Intraoperative case-irrelevant communications by content, initiator,
recipient and interference
Abstract
Rationale, aims and objectives: This study was designed to evaluate
intraoperative case irrelevant communications (CICs) by content,
initiator, recipient and interference via a real-time operative room
analysis Method: The CICs in the operative room across a purposive
sample of 52 surgical procedures were evaluated as recorded by a
tripod-capable camera in the operative room in this prospective
observational study. The CICs were evaluated by initiator, recipient and
interference. Results: Overall 106 CIC events were recorded across 52
operations (2.03/operation). Most (35.8%) of CICs referred to
irrelevant comment by context, while 28.3% of CICs referred to other
patients. Individually, external personnel (24.5%) were the most likely
initiators of a CIC, while surgical group was most likely initiator
(28.3%) of as well recipient (49.0%) of CIC. Overall every CIC
interfered with surgical work-flow, by distracting more than one member
of the team in 34.9% of cases, only one member of the team in 33.0% of
cases and the entire team in 14.1% of cases for a long-term.
Conclusions: In conclusion, this real-time operative room analysis
revealed CICs to be mainly referred to small talk or other patients for
case co-ordination and organization, while emphasize the particular role
of external staff as the most likely initiator of CICs and operating and
assisting surgeons as the most likely initiator and receiver of CICs.
Our findings seem to indicate the majority of intraoperative CICs to
interfere with surgical work-flow by causing a long-term distraction in
at least one member of the operative room team.