Improving cardiac surgical care: a work systems approach

Appl Ergon. 2010 Sep;41(5):701-12. doi: 10.1016/j.apergo.2009.12.008. Epub 2010 Mar 3.


Over the past 50 years, significant improvements in cardiac surgical care have been achieved. Nevertheless, surgical errors that significantly impact patient safety continue to occur. In order to further improve surgical outcomes, patient safety programs must focus on rectifying work system factors in the operating room (OR) that negatively impact the delivery of reliable surgical care. The goal of this paper is to provide an integrative review of specific work system factors in the OR that may directly impact surgical care processes, as well as the subsequent recommendations that have been put forth to improve surgical outcomes and patient safety. The important role that surgeons can play in facilitating work system changes in the OR is also discussed. The paper concludes with a discussion of the challenges involved in assessing the impact that interventions have on improving surgical care. Opportunities for future research are also highlighted throughout the paper.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Accidents
  • Cardiac Surgical Procedures / standards*
  • Clinical Competence / standards*
  • Fatigue / prevention & control
  • Humans
  • Iatrogenic Disease / prevention & control*
  • Leadership
  • Medical Errors / prevention & control*
  • Models, Organizational
  • Operating Rooms / standards*
  • Organizational Culture
  • Patient Care / standards
  • Quality of Health Care / standards*
  • Safety Management / methods
  • Safety Management / standards
  • Social Responsibility
  • Systems Theory
  • United States