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Social and Behavioral Aspects

Factors suggested to contribute to surgical errors: Surgeon inexperience L ow hospital volume for surgery H igh workloads F atigue P oor technology P oor supervision P oor hospital systems I neffective communication T ime of day A dministrative failures Fatigue.

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Social and Behavioral Aspects

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  1. 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 Social and Behavioral Aspects Over 50% of errors are said to be preventable.

  2. Social and Behavioral Aspects

  3. 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

  4. Developed by Reason • Goals: enhance performance, increase safety, and increase user satisfaction • Two types of error identified: • Active failure • Latent 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 Human Systems Approach

  5. Social and Behavioral Aspects (Croskerry, Cosby, Schenkel, & Wears, 2009) This table demonstrates error rates in relation to the surrounding work environment. Compare!

  6. Social and Behavioral Aspects (Sarker & Vincent, 2005)

  7. Social and Behavioral Aspects (Sarker & Vincent, 2005)

  8. 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 Key Question

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