The Selection of Main Surgical Work Factors in Operating Rooms

Dragutin Grozdanovic, Goran L Janackovic, Miroljub Grozdanovic, Milorad B Mitkovic, Milan M Mitkovic, Dragutin Grozdanovic, Goran L Janackovic, Miroljub Grozdanovic, Milorad B Mitkovic, Milan M Mitkovic

Abstract

The main component of error minimization in operating rooms (ORs) is to maintain high reliability of surgical teams. The analysis of adverse events in the OR reveals deficiencies in cognitive and interpersonal skills as the main factors influencing surgeons' errors. Therefore, research of these additional factors is necessary, besides factors related to surgeons' clinical knowledge and technical skills. In this paper, the key factors for evaluating activities in surgical operating rooms are identified. Fuzzy analytic hierarchy process is used for identification of key factors. Fifteen key factors are identified for evaluating activities in surgical operating rooms to improve the efficiency of surgical operations. For each group of activities (surgical "capabilities," operating room characteristics, and non-technical skills), five factors are identified. As the most important, the following factors are obtained: communication, indoor environment standardization, and tool handle design. The aim of the analysis of these key factors is surgeons' work capability enhancement, rational design of operating rooms, and advancement of operators' cognitive and interpersonal skills.

Keywords: activities; fuzzy analytic hierarchy process; non-technical skills; surgeons’ capabilities; surgical operating room.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Hierarchical structure of factors. Note: There are three groups of factors. The first group describes surgeons’ capabilities: mental and physical workload (S1), sensory-motor capabilities (S2), situational awareness (S3), musculoskeletal disorders (S4), and hand dexterity (S5). The second group describes operating room properties affecting the work efficiency: operating room design (O1), indoor environment standardization (O2), visualization (O3), noise (O4), and tool handle design (O5). The third group describes non-technical skills: teamwork (N1), leadership (N2), communication (N3), surgical safety checklist (N4), and stress (N5).
Figure 2.
Figure 2.
Operating room in the vascular surgery clinic, clinical center in Nis.
Figure 3.
Figure 3.
Communication scheme between three (a) and four (b) surgeons in operating room.

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