System Factors Affecting Patient Safety in the OR

This study aimed to characterize and quantify intraoperative safety threats and resilience supports in laparoscopic general surgery using a human factors approach. Researchers analyzed data from 24 elective procedures at a single center in the Netherlands, using the OR Black Box®, a multichannel synchronized recording device, to capture video, audio, and patient physiological data. Trained analysts then coded the recordings for safety threats and resilience supports across six categories: person, task, tools and technology, physical environment, organization, and external environment.

The findings revealed a median of 14 safety threats and 12 resilience supports per case. The "person" category accounted for the majority of both safety threats and resilience supports, with a median of 9 and 10 instances per case, respectively. Organizational factors contributed a median of 2 instances for both safety threats and resilience supports per case. Notably, while tools and technology were associated with a small number of safety threats (median 1 per case), they rarely provided resilience support. This quantitative analysis offers valuable insights into the safety landscape of modern endoscopic operating rooms, highlighting areas where improvements could potentially enhance surgical safety and resilience.