Identifying workflow disruptions in the cardiovascular operating room

T. N. Cohen, J. S. Cabrera, O. D. Sisk, K. L. Welsh, J. H. Abernathy, S. T. Reeves, D. A. Wiegmann, S. A. Shappell, A. J. Boquet

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


The objectives of this study were to identify the frequency and nature of flow disruptions in the operating room with respect to three cardiac surgical team members: anaesthetists; circulating nurses; and perfusionists. Data collected from 15 cases and coded using a human factors taxonomy identified 878 disruptions. Significant differences were identified in frequency relative to discipline type. Circulating nurses experienced more coordination disruptions (χ2 (2, N = 110) = 7.136, p < 0.028) and interruptions (χ2 (2, N = 427) = 29.743, p = 0.001) than anaesthetists and perfusionists, whereas anaesthetists and perfusionists experienced more layout issues than circulating nurses (χ2 (2, N = 153) = 48.558, p = 0.001). Time to resolve disruptions also varied among disciplines (λ (12, 878) = 5.186, p = 0.000). Although most investigations take a one-size fits all approach in addressing disruptions to flow, this study demonstrates that targeted interventions must focus on differences with respect to individual role.

Original languageEnglish (US)
Pages (from-to)948-954
Number of pages7
Issue number8
StatePublished - Aug 1 2016
Externally publishedYes


  • Quality measures-patient care
  • Root cause analysis: Essential elements

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine


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