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negative effects of DIDs.
Methods: Electronic databases (MEDLINE, Embase, CINAHL and PsycINFO) and reference lists were systematically searched. Included studies were required to report the quantitative outcomes of the association between DIDs and team performance, individual performance and patient safety. Two reviewers independently screened articles for inclusion, assessed study quality and extracted data. A random-effects meta-analysis was performed on a subset of studies reporting total operative time and DIDs.
Results: Twenty-seven studies were identified. The majority were prospective observational studies (n = 15) of moderate quality. DIDs were often defined, measured and interpreted differently in studies. DIDs were significantly associated with extended operative duration (n = 8), impaired team performance (n = 6), self-reported errors by colleagues (n = 1), surgical errors (n = 1), increased risk
and incidence of surgical site infection (n = 4) and fewer patient safety checks (n = 1). A random effects meta-analysis showed that the proportion of total operative time due to DIDs was 22.0% (95% confidence interval 15.7–29.9).
Conclusion: DIDs in surgery are associated with a range of negative outcomes. However, significant knowledge gaps exist about the mechanisms that underlie these relationships, as well as the potential clinical and non-clinical benefits that DIDs may deliver. Available evidence indicates that interventions to reduce the negative effects of DIDs are warranted, but current evidence is not sufficient to make recommendations about potentially useful interventions.
- operating room
- patient safety
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Creating a culture of safety and respect: a controlled, mixed-methods study of the effectiveness of a behavioural accountability intervention to reduce unprofessional behaviours
Westbrook, J., Braithwaite, J., Day, R., Middleton, S., Scott, D., Rapport, F., Mitchell, R., Baysari, M., Li, L., Ayliff, N., Hughes, C., McInnes, E., Goodier, G., Maddern, G., Cartmill, J., Churruca, K., Fletcher, M., Sunderland, N., Hibbert, P., Clay-Williams, R., Pavithra, A. & Crick, S.
1/12/17 → …