Graduate Student Seminar Series – Minnie Menezes

Graduate Student Seminar Series
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Location: HS610 – 155 College St, Room 610
Presentation Title: Identifying Challenges in the Operating Room through a Surgical Process Analysis of Orthopaedic Teams
Abstract:
Background & Purpose
Surgical performance is a key factor in the success of operative interventions, affecting patient outcomes and operating room (OR) efficiency. This is dependent on the skills of the individual surgeons, nurses, anesthesiologists, and radiation technologists and their interactions. However, the multidisciplinary nature of OR performance is often overlooked when studying surgical processes. Including interdisciplinary interactions and associated challenges may yield a more comprehensive workflow understanding. As such, the aim of this study was to conduct a multidisciplinary surgical process analysis of orthopaedic teams undertaking operative hip fracture repair.
Methods
We conducted an ethnographic study that incorporated observations and semi-structured interviews. The observations were of hip fracture fixation procedures, both in-person and via intraoperative recordings. Intraoperative recordings were captured using the OR Black Box, which includes audio, video (from five perspectives), and patient vitals, and then annotated. Semi-structured interviews were conducted with experts in four disciplines (surgery, anesthesia, nursing, and radiation technology). Two members of the research team analyzed the interview data inductively to identify themes. The researchers ensured intercoder reliability through dialogue and consensus.
Results & Discussion
A process analysis map was created from the intraoperative recording annotations and in-person observations, including phases, steps, and activities conducted by each discipline in chronological order. The intricacies of collaborations between disciplines and challenges in the OR were visually demonstrated on the map. Four themes were identified from the interview data that describes the surgical process: the main responsibilities of each discipline; system-level, case-specific, and interdisciplinary challenges; the impact/consequences of challenges on individual workflows; and a breakdown of the OR culture.
Conclusion
We created a multidisciplinary surgical process map that demonstrates the interconnections and challenges present in the orthopaedic OR during hip fracture repair. Challenges identified will inform quality improvement initiatives and educational interventions, towards improving communication and reducing workflow disruptions.
Supervisor Name: Cari Whyne
Year of Study: 2
Program of Study: MASc
Reschedule Reason: Venue and time change of BME Seminars
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