Assessing distractors and teamwork during surgery: developing an event-based method for direct observation
| Autor: | Norbert K. Semmer, Franziska Tschan, Daniel Candinas, Sandra Keller, J. C. Seelandt, Nadja Jenni, Anita Kurmann, Guido Beldi |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Intraclass correlation Human Factors Event based media_common.quotation_subject Interprofessional Relations education 610 Medicine & health Observation behavioral disciplines and activities Observational method Interviews as Topic Task Performance and Analysis Medicine Humans Observation method Attention media_common Patient Care Team Teamwork business.industry 300 Social sciences sociology & anthropology Health Policy Communication Direct observation Surgical procedures humanities Surgery ddc:128.37 790 Sports games & entertainment General Surgery Observational study Female Patient Safety business 150 Psychology |
| Zdroj: | Seelandt, J. C.; Tschan, Franziska; Keller, S.; Beldi, Guido; Jenni, N.; Kurmann, Anita; Candinas, Daniel; Semmer, Norbert (2014). Assessing distractors and teamwork during surgery: developing an event-based method for direct observation. BMJ Quality and Safety, 23(11), pp. 918-929. BMJ Publ. Group 10.1136/bmjqs-2014-002860 BMJ Quality and Safety, Vol. 23, No 11 (2014) pp. 918-929 |
| ISSN: | 2044-5423 2044-5415 |
| DOI: | 10.1136/bmjqs-2014-002860 |
| Popis: | OBJECTIVE: To develop a behavioural observation method to simultaneously assess distractors and communication/teamwork during surgical procedures through direct, on-site observations; to establish the reliability of the method for long (>3 h) procedures. METHODS: Observational categories for an event-based coding system were developed based on expert interviews, observations and a literature review. Using Cohen's κ and the intraclass correlation coefficient, interobserver agreement was assessed for 29 procedures. Agreement was calculated for the entire surgery, and for the 1st hour. In addition, interobserver agreement was assessed between two tired observers and between a tired and a non-tired observer after 3 h of surgery. RESULTS: The observational system has five codes for distractors (door openings, noise distractors, technical distractors, side conversations and interruptions), eight codes for communication/teamwork (case-relevant communication, teaching, leadership, problem solving, case-irrelevant communication, laughter, tension and communication with external visitors) and five contextual codes (incision, last stitch, personnel changes in the sterile team, location changes around the table and incidents). Based on 5-min intervals, Cohen's κ was good to excellent for distractors (0.74-0.98) and for communication/teamwork (0.70-1). Based on frequency counts, intraclass correlation coefficient was excellent for distractors (0.86-0.99) and good to excellent for communication/teamwork (0.45-0.99). After 3 h of surgery, Cohen's κ was 0.78-0.93 for distractors, and 0.79-1 for communication/teamwork. DISCUSSION: The observational method developed allows a single observer to simultaneously assess distractors and communication/teamwork. Even for long procedures, high interobserver agreement can be achieved. Data collected with this method allow for investigating separate or combined effects of distractions and communication/teamwork on surgical performance and patient outcomes. |
| Databáze: | OpenAIRE |
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