do or room distractions affect patient outcomes

Whether we undergo a relatively simple surgical procedure in an outpatient facility or a major operation in a hospital, we want our surgeons to be focused, alert, and free from distractions so that they can perform to the best of their abilities and avoid surgical errors. Unfortunately, this is not always the case, and patients may suffer as a result.

A group of researchers recently sought to measure what effect, if any, that operating room distractions and interruptions (ORDIs) had on surgeons during a relatively complex procedure.

The authors of the study, published in the Archives of Surgery, had 18 surgical residents with varying levels of experience perform laparoscopic procedures via a virtual reality simulator. During the course of some of the procedures, the researchers randomly introduced a combination of distractions (sidebar conversations, sudden movements, ringing cell phones, etc.) and/or interruptions (falling trays, unsolicited questions, etc.).

The researchers used surgical errors as the primary outcome measure, with the virtual reality device recording damage to the arteries, bile ducts and other major organs. The secondary outcome measure was whether the 18 surgical residents would be able to recall a memory task assigned to them before the procedure and which was vital to its performance.

The study found that the ORDIs had the following impact:

  • Major surgical errors were made in eight of 18 procedures where ORDIs were present. In contrast, major surgical errors were made in only one of 18 procedures where ORDIs were not present
  • The memory task was forgotten in ten of 18 procedures where ORDIs were present; The memory task was forgotten in four of 18 procedures where ORDIs were not present
  • Interrupting questions and sidebar conversations proved to be the ORDIs that caused the most surgical errors

One of the more fascinating findings was that all eight of the surgical errors where ORDIs were present occurred after 1 p.m.

If serious surgical errors can be so easily tied to distractions in the operating room – and it’s frankly surprising that it takes a scientific study to point out something that should be patently obvious – one would think hospitals would make every effort to limit distractions during procedures. If they do not, and an innocent patient suffers harm as a result, they should be held to account.

Sources: Outpatient Surgery, “What not to do while your surgeons operate,” Mark McGraw, Aug. 10, 2012; Archives of Surgery, “Abstract: Realistic distractions and interruptions that impair simulated surgical performance by novice surgeons,” July 16, 2012

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