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Tasks, multitasking and interruptions among the surgical team in an operating room: a prospective observational study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Center for Clinical Research Dalarna. Orebro Univ, Sch Hlth Sci, Fac Med & Hlth, Orebro, Sweden;Falun Cent Hosp, Dept Anaesthesia, Falun, Sweden;Falun Cent Hosp, Intens Care Unit, Falun, Sweden.ORCID iD: 0000-0002-0883-4072
Karolinska Inst, Dept Learning Informat Management & Eth, Stockholm, Sweden;Turku Univ Hosp, Dev Ctr, Turku, Finland.
Karolinska Univ Hosp, Trauma & Reparat Med Theme, Stockholm, Sweden;Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden.
Karolinska Inst, Dept Learning Informat Management & Eth, Stockholm, Sweden;Karolinska Univ Hosp, Paediat Emergency Dept, Stockholm, Sweden.
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2019 (English)In: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 9, no 5, article id e026410Article in journal (Refereed) Published
Abstract [en]

Objectives The work context of the operating room (OR) is considered complex and dynamic with high cognitive demands. A multidimensional view of the complete preoperative and intraoperative work process of the surgical team in the OR has been sparsely described. The aim of this study was to describe the type and frequency of tasks, multitasking, interruptions and their causes during surgical procedures from a multidimensional perspective on the surgical team in the OR. Design Prospective observational study using the Work Observation Method By Activity Timing tool. Setting An OR department at a county hospital in Sweden. Participants OR nurses (ORNs) (n=10), registered nurse anaesthetists (RNAs) (n=8) and surgeons (n=9). Results The type, frequency and time spent on specific tasks, multitasking and interruptions were measured. From a multidimensional view, the surgical team performed 64 tasks per hour. Communication represented almost half (45.7%) of all observed tasks. Concerning task time, direct care dominated the surgeons' and ORNs' intraoperative time, while in RNAs' work, it was intra-indirect care. In total, 48.2% of time was spent in multitasking and was most often observed in ORNs' and surgeons' work during communication. Interruptions occurred 3.0 per hour, and the largest proportion, 26.7%, was related to equipment. Interruptions were most commonly followed by professional communication. Conclusions The surgical team constantly dealt with multitasking and interruptions, both with potential impact on workflow and patient safety. Interruptions were commonly followed by professional communication, which may reflect the interactions and constant adaptations in a complex adaptive system. Future research should focus on understanding the complexity within the system, on the design of different work processes and on how teams meet the challenges of a complex adaptive system. Trial registration number 2016/264.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019. Vol. 9, no 5, article id e026410
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Health Care Service and Management, Health Policy and Services and Health Economy
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URN: urn:nbn:se:uu:diva-398727DOI: 10.1136/bmjopen-2018-026410ISI: 000471192800188PubMedID: 31097486OAI: oai:DiVA.org:uu-398727DiVA, id: diva2:1376529
Available from: 2019-12-09 Created: 2019-12-09 Last updated: 2019-12-09Bibliographically approved

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