Realizing improved patient care through human-centered operating room design: a human factors methodology for observing flow disruptions in the cardiothoracic operating room.
نویسندگان
چکیده
BACKGROUND Human factors engineering has allowed a systematic approach to the evaluation of adverse events in a multitude of high-stake industries. This study sought to develop an initial methodology for identifying and classifying flow disruptions in the cardiac operating room (OR). METHODS Two industrial engineers with expertise in human factors workflow disruptions observed 10 cardiac operations from the moment the patient entered the OR to the time they left for the intensive care unit. Each disruption was fully documented on an architectural layout of the OR suite and time-stamped during each phase of surgery (preoperative [before incision], operative [incision to skin closure], and postoperative [skin closure until the patient leaves the OR]) to synchronize flow disruptions between the two observers. These disruptions were then categorized. RESULTS The two observers made a total of 1,158 observations. After the elimination of duplicate observations, a total of 1,080 observations remained to be analyzed. These disruptions were distributed into six categories such as communication, usability, physical layout, environmental hazards, general interruptions, and equipment failures. They were further organized into 33 subcategories. The most common disruptions were related to OR layout and design (33%). CONCLUSIONS By using the detailed architectural diagrams, the authors were able to clearly demonstrate for the first time the unique role that OR design and equipment layout has on the generation of physical layout flow disruptions. Most importantly, the authors have developed a robust taxonomy to describe the flow disruptions encountered in a cardiac OR, which can be used for future research and patient safety improvements.
منابع مشابه
A Mathematical Model for Operating Room Scheduling Considering Limitations on Human Resources Access and Patient Prioritization
Operating room scheduling is an important task in healthcare sector. This study proposes a Mixed Integer Nonlinear Programming (MINLP) mathematical model for the scheduling of the operating rooms. In the presented model, apart from scheduling the patients’ surgery process, shifting of the medical staff is also carried out. The innovation considered in the proposed model is aimed at prioritizing...
متن کاملEvaluation of the Patient Safety Culture Status and its related Factors from the Perspective of Operating Room Personnel
Background: Patient safety is one of the essential principles of health care and evaluation of patient safety culture is a motive to provide safe conditions for patient care. Regarding the invasive procedures and the necessity of special attention to patient safety in the operating room, this study aimed to determine the patient safety culture from the perspective of operating room personnel. ...
متن کاملUsing Fuzzy FMEA to Increase Patient Safety in Fundamental Processes of Operating Room
Risk assessment is a standard tool in health care systems which is used to improve patient safety. Failure mode and effects analysis (FMEA) as a powerful risk assessment tool for safety and reliability widely applied by industries such as aerospace, nuclear, automotive, chemical, mechanical, medical technologies, and electronics. FMEA is popular technique, but it has some substantial deficienci...
متن کاملExperiences of the civilian Iranian operating room nurses: A historical survey of the Iran-Iraq war
Background and Purpose: Upon centuries, wars have taken over countries due to theadvancement of sophisticated warfare,causingserious injuries among soldiers. Nurses are directly involved in preoperative and postsurgical patient care. One of the most remarkable contributions of the Iranian operating room nurses was to provide medical care for wounded soldiers in field hospitals during the Iran...
متن کاملEducation and Treatment Guideline for Evaluation of Applying Basic Standards of Anesthesia Care in Surgery
Introduction: Applying basic standards of anesthesia care is crucial. Patients’ status should be evaluated based on a standard checklist. In case of mismanagement, logical approaches must be conducted. The main objective of the present study is to develop a checklist for evaluation of implementing anesthesia care standards, and its application by observing the practice of anesthesiologists and ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Anesthesiology
دوره 119 5 شماره
صفحات -
تاریخ انتشار 2013