. 2007;66:320–6.

    Article  CAS  Google Scholar 

  16. Birgand G, Toupet G, Rukly S, et al. Air contamination for predicting wound contamination in clean surgery: a large multicenter study. Am J Infect Control. 2015;43:516–21.

    Article  Google Scholar 

  17. • Bohl MA, Clark JC, Oppenlander ME, et al. The Barrow Randomized Operating Room Traffic (BRITE) trial: an observational study on the effect of operating room traffic on infection rates. Neurosurgery. 2016;63(Suppl 1):91–5. Randomized trial showing the lack of contribution of OR door opening to surgical site infection.

    Article  Google Scholar 

  18. Weerakkody RA, Cheshire NJ, Riga C, et al. Surgical technology and operating-room safety failures: a systematic review of quantitative studies. BMJ Qual Saf. 2013;22:710–8.

    Article  Google Scholar 

  19. Martinez EA, Thompson DA, Errett NA, et al. Review article: high stakes and high risk: a focused qualitative review of hazards during cardiac surgery. Anesth Analg. 2011;112:1061–74.

    Article  Google Scholar 

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Correspondence to Timothy L. Heinke.

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Timothy L. Heinke, Kenneth M. Catchpole, and James H. Abernathy III declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Patient Safety in Anesthesia

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Heinke, T.L., Catchpole, K.M. & Abernathy, J.H. Designing for Safety: the Importance of the Physical Space. Curr Anesthesiol Rep 7, 306–309 (2017). https://doi.org/10.1007/s40140-017-0223-8

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  • DOI: https://doi.org/10.1007/s40140-017-0223-8

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