The impact of preventable disruption on the operative time for minimally invasive surgery

Al-Hakim, Latif (2011) The impact of preventable disruption on the operative time for minimally invasive surgery. Surgical Endoscopy: Surgical and Interventional Techniques, 25 (10). pp. 3385-3392. ISSN 0930-2794


Current ergonomic studies show that disruption exposes surgical teams to stress and musculoskeletal disorders. This study considers minimally invasive surgery as a sociotechnical process subjected to a variety of disruption events other than those recognized by ergonomic science. The research takes into consideration the impact of preventable disruption on operating time rather than on the physical and emotional status of the surgical team. Events inside operating rooms that disturbed operative time were recorded for 17 minimally invasive surgeries. The disruption events were classified into four main areas: prerequisite requirements, work design, communication during surgery, and other. Each area was further classified according to sources of disruption. Altogether, 11 sources of disruption were identified: patient record, protocol and policy, surgical requirements and surgeon preferences, operating table and patient positioning, arrangement of instruments, lighting, monitor, clothing, surgical teamwork, coordination, and other. Disruption prolonged operative time by more than 32%. Teamwork forms the main source of disruption followed by operating table and patient positioning and arrangement of instruments. These three sources represented approximately 20% of operative time. Failure to follow principles of work design had a significant negative impact, lengthening operative time by approximately 15%. Although lighting and monitors had a relatively small impact on operative time, these factors could create inconvenience and stress within the surgical teams. In addition, the effect of failure to follow surgical protocols and policies or having incomplete patient records may have a limited effect on operative time but could have serious consequences. This report demonstrates that preventable disruption caused an increase in operative time and forced surgeons and patients to endure unnecessary delay of more than 32%. Such additional time could be used to deal with the pressure of emergency cases and to reduce waiting lists for elective surgery.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: © Springer Science+Business Media, LLC 2011. Permanent restricted access to published version due to publisher copyright policy.
Faculty / Department / School: Historic - Faculty of Business and Law - School of Management and Marketing
Date Deposited: 02 Oct 2011 06:08
Last Modified: 05 Mar 2018 07:09
Uncontrolled Keywords: disruption; minimally invasive surgery; operative time; musculoskeletal diseases; occupational diseases; operating rooms; patient care team; risk assessment; risk factors; physiological stress; surgical procedures; task performance and analysis; time factors; waiting lists
Fields of Research : 11 Medical and Health Sciences > 1117 Public Health and Health Services > 111705 Environmental and Occupational Health and Safety
11 Medical and Health Sciences > 1103 Clinical Sciences > 110323 Surgery
11 Medical and Health Sciences > 1117 Public Health and Health Services > 111709 Health Care Administration
Socio-Economic Objective: E Expanding Knowledge > 97 Expanding Knowledge > 970111 Expanding Knowledge in the Medical and Health Sciences
Identification Number or DOI: 10.1007/s00464-011-1735-9

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