Associations of Intraoperative Flow Disruptions and Operating Room Teamwork During Robotic-assisted Radical Prostatectomy - 11/04/18
Abstract |
Objective |
To identify type and severity of surgical flow disruptions and to determine their impact on the perception of intraoperative teamwork.
Methods |
Forty radical prostatectomy cases were studied in an academic department for urology. A standardized observational tool for identification of type and severity of flow disruptions was applied during real-time prostatectomy procedures. Additionally, all operating room team members evaluated intraoperative teamwork immediately after the procedure. Procedures were divided into 4 phases: prerobot, docking, console time, and postrobot.
Results |
A total of 2012 flow disruptions were observed, with an average rate of 16.27 events per hour. The highest rate was during the robot docking phase. Although the frequency of disruption types varied across phases, the most severe disruptions were related to communication and coordination during the prerobot and docking phase. Equipment- and communication-related disruptions were mostly severe during the time the surgeons were on the console. Among the surgeons, we identified a significant relationship between disruptions and intraoperative teamwork such that during procedures with frequent severe disruptions, surgeons experienced inferior teamwork (β = −0.40, P = .01). This was not the case for nurses and anesthetists.
Conclusion |
Emphasis on improving operating room team communication and coordination would help to establish efficient and smooth surgical workflow.
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Financial Disclosure: The authors declare that they have no conflict of interest. |
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Funding Support: The study was co-funded by the Munich Centre for Health Sciences (Mc-Health) and the Bavarian Research Alliance (BAYFOR). Data collection was part of the Master Thesis Requirements of Jeannette Weber (LMU University, Munich). |
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Ethical approval: The study protocol was approved by the Ethics Committee of the Faculty of Medicine, Munich University (539-11). |
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Informed consent: Informed consent was obtained from all individual participants included in the study. |
Vol 114
P. 105-113 - avril 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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