Awareness of Human Factors in the operating theatres during the COVID-19 pandemic

Abstract

One of the priorities at our large Operating Theatres Department is to support awareness and basic education of the multi-disciplinary teams in clinical Human Factors, to help build competence and capacity in healthcare towards a resilient system. From May 2019 until February 2020, our Human Factors Champions embarked on a project called Observation of Non-technical Skills and Teamwork in the operating theatres (ONSeT), to monitor and evaluate the benefits of local Human Factors education. In September 2020, six months after the COVID-19 pandemic hit the UK and caused a major disruption of surgical services, we decided to investigate the usefulness of the project and the impact of COVID-19 in the operating theatres, looking through the eyes of the Human Factors Champions. Results pointed to a consensus about ONSeT having helped during the pandemic, with regards to how teams worked and in enabling team leaders to be more responsive. Human Factors Champions found that feedback on performance was received in a non-threatening way and observation of performance became ‘second nature’. As organisations need to develop critical thinking, we think that the ONSeT project has helped us build some capacity for this, from the front-line onwards.

The rise of resilient healthcare research during COVID-19: scoping review of empirical research

“…Several studies expressed increased “connection” [ 72 ], “collaboration” [ 39 , 70 – 72 ] and a “sense of camaraderie” [ 70 ] among teams during the pandemic as they “rallied together” [ 40 ] and “worked together toward a common goal” [ 70 ]. Traditional clinical hierarchies were also reported as less important during delivery of care [ 72 ], leading to enhanced team dynamics and coordination [ 73 ]. Three studies also highlighted the role of “peer support” [ 56 , 65 , 69 ] as co-workers provided reassurance and supported staff wellbeing.…”

“…What was clear was that the included studies reported varying degrees of preparedness and adaptive capacity across the different healthcare services. For example, a number of studies reported how well organisations or the people who work in them “evolved” to make things work [ 39 , 54 , 81 ], while others reported extreme physical and emotional demands, leading to stress and burnout amongst healthcare workers and poor clinical care [ 37 , 39 , 43 , 65 , 69 , 73 ]. This discrepancy between resilient performance and physical and emotional burnout could be explained by the extensive use of short-term adaptations, rather than long-term innovation and system change [ 35 ].…”

Non-technical skills in surgery during the COVID-19 pandemic: An observational study

“…These improvements can translate into improved team performance and safety, but they require strong leadership and a culture of error management rather than error aversion to ensure that stressors do not degrade performance [ 22 ]. Surgeons and surgical leaders should employ collaborative leadership to identify and mitigate stressors imposed by the COVID-19 pandemic as we enter yet another wave to ensure that improved teamwork translates into improved team performance and, ultimately, improved patient safety [ 24 ].…”