Associations of flow disruptions with patient, staff, and process outcomes : a prospective observational study of robotic-assisted radical prostatectomies

© 2023. The Author(s)..

BACKGROUND: Technological advancements in the operating room (OR) have sparked new challenges for surgical workflow, OR professionals, and patient safety. Disruptive events are frequent across all surgical specialties, but little is known about their effects on patient outcomes and the influence of systemic factors. The aim was to explore the associations of intraoperative flow disruptions (FDs) with patient outcomes, staff workload, and surgery duration.

METHODS: Prospective, single-center, and multi-source study comprising direct and standardized OR observations of urologic surgical procedures, clinical patient outcomes, and staff- and patient-reported outcome data (PROMs; 3-month follow-up). All data were recorded between 01/2020 and 10/2021. FDs were assessed using standardized procedure observations. Linear and logistic regression analyses including multiple system factors were used to explore the effects of FDs on surgical outcomes.

RESULTS: 61 robotic-assisted radical prostatectomy procedures were captured (with 61 patients and 243 staff reports). High rates of FDs were observed; however, our analyses did not show significant relationships with patient complication rates. Equipment- and patient-related FDs were associated with increased staff workload. No association was found between higher rates of FDs and procedure duration.

CONCLUSIONS: FDs were not related to inferior patient outcomes. Our findings may inform future OR investigations that scrutinize the complex interplay of human, team, process, and technological components that mitigate the effects of FDs during surgery.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:37

Enthalten in:

Surgical endoscopy - 37(2023), 9 vom: 19. Sept., Seite 6964-6974

Sprache:

Englisch

Beteiligte Personen:

Koch, Amelie [VerfasserIn]
Quartucci, Caroline [VerfasserIn]
Buchner, Alexander [VerfasserIn]
Schlenker, Boris [VerfasserIn]
Becker, Armin [VerfasserIn]
Catchpole, Ken [VerfasserIn]
Weigl, Matthias [VerfasserIn]

Links:

Volltext

Themen:

Flow disruptions
Journal Article
Observational Study
Patient safety
Prostate cancer
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Robotic surgery
Teamwork

Anmerkungen:

Date Completed 31.08.2023

Date Revised 10.09.2023

published: Print-Electronic

ClinicalTrials.gov: NCT04226391

Citation Status MEDLINE

doi:

10.1007/s00464-023-10162-2

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM35838379X