A method for measuring threats and errors in surgery

K. R. Catchpole; A. E.B. Giddings; G. Hirst; T. Dale; G. J. Peek; M. R. De Leval

doi:10.1007/s10111-007-0093-9

A method for measuring threats and errors in surgery

K. R. Catchpole, A. E.B. Giddings, G. Hirst, T. Dale, G. J. Peek, M. R. De Leval

Cardiovascular & Thoracic Surgery

Research output: Contribution to journal › Article › peer-review

31 Scopus citations

Abstract

We examined the measurement of non-technical skills for surgical teams using a framework derived from aviation. Twenty four paediatric cardiac surgical and 20 orthopaedic operations were studied by a single observer. Predefined intraoperative failures were recorded, from which it was possible to derive measures of technical errors, threats, and non-technical errors (NTEs). A second non-technical scoring (NTS) method was used which required the observer to give a score from 1 to 4 on the four dimensions of the scale for three stages of each operation. There was a significant positive relationship between NTEs and operative duration in orthopaedic surgery (p < 0.01). In paediatric cardiac surgery, the ranked NTS measures correlated positively with the number of threats (p < 0.005) and with operative duration (p < 0.005). Non-technical skills measures (ranked NTS and NTEs) were also significantly positively correlated (p < 0.01). This suggests that it is possible to evaluate non-technical skills in operating theatre teams, but further work is needed to improve the reliability and accuracy of the measurement methods.

Original language	English (US)
Pages (from-to)	295-304
Number of pages	10
Journal	Cognition, Technology and Work
Volume	10
Issue number	4
DOIs	https://doi.org/10.1007/s10111-007-0093-9
State	Published - Oct 2008

Keywords

Error
Non-technical skills
Safety
Surgery
Teamwork

ASJC Scopus subject areas

Philosophy
Human-Computer Interaction
Computer Science Applications

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10.1007/s10111-007-0093-9

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abstract = "We examined the measurement of non-technical skills for surgical teams using a framework derived from aviation. Twenty four paediatric cardiac surgical and 20 orthopaedic operations were studied by a single observer. Predefined intraoperative failures were recorded, from which it was possible to derive measures of technical errors, threats, and non-technical errors (NTEs). A second non-technical scoring (NTS) method was used which required the observer to give a score from 1 to 4 on the four dimensions of the scale for three stages of each operation. There was a significant positive relationship between NTEs and operative duration in orthopaedic surgery (p < 0.01). In paediatric cardiac surgery, the ranked NTS measures correlated positively with the number of threats (p < 0.005) and with operative duration (p < 0.005). Non-technical skills measures (ranked NTS and NTEs) were also significantly positively correlated (p < 0.01). This suggests that it is possible to evaluate non-technical skills in operating theatre teams, but further work is needed to improve the reliability and accuracy of the measurement methods.",

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note = "Funding Information: This project was funded by the UK Department of Health Patient Safety Research Programme. We would like to extend our thanks to the patients and staff who allowed us to include them in our studies. Thanks also to Dr Paul Godden, Dr Martin Utley, and Professor Steve Gallivan, of the Clinical Operational Research Unit, University College London, for their assistance with this work. Research at the Institute of Child Health and Great Ormond Street Hospital for Children NHS Trust benefits from research and development funding received from the NHS Executive.",

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A method for measuring threats and errors in surgery

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