title: Workflow interruptions and failed action regulation in surgery personnel.
abstract: BACKGROUND
  Workflow interruptions during surgery may cause a threat to patient's safety. Workflow interruptions were tested to predict failure in action regulation that in turn predicts near-accidents in surgery and related health care.
  
  
  METHODS
  One-hundred-and-thirty-three theater nurses and physicians from eight Swiss hospitals participated in a cross-sectional questionnaire survey. The study participation rate was 43%.
  
  
  RESULTS
  Structural equation modeling confirmed an indirect path from workflow interruptions through cognitive failure in action regulation on near-accidents (p < 0.05). The indirect path was stronger for workflow interruptions by malfunctions and task organizational blockages compared with workflow interruptions that were caused by persons. The indirect path remained meaningful when individual differences in conscientiousness and compliance with safety regulations were controlled.
  
  
  CONCLUSIONS
  Task interruptions caused by malfunction and organizational constraints are likely to trigger errors in surgery. Work redesign is recommended to reduce workflow interruptions by malfunction and regulatory constraints.
authors.affiliation: Department of Work and Organizational Psychology, University of Bern, Switzerland.
authors.forename: Achim
authors.initials: A
authors.lastname: Elfering
authors.affiliation: Department of Work and Organizational Psychology, University of Bern, Switzerland.
authors.forename: Marina
authors.initials: M
authors.lastname: Nützi
authors.affiliation: Department of Work and Organizational Psychology, University of Bern, Switzerland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Koch
authors.affiliation: Bern University of Applied Sciences, Health Division, Bern, Switzerland.
authors.forename: Heiner
authors.initials: H
authors.lastname: Baur
keywords: cognitive failure; occupational stress; patient safety