Understanding and Mitigating the Effects of Operating Room Distractions

Operating rooms (ORs) are complex dynamic environments with frequent distractions. Literature has limited evidence on OR distractions leading to adverse surgical outcomes; in fact, studies increasingly agree that distractions under certain circumstances can be beneficial. A notable limitation of existing studies is the drawbacks of data collection methods. This study is the first to use a naturalistic dataset, the OR Black Box, to investigate the relation of OR distractions and intraoperative technical events. Increased machine alarm rates, decreased technical skill levels, and increased body mass index levels were found to be associated with increased likelihood of observing more than one severe technical event during high criticality/medium-high difficulty procedural steps of Roux-en-Y gastric bypass operations. Mitigation strategies to reduce the negative effects of OR distractions were identified through a literature review and discussions with OR members. A taxonomy was created through systems perspective to support the selection of appropriate mitigation strategies.M.A.S