OBJECTIVE: To provide a review of human factors research within the context of surgery. DATA SOURCES: We searched PubMed for relevant studies published from the earliest available date through February 29, 2012. STUDY SELECTION: The search was performed using the following keywords: human factors, surgery, errors, teamwork, communication, stress, disruptions, interventions, checklists, briefings, and training. Additional articles were identified by a manual search of the references from the key articles. As 2 human factors specialists, a senior clinician, and a junior clinician, we carefully selected the most appropriate exemplars of research findings with specific relevance to surgical error and safety. DATA EXTRACTION: Seventy-seven articles of relevance were selected and reviewed in detail. Opinion pieces and editorials were disregarded; the focus was solely on articles based on empirical evidence, with a particular emphasis on prospectively designed studies. DATA SYNTHESIS: The themes that emerged related to the development of human factors theories, the application of those theories within surgery, a specific interest in the concept of flow, and the theoretical basis and value of human-related interventions for improving safety and flow in surgery. CONCLUSIONS: Despite increased awareness of safety, errors routinely continue to occur in surgical care. Disruptions in the flow of an operation, such as teamwork and communication failures, contribute significantly to such adverse events. While it is apparent that some incidence of human error is unavoidable, there is much evidence in medicine and other fields that systems can be better designed to prevent or detect errors before a patient is harmed. The complexity of factors leading to surgical errors requires collaborations between surgeons and human factors experts to carry out the proper prospective and observational studies. Only when we are guided by this valid and real-world data can useful interventions be identified and implemented.
OBJECTIVE: To provide a review of human factors research within the context of surgery. DATA SOURCES: We searched PubMed for relevant studies published from the earliest available date through February 29, 2012. STUDY SELECTION: The search was performed using the following keywords: human factors, surgery, errors, teamwork, communication, stress, disruptions, interventions, checklists, briefings, and training. Additional articles were identified by a manual search of the references from the key articles. As 2 human factors specialists, a senior clinician, and a junior clinician, we carefully selected the most appropriate exemplars of research findings with specific relevance to surgical error and safety. DATA EXTRACTION: Seventy-seven articles of relevance were selected and reviewed in detail. Opinion pieces and editorials were disregarded; the focus was solely on articles based on empirical evidence, with a particular emphasis on prospectively designed studies. DATA SYNTHESIS: The themes that emerged related to the development of human factors theories, the application of those theories within surgery, a specific interest in the concept of flow, and the theoretical basis and value of human-related interventions for improving safety and flow in surgery. CONCLUSIONS: Despite increased awareness of safety, errors routinely continue to occur in surgical care. Disruptions in the flow of an operation, such as teamwork and communication failures, contribute significantly to such adverse events. While it is apparent that some incidence of human error is unavoidable, there is much evidence in medicine and other fields that systems can be better designed to prevent or detect errors before a patient is harmed. The complexity of factors leading to surgical errors requires collaborations between surgeons and human factors experts to carry out the proper prospective and observational studies. Only when we are guided by this valid and real-world data can useful interventions be identified and implemented.
Authors: William O Cooper; Oscar Guillamondegui; O Joe Hines; C Scott Hultman; Rachel R Kelz; Perry Shen; David A Spain; John F Sweeney; Ilene N Moore; Joseph Hopkins; Ira R Horowitz; Russell M Howerton; J Wayne Meredith; Nathan O Spell; Patricia Sullivan; Henry J Domenico; James W Pichert; Thomas F Catron; Lynn E Webb; Roger R Dmochowski; Jan Karrass; Gerald B Hickson Journal: JAMA Surg Date: 2017-06-01 Impact factor: 14.766
Authors: Daniel G Hottinger; Isam Nasr; Joseph K Canner; Deepa Kattail; Rahul Koka; Deborah Schwengel Journal: Public Health Rep Date: 2018-08-01 Impact factor: 2.792
Authors: William O Cooper; David A Spain; Oscar Guillamondegui; Rachel R Kelz; Henry J Domenico; Joseph Hopkins; Patricia Sullivan; Ilene N Moore; James W Pichert; Thomas F Catron; Lynn E Webb; Roger R Dmochowski; Gerald B Hickson Journal: JAMA Surg Date: 2019-09-01 Impact factor: 14.766
Authors: Monica Jain; Brian T Fry; Luke W Hess; Jennifer T Anger; Bruce L Gewertz; Ken Catchpole Journal: J Surg Res Date: 2016-07-04 Impact factor: 2.192
Authors: Nabeeha Ahmad; Ahmed A Hussein; Lora Cavuoto; Mohamed Sharif; Jenna C Allers; Nobuyuki Hinata; Basel Ahmad; Justen D Kozlowski; Zishan Hashmi; Ann Bisantz; Khurshid A Guru Journal: BJU Int Date: 2016-02-21 Impact factor: 5.588