Operating room scheduling by considering the decision-making styles of surgical team members: A comprehensive approach

Introduction Members of the surgical team experience musculoskeletal (MS) symptoms that impact occupational health. Although the prevalence of MS symptoms in this population is well-recognized, limited interventions with sustained success exist for the operating room (OR) environment. The purpose of this work was to determine the facilitators of and barriers to exoskeleton technology in the OR, as a potential intervention to reduce upper-body MS pain and discomfort for surgical team members. Methods After providing informed consent, participants completed a two-part study: focus groups and a simulated laparoscopic skills task while wearing a passive arm-support exoskeleton (Levitate AirFrameTM). Seven surgical residents, four surgical technicians, and two attending surgeons participated in this study. A script including questions on technology adoption, supporting workers tasks/job, and safety and health (adapted from Kim et al., 2016) was used to guide each focus group. Content analysis of the focus groups was completed by three study team members to identify relevant themes from participants’ responses, and two raters coded all remaining sessions. Subsequently, nine participants completed repetitions of the Fundamentals of Laparoscopic Surgery peg transfer task for 10 minutes wearing the noted exoskeleton. Afterwards, their overall impressions of the exoskeleton were assessed using the System Usability Scale (SUS; Brooke, 1996). Results/Discussion Four main themes related to the adoption of exoskeletons in the OR were identified: characteristics of individuals, benefits, barriers, and intervention characteristics. Theme 1: Characteristics of individuals. It was noted that implementation of exoskeletons would require a champion at an institution to spearhead the efforts. Additionally, individual curiosity and awareness of MS ergonomics problems were found as facilitators of adoption. Theme 2: Benefits. Expected long-term benefits of an exoskeleton were mentioned. Specifically, stakeholders anticipated a decrease in MS symptoms and expected that it would help with workforce retention and prevention of early retirement. The user role that was identified to most benefit from exoskeletons were the surgical assistants ( n = 9). Theme 3: Barriers. Seven categories of barriers were found. Safety and sterility were major concerns in the OR. Main concerns included ensuring that the arm cuffs were not in the area of surgical scrub (i.e., below the elbows) and the added bulk to wear inside the surgical gown. Furthermore, the factors of familiarity, perception, buy-in, and immediate results were noted to influence the use of an exoskeleton. Theme 4: Intervention characteristics. The theme of intervention characteristics was identified separately from benefits and barriers, as the categories in this theme could either help facilitate or hinder the adoption of exoskeletons in the OR. Workers reported that investment, specifically monetary, and maintenance of the equipment would likely influence wide-spread adoption. Usability of the exoskeleton was indicated as having a large influence on adoption. Workers in all roles noted that whether they adopt the exoskeleton during surgical procedures would depend on usability. The mean SUS score for the exoskeleton tested was 82.2 out of 100 ( SD = 7.9), which was within the acceptable range of usability. Passive exoskeleton technology has the potential to minimize MS symptoms and fatigue for the surgical team (Liu et al., 2018). The current work identified themes for adopting exoskeletons in the OR, and thus builds a better understanding of facilitators of and hinderances to stakeholders using this technology. Exoskeletons were suggested as having the potential to improve workforce retention and decrease MS symptoms. These results suggest that the use of arm-support exoskeletons can be valuable, though barriers such as cost and team member buy-in need to be addressed. Acknowledgements. This work was supported by Cooperative Agreement T42 OH008455, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the CDC or DHHS. The exoskeleton used in this study was loaned by the Levitate company; the company had no involvement in study design, analysis, or interpretation, nor the decision for publication.

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Supporting Surgical Teams: Identifying Needs and Barriers for Exoskeleton Implementation in the Operating Room

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720819879271 ◽

2019 ◽

Vol 62 (3) ◽

pp. 377-390 ◽

Cited By ~ 1

Author(s):

Jackie S. Cha ◽

Sara Monfared ◽

Dimitrios Stefanidis ◽

Maury A. Nussbaum ◽

Denny Yu

Keyword(s):

Operating Room ◽

Early Career ◽

Upper Body ◽

Surgical Team ◽

Team Members ◽

Societal Factors ◽

Effective Interventions ◽

System Usability Scale ◽

And Performance ◽

Surgical Teams

Objective The objective of this study was to identify potential needs and barriers related to using exoskeletons to decrease musculoskeletal (MS) symptoms for workers in the operating room (OR). Background MS symptoms and injuries adversely impact worker health and performance in surgical environments. Half of the surgical team members (e.g., surgeons, nurses, trainees) report MS symptoms during and after surgery. Although the ergonomic risks in surgery are well recognized, little has been done to develop and sustain effective interventions. Method Surgical team members ( n = 14) participated in focus groups, performed a 10-min simulated surgical task with a commercial upper-body exoskeleton, and then completed a usability questionnaire. Content analysis was conducted to determine relevant themes. Results Four themes were identified: (1) characteristics of individuals, (2) perceived benefits, (3) environmental/societal factors, and (4) intervention characteristics. Participants noted that exoskeletons would benefit workers who stand in prolonged, static postures (e.g., holding instruments for visualization) and indicated that they could foresee a long-term decrease in MS symptoms with the intervention. Specifically, raising awareness of exoskeletons for early-career workers and obtaining buy-in from team members may increase future adoption of this technology. Mean participant responses from the System Usability Scale was 81.3 out of 100 ( SD = 8.1), which was in the acceptable range of usability. Conclusion Adoption factors were identified to implement exoskeletons in the OR, such as the indicated need for exoskeletons and usability. Exoskeletons may be beneficial in the OR, but barriers such as maintenance and safety to adoption will need to be addressed. Application Findings from this work identify facilitators and barriers for sustained implementation of exoskeletons by surgical teams.

