title: Improving cardiac surgical care: a work systems approach.
abstract: Over the past 50 years, significant improvements in cardiac surgical care have been achieved. Nevertheless, surgical errors that significantly impact patient safety continue to occur. In order to further improve surgical outcomes, patient safety programs must focus on rectifying work system factors in the operating room (OR) that negatively impact the delivery of reliable surgical care. The goal of this paper is to provide an integrative review of specific work system factors in the OR that may directly impact surgical care processes, as well as the subsequent recommendations that have been put forth to improve surgical outcomes and patient safety. The important role that surgeons can play in facilitating work system changes in the OR is also discussed. The paper concludes with a discussion of the challenges involved in assessing the impact that interventions have on improving surgical care. Opportunities for future research are also highlighted throughout the paper.
authors.affiliation: Department of Industrial and Systems Engineering, 1513 University Ave, 3214 Mechanical Engineering Bldg, University of Wisconsin-Madison, Madison, WI 53706, USA. dawiegmann@wisc.edu
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Wiegmann
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Eggman
authors.forename: Andrew W
authors.initials: AW
authors.lastname: Elbardissi
authors.forename: Sarah Henrickson
authors.initials: SH
authors.lastname: Parker
authors.forename: Thoralf M
authors.initials: TM
authors.lastname: Sundt
mesh_terms: D000059:Accidents; D006348:Cardiac Surgical Procedures / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D005221:Fatigue / Q000517:prevention & control; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control*; D007857:Leadership; D019300:Medical Errors / Q000517:prevention & control*; D017146:Models, Organizational; D009873:Operating Rooms / Q000592:standards*; D015279:Organizational Culture; D005791:Patient Care / Q000592:standards; D011787:Quality of Health Care / Q000592:standards*; D017751:Safety Management / Q000379:methods / Q000592:standards; D012941:Social Responsibility; D013598:Systems Theory; D014481:United States