Observational study of anaesthesia workflow to evaluate physical workspace design and layout.


Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 14 08 2019
revised: 31 07 2020
accepted: 24 08 2020
pubmed: 9 11 2020
medline: 9 3 2021
entrez: 8 11 2020
Statut: ppublish

Résumé

The safety and efficiency of anaesthesia care depend on the design of the physical workspace. However, little is known about the influence that workspace design has on the ability to perform complex operating theatre (OT) work. The aim of this study was to observe the relationship between task switching and physical layout, and then use the data collected to design and assess different anaesthesia workspace layouts. In this observational study, six videos of anaesthesia providers were analysed from a single centre in the United States. A task analysis of workflow during the maintenance phase of anaesthesia was performed by categorising tasks. The data supported evaluations of alternative workspace designs. An anaesthesia provider's time was occupied primarily by three tasks: patient (mean: 30.0% of total maintenance duration), electronic medical record (26.6%), and visual display tasks (18.6%). The mean time between task switches was 6.39 s. With the current workspace layout, the anaesthesia provider was centred toward the patient for approximately half of the maintenance duration. Evaluating the alternative layout designs showed how equipment arrangements could improve task switching and increase the provider's focus towards the patient and visual displays. Our study showed that current operating theatre layouts do not fit work demands. We report a simple method that facilitates a quick layout design assessment and showed that the anaesthesia workspace can be improved to better suit workflow and patient care. Overall, this arrangement could reduce anaesthesia workload while improving task flow efficiency and potentially the safety of care.

Sections du résumé

BACKGROUND BACKGROUND
The safety and efficiency of anaesthesia care depend on the design of the physical workspace. However, little is known about the influence that workspace design has on the ability to perform complex operating theatre (OT) work. The aim of this study was to observe the relationship between task switching and physical layout, and then use the data collected to design and assess different anaesthesia workspace layouts.
METHODS METHODS
In this observational study, six videos of anaesthesia providers were analysed from a single centre in the United States. A task analysis of workflow during the maintenance phase of anaesthesia was performed by categorising tasks. The data supported evaluations of alternative workspace designs.
RESULTS RESULTS
An anaesthesia provider's time was occupied primarily by three tasks: patient (mean: 30.0% of total maintenance duration), electronic medical record (26.6%), and visual display tasks (18.6%). The mean time between task switches was 6.39 s. With the current workspace layout, the anaesthesia provider was centred toward the patient for approximately half of the maintenance duration. Evaluating the alternative layout designs showed how equipment arrangements could improve task switching and increase the provider's focus towards the patient and visual displays.
CONCLUSIONS CONCLUSIONS
Our study showed that current operating theatre layouts do not fit work demands. We report a simple method that facilitates a quick layout design assessment and showed that the anaesthesia workspace can be improved to better suit workflow and patient care. Overall, this arrangement could reduce anaesthesia workload while improving task flow efficiency and potentially the safety of care.

Identifiants

pubmed: 33160603
pii: S0007-0912(20)30819-9
doi: 10.1016/j.bja.2020.08.063
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

633-641

Subventions

Organisme : AHRQ HHS
ID : P30 HS024380
Pays : United States

Informations de copyright

Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Katherina A Jurewicz (KA)

Department of Industrial Engineering, Clemson University, Clemson, SC, USA.

David M Neyens (DM)

Department of Industrial Engineering, Clemson University, Clemson, SC, USA. Electronic address: dneyens@clemson.edu.

Ken Catchpole (K)

Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA.

Anjali Joseph (A)

School of Architecture, Clemson University, Clemson, SC, USA.

Scott T Reeves (ST)

Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, SC, USA.

James H Abernathy (JH)

Department of Anesthesiology and Critical Care Medicine, Johns Hopkins, Baltimore, MD, USA.

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Classifications MeSH