Quantifying distraction and interruption in urological surgery.
BACKGROUND
To enhance safety in surgery, it is necessary to develop a variety of tools for measuring and evaluating the system of work. One important consideration for safety in any high-risk work is the frequency and effect of distraction and interruption.


OBJECTIVE
To quantify distraction and interruption to the sterile surgical team in urology.


METHODS
Observation of the behaviour of the surgical team and their task activity determined distraction and interruption recorded. Using an ordinal scale, an observer rated each salient distraction or interruption observed in relation to the team's involvement.


RESULTS
The frequency of events and their attached ratings were high, deriving from varying degrees of equipment, procedure and environment problems, telephones, bleepers and conversations.


CONCLUSIONS
With further refinement and testing, this method may be useful for distinguishing ordinal levels of work interference in surgery and helpful in raising awareness of its origin for postoperative surgical team debriefing.
Healey
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Imperial College, London, UK. a.healey@imperial.ac.uk
Primus
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CP
Koutantji
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D001288:Attention; D006804:Ergonomics; D006272:Health Facility Environment; D006784:Hospitals, Teaching; D006801:Humans; D008131:London; D019300:Medical Errors / Q000517:prevention & control / Q000523:psychology*; D009068:Movement; D009623:Noise, Occupational; D019370:Observation; D009873:Operating Rooms / Q000592:standards*; D010348:Patient Care Team; D011183:Postoperative Complications; D018570:Risk Assessment; D017751:Safety Management / Q000379:methods*; D013520:Urologic Surgical Procedures