* Social and Behavioral Aspects

Factors suggested to contribute to surgical errors:

• Surgeon inexperience• Low hospital volume for surgery• High workloads• Fatigue• Poor technology • Poor supervision• Poor hospital systems• Ineffective communication• Time of day• Administrative failures • Fatigue

Over 50% of errors are said to be

preventable.

* Social and Behavioral Aspects

Surgical error

Workload

Inexperience

Fatigue

Poor Supervision

Poor Communicatio

n

Time of Day

Low hospital volume for operation

Looking at the literature:Sarker and Vincent (2005) defined surgical competency, noting mishaps are waiting to happen. Their definition states:

“Surgical competency is a combination of technical skill, team performance and communication, and decision making.”

-Vincent, Taylor-Adams, and Stanhope (1998) claim surgical errors stem from “systemic features operating at different levels—the task, team, work environment, and organization.”

* Social and Behavioral Aspects

* Human Systems Approach

• Developed by Reason

Goals: enhance performance, increase safety, and increase user satisfaction

• Two types of error identified:Active failureLatent failure

Active unsafe actions such as memory lapses, using the wrong equipment, and breaking surgical protocols or standards

Latent poor decisions that lead to times of error or critical incident; shown to cause unfavorable events

* Social and Behavioral Aspects

(Croskerry, Cosby, Schenkel, & Wears, 2009)

This table demonstrates error rates in relation to the surrounding work environment. Compare!

* Social and Behavioral Aspects

(Sarker & Vincent, 2005)

* Social and Behavioral Aspects

(Sarker & Vincent, 2005)

* Key Question

Should these factors/aspects be considered when looking at surgery from a public health perspective? YES.

• Researchers have formulated models to explain the relationship between influencing factors in the work environment and surgical professionals.

-many factors shown-identification to develop interventions

How does the literature and topic relate to theories we have discussed?

Social-Ecological Model This model involves the interrelationship between personal and environmental factors.

Social Cognitive Theory Personal, environmental, and behavioral factors influence each other. (Relationship between sleep, workload, admin support— “the system”)

Theory of Reasoned Action Individuals actions can be affected by subjected norms, control, and attitudes. (Breaking protocols, pressures)