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Concerns About Verbal Communication in the Operating Room: A Field Study

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720819858274 ◽

2019 ◽

Vol 62 (6) ◽

pp. 940-953 ◽

Cited By ~ 2

Author(s):

Ehsan Garosi ◽

Reza Kalantari ◽

Ahmad Zanjirani Farahani ◽

Mojgan Zuaktafi ◽

Esmaeil Hosseinzadeh Roknabadi ◽

...

Keyword(s):

Field Study ◽

Operating Room ◽

Poor Performance ◽

Operating Rooms ◽

Verbal Communication ◽

Communication Patterns ◽

Surgical Team ◽

Negative Effects ◽

Cross Sectional ◽

Team Members

Objective To assess verbal communication patterns which could contribute to poor performance among surgical team members in an operating room. Background There exist certain challenges in communication in health care settings. Poor communication can have negative effects on the performance of a surgical team and patient safety. A communication pattern may be associated with poor performance when the process of sending and receiving information is interrupted or the content of conversation is not useful. Method This cross-sectional field study was conducted with 54 surgical teams working in two Iranian hospitals during 2015. Two observers recorded all verbal communications in an operating room. An in-depth assessment of various annotated transcripts by an expert panel was used to assess verbal communication patterns in the operating room. Results Verbal communication patterns which could contribute to poor performance were observed in 63% of the surgeries, categorized as communication failures (17 events), protests (23 events), and irrelevant conversations (164 events). The anesthesiologists and the circulating nurses had the most concerning communication patterns. The failure of devices and poor planning were important factors that contributed to concerning patterns. Conclusion Concerning patterns of verbal communication are not rare in operating rooms. Analyzing the annotated transcripts of surgeries can conduce to identifying all these patterns, and their causes. Concerning communication patterns can be reduced in the operating room by providing interventions, properly planning for surgeries, and fixing defective devices. Application The method used in this study can be followed to assess communication problems in operating rooms and to find solutions.

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Non-technical Skill Assessment Tools for Surgical Team Members in the Operating Room: A Critical Review

Shiraz E-Medical Journal ◽

10.5812/semj.101291 ◽

2020 ◽

Vol In Press (In Press) ◽

Author(s):

Peigham Heidarpoor ◽

Shahram Yazdani ◽

Leila Sadati

Keyword(s):

Operating Room ◽

Critical Review ◽

Technical Skills ◽

Technical Skill ◽

Assessment Tools ◽

Skill Assessment ◽

Surgical Team ◽

Team Members ◽

Technical Performance ◽

Surgical Teams

Context: The operating room is a unique environment in which learning happens through interactions with others and facing complex situations. The results of studies show that non-technical skills play a key role in successful technical performance in critical situations. Therefore, the identification and assessment of them are very valuable. This review study was performed to identify and critique non-technical skill assessment tools for surgical team members. Evidence Acquisition: The Carnwell and Daly critical review method was used for the study design. Articles and documents were searched in databases of PubMed, Google Scholar, Scopus, and ScienceDirect from 1999 to 2019. Results: This literature review yielded 13 assessment tools of non-technical skills in the operating room, including ANTS, AS-NTS, N-ANTS, ANTS-AP for the anesthesia team, OTAS, Oxford NOTEHS, Oxford NOTECHS II, and Revised NOTECHS for the surgical team, SPINTS for scrub nurses, and OSANTS, NOTSS, SDM-RS, and SLI for surgeons. Conclusions: Since the development of the tools depends entirely on the context and task analysis of any member of the surgical team, all countries must customize the available tools and develop similar tools for other members of surgical teams.

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Leadership In Surgical Science: Literature Review

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v6i1.275 ◽

2020 ◽

Vol 6 (1) ◽

pp. 258-260

Author(s):

Chaula Luthfia Sukasah ◽

Indri Aulia ◽

T. Fadli Nazwan Sani

Keyword(s):

Decision Making ◽

Literature Review ◽

Leadership Style ◽

Literature Search ◽

Clinical Situation ◽

Science Literature ◽

Surgical Team ◽

Relevant Research ◽

Team Members

Background : A Surgeon should have good leadership. Leadership plays an important role in improving health services. Leadership can shape a better future. Method : A literature search was conducted in November 2019. Related keywords were applied to Pubmed, Medline, and SCOPUS for studies published in the last five years. Relevant research is taken to be used as the discussion material. Result : The key to surgical leadership is collaboration and cooperation, humanism and mentorship, and operational efficiency. Conclusion: Effective leadership in a surgical team has the following characteristics: (1) Defines the role of a leader clearly, especially in critical situations; (2) Leadership style that suits the clinical situation; (3) Clear directions to team members; (4) Consistently seeking input from team members; (5) Involving members in decision making.

