On the day of surgery: how long does preventable disruption prolong the patient journey?

Abstract

Surgical disruption has substantial financial implications for hospitals. This research indicates that it is possible to reduce operative time considerably by eliminating preventable disruption. Such additional time could be utilised to deal with the pressure of emergency cases, reduce the waiting lists for elective surgery, increase operating room utilisation, and reduce medical errors.

Human error identification for laparoscopic surgery: Development of a motion economy perspective

“…We relied on literature on human factors, patient safety, and operating theatre techniques (Barnes, 1980;Dankanich;Karwowski and Salvendy, 2010;Meyers and Stewart, 2002;Philips, 2004;Wachter, 2012) as well as on our team's ergonomics and clinical experience to select and adapt the traditional principles. In addition, we consulted related research studies on surgery (Al-Hakim, 2011;Al-Hakim and Gong, 2012;Berguer, 1999;Etchells et al, 2003;He et al, 2013;Jaschinski et al, 1998;Manasnayakorn et al, 2009;Moorthy et al, 2005;Sevdalis et al, 2007;Stifelman et al, 2001;van Det et al, 2009;van Veelen et al, 2002;Vereczkei et al, 2004;Wiegmann et al, 2007;Wong et al, 2011;Zheng et al, 2007) to develop new areas and principles for motion economy.…”

“…Research works on disruption in theatres explore high correlation between the accuracy, availability of information in patient's record and surgical disruption which, in turn, predisposes surgical team to fatigue and affect their motion and movement (Al-Hakim, 2011;Al-Hakim and Gong, 2012;Etchells et al, 2003;Sevdalis et al, 2007;Wiegmann et al, 2007). This principle requires surgeons and anaesthetists to provide adequate information before surgery (e.g., required instruments, material and medical tests, sketch of the positioning).…”

“…The new motion economy area E 'communication and team work' comprises 4 principles dealing with the availability and quality of the required information (Al-Hakim, 2011;Al-Hakim and Gong, 2012;Etchells et al, 2003;Sevdalis et al, 2007;Wiegmann et al, 2007;Wong et al, 2011), importance of satisfying surgeon requests during surgery, synchronising and coordination of the hand motion of the surgical team (He et al, 2013;Moorthy et al, 2005;Zheng et al, 2007), and the relative position of the surgical team. In total, we have 30 motion economy principles that suit surgical performance in operating theatres.…”

Continuity of care in day surgical care – perspective of patients

“…Several previous studies show that patients have to be able to coordinate their own care in day surgery . Brief hospital stay and self‐care have become an increasingly important part of the preparation for, and recovery from, elective surgery . In an earlier study by Renholm et al.…”

“…For example, preventable disruption caused an increase of approximately 25% in surgical time in a study done in Australia. Preventable disruption consisted of poor information flow and lack of communication .…”