Distractions in the Operating Room Are a Big Problem

Is surgical suite staff paying attention or are unnecessary distractions threatening patient care? The Institute of Medicine reported that almost half of surgical suite managers have seen healthcare providers distracted by electronic devices, and more than 5% are aware of an adverse event (including wrong-site surgery) linked to personal use of a mobile device. It recommended a No Interruption Zone in the operating room (OR). The American Journal of Surgery published a study indicating that some distractions may be inevitable in the OR but they can also be detrimental to the team.

The study team acknowledged what we all know: multi-tasking can affect performance. Little research has been done to determine how often interruptions occur in the OR. A surgeon and a behavioral scientist observed 90 general surgery cases in real time. To minimize bias, the researchers visited the ORs without conducting observations before the study started to familiarize OR staff with their presence. They used validated tools to measure workload and stress.

Almost all (98%) OR cases involved distractions.

Who was most likely to cause distraction? External staff was the leading cause of distraction, and 81% of these distractions were irrelevant to the case.

Case-irrelevant conversations were common and associated with poorer team performance. If surgeons initiated these conversations, teamwork suffered more than if others initiated the case-irrelevant conversation.

Which distractions elevated stress? Equipment-related distractions caused significantly higher stress and affected nurses’ teamwork contributions negatively. For surgeons, acoustic distractions were more likely to increase stress. For anesthesiologists, higher workload was the most significant stressor.

These results suggest that more research is needed on the effect of distractions on surgical team members’ behavior and cognitive processes.