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The Effect of Educational Intervention on the Improvement of Nontechnical Skills in Circulating Nurses

BioMed Research International ◽

10.1155/2021/5856730 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Reza Kalantari ◽

Zahra Zamanian ◽

Mehdi Hasanshahi ◽

Seyed Aliakbar Faghihi ◽

Jamshid Jamali ◽

...

Keyword(s):

Operating Room ◽

Educational Intervention ◽

Situational Awareness ◽

Intervention Group ◽

Educational Interventions ◽

Surgical Team ◽

Team Members ◽

Nontechnical Skills ◽

Safe Performance ◽

One Way Anova

Background. Nontechnical skills are necessary for clinicians’ safe performance and prevention of errors in the operating room. Educational intervention is a useful way to improve these skills, which are a vital area for improvement. Circulating nurses are surgical team members whose work depends heavily on using nontechnical skills. This study is aimed at assessing the effect of an educational intervention on the improvement of circulating nurses’ nontechnical skills. Methods. This semiexperimental study was conducted on 300 circulating nurses divided into the intervention and no intervention groups each containing 150 participants. The nontechnical skills were assessed using the circulating practitioners’ list of nontechnical skills. Then, the intervention group received training regarding these skills, and the two groups were evaluated again. After all, the data were entered into the SPSS 24 software and were analyzed using descriptive statistics and Wilcoxon and Mann–Whitney tests. Furthermore, Kendall’s tau, independent sample t -test, and one-way ANOVA were used for assessment of relationship between median scores and demographics. Results. The results revealed a significant improvement in the scores of all domains of nontechnical skills in the intervention group ( p < 0.05 ). The highest and lowest improvements were observed in teamwork (42%) and situational awareness (16.7%), respectively. After the intervention, the scores of some of the behaviors were still below the average level or were not improved significantly. Conclusions. Circulating nurses’ nontechnical skills can be improved by educational interventions. However, regarding the low scores or no improvements in the scores of some behaviors, other intervention types such as policymaking and correcting the existing hierarchies in the operating room can be useful to complete the educational interventions.

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Influence of music on work performance during joint replacement surgery, attitudes of surgical team members

Slauga. Mokslas ir praktika ◽

10.47458/slauga.2021.2.2 ◽

2021 ◽

Vol 2 (2 (290)) ◽

pp. 1-10

Author(s):

Aurelija Zybartaitė ◽

Lina Gedrimė

Keyword(s):

Operating Room ◽

Joint Replacement ◽

Work Performance ◽

Point Of View ◽

Surgical Team ◽

Team Members ◽

Joint Replacement Surgery ◽

Replacement Surgery ◽

Operating Team ◽

The Impact

Progress is constantly being made in almost all areas of life, including medicine. For this reason, various measures are being introdu-ced to make any work done more efficient, easier, more productive. Music can be used in medicine, especially in the operating room, as its effect on the members of the operating team is extremely positive. And while this is acknowledged, there is not much research on this topic – the impact of music on members of the operating team.Object – is the influence of music on work performance during joint replacement, from the point of view of surgical team members.Problem – is whether music during endoprosthesis surgery can increase the productivity of surgical team members?Aim – to analyze the influence of music on the performance of work during endoprosthesis operations, from the point of view of the members of the operating team – was aimed at implementing the research objectives:1) to review the peculiarities of joint endoprosthesis operations; 2) to reveal the influence of music on work in the operating room from the point of view of team members;3) to study the influence of music on the quality of work during joint arthroplasty.Methods: The method of questionnaire survey was chosen to study the attitude of the members of the operating team to the influence of music on the work productivity in the operating room. The questionnaire is considered to be the most appropriate method for explaining people’s opinions and behavior, and it is based on reliability.This was related to the aims of this study - to analyze the impact of music on performance during endoprosthesis operations. The study was conducted by submitting questionnaires to 100 members of the operating team (surgeon-operator, anesthesiologist, resuscitator, anesthesiologist, resident, anesthesia and intensive care nurse, operating nurse, and operating assistant) working in health care facilities. It should be noted that during the data collection, the members of the operational team filled in the questionnaires remotely - links to the online uploaded questionnaire were sent to each respondent. This method of conducting the study was chosen due to the current situation in Lithuania - the COVID-19 pande-mic.Results of the study. The study revealed that joint replacement surgery is seen as a complicated procedure, which is complicated by team changes, because it often increases tension, affects everyone’s joint work, feels general discomfort, becomes more difficult to concentrate, increa-ses the likelihood of errors. In order to make teamwork smoother, attention should be paid to the organization of work, the fostering of interperso-nal relationships, the assessment of one’s own characteristics and peculiarities of communication, and the stronger fostering of the work envi-ronment. Music can be an effective and valuable tool for making a positive impact on operational team members. Music can help reduce anxiety, encourage relaxation, suppress the response to stressful situations, and increase the effectiveness of actions. It is very important that the music is selected in the right genre to suit the members of the operating team.

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