Identifying workflow disruptions in the cardiovascular operating room

Anaesthesia. 2016 Aug;71(8):948-54. doi: 10.1111/anae.13521.


The objectives of this study were to identify the frequency and nature of flow disruptions in the operating room with respect to three cardiac surgical team members: anaesthetists; circulating nurses; and perfusionists. Data collected from 15 cases and coded using a human factors taxonomy identified 878 disruptions. Significant differences were identified in frequency relative to discipline type. Circulating nurses experienced more coordination disruptions (χ(2) (2, N = 110) = 7.136, p < 0.028) and interruptions (χ(2) (2, N = 427) = 29.743, p = 0.001) than anaesthetists and perfusionists, whereas anaesthetists and perfusionists experienced more layout issues than circulating nurses (χ(2) (2, N = 153) = 48.558, p = 0.001). Time to resolve disruptions also varied among disciplines (λ (12, 878) = 5.186, p = 0.000). Although most investigations take a one-size fits all approach in addressing disruptions to flow, this study demonstrates that targeted interventions must focus on differences with respect to individual role.

Keywords: quality measures-patient care; root cause analysis: essential elements.

MeSH terms

  • Anesthetists
  • Cardiac Surgical Procedures*
  • Humans
  • Nurses
  • Operating Rooms*
  • Patient Care Team
  • Professional Role
  • Workflow*