Influence of hierarchy on risk communication during robot-assisted surgery: a preliminary study

Autor: Taylor Kunkes, Ann M. Bisantz, Naif A. Aldhaam, Ahmed Elsayed, Ahmed A. Hussein, Jeff Higginbotham, Khurshid A. Guru, Lora Cavuoto
Rok vydání: 2021
Předmět:
Zdroj: Surgical Endoscopy. 36:3087-3093
ISSN: 1432-2218
0930-2794
Popis: A hierarchical structure is where all individuals are organized according to importance and are subordinate to a single person. In the operating room (OR), this structure may negatively impact the quality of communication and jeopardize patient safety. We examined how the surgical team’s hierarchical relationships affect the frequency and timing of risk communication, and their influence on situational awareness (SA) in the OR. Overhead cameras and lapel microphones were used to record the OR environment. Recordings and transcriptions of 10 robot-assisted prostatectomies were examined for risk utterances among team members. Utterances were classified by sender–recipient exchange, timing (determined by phrasing to be proactive or reactive to an error/negative event), and the Oxford Non-Technical Skills (NOTECHS) SA score. Surgeon’s and trainee surgeon’s utterances were classified by their on-console status. Chi-square tests were used to determine associations between dependent factors, and ANOVAs were used to evaluate the effect of hierarchy and timing on NOTECHS score. Of 4,583 examined utterances, 329 (7%) were risk-related. There was no significant difference in utterance frequency based on hierarchical status of sender and recipient (p = 0.16). Utterances made by the surgeon or trainee surgeon had higher NOTECHS scores when off versus on the console (scores: 1.8 vs 2.4, p
Databáze: OpenAIRE
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