Improving Safety Culture in Surgery: A Literature Review Using a Human Factors Approach (Preprint)

UNSTRUCTURED The safety culture of surgical teams is essential to minimising patient harm and improving outcomes, yet challenges remain in establishing an optimal environment. This literature review synthesises existing evidence on factors influencing the safety culture within surgical teams, using a Human Factors approach integrating the Systems Engineering Initiative for Patient Safety (SEIPS) model. A search of three major databases yielded six relevant studies, which were analysed to identify key factors such as tools and technology, task complexity, communication, leadership, internal and external environment, and organisational influences. Findings highlight that well-designed tools, effective communication, strong leadership, and manageable workloads are crucial to fostering a positive safety culture. Additionally, organisational factors such as leadership support, work environment optimisation, and the ability to speak up without fear of retribution play significant roles in improving patient safety. This review underscores the need for targeted interventions to enhance the safety culture of surgical teams. The findings also highlight the importance of systems-based approaches in improving surgical safety and lay the groundwork for future research and intervention development.