Kristin L Chrouser1, Jie Xu2, Susan Hallbeck3, Matthew B Weinger4, Melissa R Partin5. 1. Minneapolis VA Health Care Center, 1 Veterans Dr, Minneapolis, MN 55417, USA; The University of Minnesota, Dept of Urology, 420 Delaware St SE, Minneapolis, MN 55455, USA. Electronic address: chrouser@umn.edu. 2. Center for Psychological Science, Zhejiang University, China; Vanderbilt University School of Medicine, Dept of Anesthesiology, 1121 21st Avenue S., MAB Suite 732, Nashville, TN 37212, USA. Electronic address: jie.xu@vanderbilt.edu. 3. Mayo Clinic Health Sciences Research Department, Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. Electronic address: Hallbeck.susan@mayo.edu. 4. Vanderbilt University School of Medicine, Dept of Anesthesiology, 1121 21st Avenue S., MAB Suite 732, Nashville, TN 37212, USA. Electronic address: Matt.weinger@vanderbilt.edu. 5. Minneapolis VA Health Care Center, Center for Chronic Disease Outcomes Research, 1 Veterans Dr (152/Bldg 9), Minneapolis, MN 55417, USA. Electronic address: Melissa.partin@va.gov.
Abstract
BACKGROUND: Surgical adverse events persist despite several decades of system-based quality improvement efforts, suggesting the need for alternative strategies. Qualitative studies suggest stress-induced negative intraoperative interpersonal dynamics might contribute to performance errors and undesirable patient outcomes. Understanding the impact of intraoperative stressors may be critical to reducing adverse events and improving outcomes. DATA SOURCES: We searched MEDLINE, psycINFO, EMBASE, Business Source Premier, and CINAHL databases (1996-2016) to assess the relationship between negative (emotional and behavioral) responses to acute intraoperative stressors and provider performance or patient surgical outcomes. RESULTS/ CONCLUSIONS: Drawing on theory and evidence from reviewed studies, we present the Surgical Stress Effects (SSE) framework. This illustrates how emotional and behavioral responses to stressors can influence individual surgical provider (e.g. surgeon, nurse) performance, team performance, and patient outcomes. It also demonstrates how uncompensated intraoperative threats and errors can lead to adverse events, highlighting evidence gaps for future research efforts. Published by Elsevier Inc.
BACKGROUND: Surgical adverse events persist despite several decades of system-based quality improvement efforts, suggesting the need for alternative strategies. Qualitative studies suggest stress-induced negative intraoperative interpersonal dynamics might contribute to performance errors and undesirable patient outcomes. Understanding the impact of intraoperative stressors may be critical to reducing adverse events and improving outcomes. DATA SOURCES: We searched MEDLINE, psycINFO, EMBASE, Business Source Premier, and CINAHL databases (1996-2016) to assess the relationship between negative (emotional and behavioral) responses to acute intraoperative stressors and provider performance or patient surgical outcomes. RESULTS/ CONCLUSIONS: Drawing on theory and evidence from reviewed studies, we present the Surgical Stress Effects (SSE) framework. This illustrates how emotional and behavioral responses to stressors can influence individual surgical provider (e.g. surgeon, nurse) performance, team performance, and patient outcomes. It also demonstrates how uncompensated intraoperative threats and errors can lead to adverse events, highlighting evidence gaps for future research efforts. Published by Elsevier Inc.
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