Human Factors and Patient Safety in Surgery - Everything You Need to Know

Introduction:

Surgery should be performed with the utmost care, following an established proper procedure and using suitable equipment and quality materials. At times, the quality of the surgery may be jeopardized with or without the patients' knowledge. Such issues can occur due to human factors and other causes like environmental factors, resource availability, etc. Patient safety is ensured by following proper protocols and management. The fundamental duty of a physician is to treat the patient without mishap. As safe surgery should always be the primary concern, human factors, and patient safety come into play.

What Are Human Factors in Surgery?

Generally, human factors are those that determine an individual's performance. In surgery, "human factors" include every person who helps with the treatment and how well they work as a group. Human factors can be grouped based on the type of work, the person, and the company.

1. Human factors based on the type of work include:

• Nature of the Task: The task must match physical and mental strengths and the individual's limitations. An under-experienced surgeon can only manage a complex surgery at a time.

• Workload: Proper scheduling of surgeries to balance the increasing workload of surgeries and considering emergency cases.

2. Human factors based on the individual include:

• Competency: A learned trait to improve the quality of the surgical outcome.

• Skills: Skills in assisting surgeons and co-surgeons, handling the latest instruments, and basic skills also come into consideration.

• Risk Perception: The individual must be able to sense any upcoming risks so that the risks can be avoided.

3. Human factors based on the organization include:

• Communication: Proper communication between all the surgeons, assisting nurses, and management of the organization, including the patient, is necessary.

• Resources: Availability of resources can be beneficial in carrying out a procedure in less time.

• Teamwork: As there are several different tasks to be performed in a single surgery, everyone involved in the treatment should be coordinated in their efforts.

Why Are Human Factors Considered Important?

Most complications due to medical errors can be avoided. Approaching surgery while considering all the human factors is the key to safe health care delivery. The health factor is a minute but important aspect to be considered to reduce major mishaps.

What Are Medical Errors?

These errors are preventable adverse effects of medical care that occur due to many reasons, like changes in the procedure to be carried out, unplanned action, infrastructure failure, environmental factors, human factors, and so on. A few examples of medical errors are -

• Surgery at the wrong site.

• Patient suicide.

• Operative and post-operative complications.

• Delay in treatment.

• Medication error.

How Are Medical Errors Prevented?

Medical errors can be prevented by following

• Surgical checklist.

• Proper training for healthcare professionals.

• Recording the medical data.

• Operating room briefing and debriefing.

1. Surgical Checklist: It effectively avoids medical errors and improves patient safety.

• Check 1: The patient's identity, site marking, and correct patient labels are checked. After the approval of check one by a member of the ward staff and a member of the reception staff.

• Check 2: The patient's identity, site documentation, the chief surgeon, and marked site, if not completed in the ward, are all verified. Then, after the consultant chief surgeon approves it, check number three begins.

• Check 3: Confirmation of the correct patient, marking the correct surgical site, consent regarding the procedure to be performed, patient position, and availability of necessary resources and reports are checked. Check three is then signed by the consultant surgeon, head nurse, and senior anesthetist.

• Such a checklist can be made and carried out for every surgery, which helps distribute the work and reduce the workload.

2. Human Factors Approach Training for Healthcare Professionals: Certain training programs are held for healthcare professionals to reduce human error. These programs aim at developing the non-technical, increasing adherence to safety standards, and improving decision-making within the team. Human factors approach training includes development in the following aspects:

• Situation awareness.

• Decision-making.

• Teamwork.

• Communication.

• Leadership.

3. Medical Data Recorded (MDR):

• All the procedures carried out are noted for future records.

• The time of drug (medication) administration, the amount of IV (intravenous) fluids given, and the steps from the beginning of surgery to the end are recorded.

• The visuals of the entire surgery are recorded, and the surgeons involved gather to brief the process as a record. In a few places, the hospital's management can also be involved.

4. OR (operating room) briefing and debriefing:

• Most of the time, these talks are led by the surgeon and are meant to keep adverse events from occurring by making communication easier. Below are the discussion briefings:

  • The role of each team member is allotted.

  • Expectations for the operating procedure.

  • Particular focus on problems that can arise.

Even though it's not the only way to eradicate medical mistakes, it can help reduce them and make patients safer.

What Is Patient Safety in Surgery?

• The process of avoiding medical errors resulting from the healthcare process can be termed patient safety.

• Patient safety is usually maintained by following a proper sterilization protocol and a professional quality approach to the surgery.

• It includes creating a safe operating room with proper fumigation done.

• A perioperative nurse is allotted to look after the patient before, during, and after the surgery.

How Do Human Factors Affect Patient Safety in Surgery?

Medical errors in surgery do not occur due to surgeons' insufficiency but mostly due to equipment, process, or system failures. Using the human factors approach to managing medical errors, patients will be safer, and their needs will be met.

Human factors, like being aware of the situation, making decisions, working as a team, communicating, and being a leader, will help the surgery go well.

Conclusion:

Every individual working on the team to perform a surgery carries a lot of responsibility and accountability. One's performance at any job is affected by the workload. The human factors approach can be used to improve the quality of the surgery and patient safety by the operating team, benefiting both the patient and the healthcare team. Every action and movement of the team during a particular task is considered for achieving a positive outcome of the treatment.