Surgeons are being distracted in the operating room it’s endangering patients, says Canadian study

A new study finds that surgeons are being distracted by pagers and phone calls during surgery and that these interruptions are affecting both their surgical performance and their clinical practice.

Researchers tested obstetrics and gynecology (Ob/Gyn) residents at the McMaster University Centre for Minimal Access Surgery in Hamilton, Ontario, to see if their ability to perform virtual laparoscopic surgery was affected by their having to respond to questions about patient care. The results showed that not only did many of them fail to perform the surgery in the allotted amount of time but the responses they gave concerning other patient care were often inferior, and sometimes downright unsafe.

The idea of the multitasking surgeon may make some in the general public a little nervous but in fact it is commonplace for surgeons to take phone calls while performing operations, with some reports putting the number somewhere between 1.9 and 4 calls per hour.

“The image of the circulating nurse holding a phone up to the ear of a scrubbed surgical resident is not foreign to many surgeons working in academic institutions,” say the McMaster study’s authors.

Typically, surgical residents begin their shift with ward rounds before heading into the operating room. And just as typical are the follow-up questions and emergency room consults to which the operating surgeon must then respond. While studies have so far produced conflicting results about how these distractions affect the quality of the surgery, it is clear that there is an impact on time of completion. The current study’s novelty stems from its measurement of the quality of responses to patient care questions while operating. And the results are not good.

Residents responding while operating scored an average of 80 per cent on the questions and 63 per cent of residents made at least one unsafe clinical decision in their responses, some making three unsafe decisions. In comparison, a group undistracted residents scored an average of 93 per cent on the questions and only 20 per cent made unsafe decisions, none making more than one.

“Our study clearly demonstrates that residents’ ability to make sound clinical patient-care decisions is hindered while operating,” say the study’s authors. “That 63 % of residents made at least one unsafe decision while operating is a sobering finding, and institutions should consider strategies aimed at mitigating this significant risk to patients.”

The authors say that the potential dangers are further compounded by the fact that it is often the novice surgical residents who are handling the double duties of performing surgery and having to respond to patient care phone calls – all the while still learning and developing their surgical skills.

The practice of multitasking, once the trendy term of the 90‘s and 2000’s, is now more often referred to as a mirage than the key to productivity. Neuroscientist Earl K. Miller of the Massachusetts Institute of Technology puts it this way: “People aren’t good at multitasking. We are only good at doing one thing at a time. [When we multitask] we are switching back and forth. Your brain has to backtrack and figure out where it was in the first place.”

The study was published online in the journal Surgical Endoscopy.

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