The Prevalence and Potential Effects of Distractions in General Surgery: A Mixed-Methods Study

Distractions can interfere with surgical tasks and may negatively impact task performance, surgery duration, and mood of surgical team members. A mixed-methods study was conducted to examine the prevalence and potential effects of distractions during general surgery, in particular during the surgical procedure and post-operative counts. An audio-video recording platform named the OR BlackBox® was used to record data from 40 surgical cases, which was in turn coded by multiple raters. Supporting qualitative data was collected through interviews with four OR staff members. The audio-video data revealed that distractions occurred on the average about every three minutes during the surgical procedure, and most frequently observed effect was distracted members not noticing other members’ requests. Twenty-nine of the cases had at least one changeover during the surgical procedure whereas overall four changeovers occurred during post-operative counts; in one of these cases the count was repeated, resulting in a delay of almost 15 minutes. Other distractions (OR traffic, communication, and others) were frequent both during the surgical procedure (M=0.39 per minute per case, SD=0.15) and post-operative counts (M=0.75 per minute per case, SD=0.44). The interviews were preliminary in nature and provided additional insights on the effects of OR distractions and potential mitigation strategies to inform future OR distraction research.