TY - JOUR
T1 - Applicability of the disruptions in surgery index in the cardiovascular management scenarios - A marker for developing functionally efficient teams
AU - Nina, Vinicius
AU - Mendes, Augusto Gonçalves
AU - Sevdalis, Nick
AU - Marath, Aubyn
AU - Mejia, Omar Vilca
AU - Brandão, Carlos Manuel A.
AU - Monteiro, Rosangela
AU - Mendes, Vinícius Giuliano
AU - Jatene, Fabio B.
N1 - Funding Information:
Funding: The authors received no financial support for the
Publisher Copyright:
© 2021, Sociedade Brasileira de Cirurgia Cardiovascular. All rights reserved.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach’s alpha coefficient. Nonparametric Kruskal-Wallis test and Dunn’s post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. Results: Cronbach’s alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: An individual’s skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patientrelated disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues’ disruptive behaviors than their own (P=0.0001). Conclusion: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR.
AB - Introduction: To support the development of practices and guidelines that might help to reduce adverse events related to human factors, we aimed to study the response and perception by members of a cardiovascular surgery team of various error-driven or adverse features that might arise in the operating room (OR). Methods: A previously validated Disruptions in Surgery Index (DiSI) questionnaire was completed by individuals working together in a cardiovascular surgical unit. Results were submitted to reliability analysis by calculating the Cronbach’s alpha coefficient. Nonparametric Kruskal-Wallis test and Dunn’s post-test were performed to estimate differences in perceptions of adverse events or outcomes between the groups (surgeons, nurses, anesthesiologists, and technicians). P<0.05 was considered statistically significant. Results: Cronbach’s alpha reliability coefficients showed consistency within the recommended range for all disruption types assessed in DiSI: An individual’s skill (0.85), OR environment (0.88), communication (0.81), situational awareness (0.92), patientrelated disruption (0.89), team cohesion (0.83), and organizational disruption (0.83). Nurses (27.4%) demonstrated significantly higher perception of disruptions than surgeons (25.4%), anesthetists (23.3%), and technicians (23.0%) (P=0.005). Study participants were more observant of their colleagues’ disruptive behaviors than their own (P=0.0001). Conclusion: Our results revealed that there is a tendency among participants to hold a positive self-perception position. DiSI appears to be a reliable and useful tool to assess surgical disruptions in cardiovascular OR teams, identifying negative features that might imperil teamwork and safety in the OR. And human factors training interventions are available to develop team skills and improve safety and efficiency in the cardiovascular OR.
KW - Cardiovascular Surgery
KW - Communication
KW - Patient Safety
KW - Perception
KW - Problem Behavior
KW - Self-Concept
KW - Surgeons
UR - http://www.scopus.com/inward/record.url?scp=85117136979&partnerID=8YFLogxK
U2 - 10.21470/1678-9741-2020-0685
DO - 10.21470/1678-9741-2020-0685
M3 - Article
AN - SCOPUS:85117136979
SN - 0102-7638
VL - 36
SP - 445
EP - 452
JO - Brazilian Journal of Cardiovascular Surgery
JF - Brazilian Journal of Cardiovascular Surgery
IS - 4
ER -