Are operating room distractions, interruptions and disruptions associated with performance and patient safety? A systematic review and meta-analysis

Abstract Objective The operating room is a complex environment in which distractions, interruptions and disruptions (DIDs) are frequent. Our aim was to synthesize research on the relationships between DIDs (i) operative duration, (ii) team performance, (iii) individual performance (iv) patient safety outcomes order better understand how interventions can be designed mitigate negative effects of DIDs. Methods Electronic databases (MEDLINE, Embase, CINAHL PsycINFO) reference lists were systematically searched. Included studies required report quantitative association safety. Two reviewers independently screened articles for inclusion, assessed study quality extracted data. A random-effects meta-analysis performed subset reporting total time Results Twenty-seven identified. majority prospective observational (n = 15) moderate quality. often defined, measured interpreted differently studies. significantly associated with extended duration 8), impaired 6), self-reported errors by colleagues 1), surgical increased risk incidence site infection 4) fewer checks 1). showed that proportion due 22.0% (95% confidence interval 15.7–29.9). Conclusion surgery range outcomes. However, significant knowledge gaps exist about mechanisms underlie these relationships, as well potential clinical non-clinical benefits may deliver. Available evidence indicates reduce warranted, but current not sufficient make recommendations potentially useful interventions.