Optimizing the operating theatre environment.

The operating theatre is a complex place. There are many potential factors which can interfere with surgery and predispose to errors. Optimizing the operating theatre environment can enhance surgeon performance, which can ultimately improve patient outcomes. These factors include the physical environment (such as noise and light), human factors (such as ergonomics), and surgeon-related factors (such as fatigue and stress). As individual factors, they may not affect surgical outcome but in combination, they may exert a significant influence. The evidence for some of these working environment factors are examined individually. Optimizing the operating environment may have a potentially more significant impact on overall surgical outcome than improving individual surgical skill.