Widmer Lukas W, Keller Sandra, Tschan Franziska, Semmer Norbert K, Holzer Eliane, Candinas Daniel, Beldi Guido
Department of Visceral Surgery and Medicine, University Hospital of Bern, 3010, Bern, Switzerland.
University of Neuchâtel, Institute of Work and Organizational Psychology, Neuchâtel, Switzerland.
World J Surg. 2018 Jul;42(7):2011-2017. doi: 10.1007/s00268-017-4442-4.
Case-irrelevant communication (CIC) is defined as "any conversation" irrelevant to the case. It includes small talk, but also communication related to other work issues besides the actual task. CIC during surgeries is generally seen as distracting, despite a lack of knowledge about the content of CIC and its regulation in terms of adjustments to the situation of CIC. Primary goal of the study was to evaluate CIC content; secondary goal was to evaluate whether surgical teams regulate CIC according to different concentration demands of surgical procedures.
In 125 surgeries, 1396 CIC events were observed. CIC were content coded into work-related CIC (pertaining to other tasks or work in general) and social CIC (pertaining to acquaintance talk, gossip, or private conversation). The impact of different phases and the difficulty of the surgical procedure on CIC were assessed.
Work-related CIC were significantly more frequent (2.49 per hour, SD = 2.17) than social CIC (1.42 per hour, SD = 2.17). Across phases, frequency of work-related CIC was constant, whereas social CIC increased significantly across phases. In surgeries assessed as highly difficult by the surgeons, social CIC were observed at a lower frequency, and less work-related CIC were observed during the main phase compared to surgeries assessed as less difficult.
The high proportion of work-related CIC indicates that surgical teams deal with other tasks during surgeries. Surgical teams adapt CIC according to the demands of the procedure. Hospital policies should support these adaptations rather than attempt to suppress CIC entirely.
与病例无关的交流（CIC）被定义为与病例“无关的任何对话”。它包括闲聊，但也包括与实际任务之外的其他工作问题相关的交流。手术期间的CIC通常被视为分散注意力的因素，尽管对CIC的内容及其根据CIC情况进行调整的规范缺乏了解。该研究的主要目标是评估CIC的内容；次要目标是评估手术团队是否根据手术程序的不同注意力需求来规范CIC。
在125台手术中，观察到1396次CIC事件。CIC的内容被编码为与工作相关的CIC（与其他任务或一般工作有关）和社交CIC（与熟人交谈、闲聊或私人对话有关）。评估了不同阶段和手术程序难度对CIC的影响。
与工作相关的CIC明显比社交CIC更频繁（每小时2.49次，标准差=2.17）（每小时1.42次，标准差=2.17）。在各个阶段，与工作相关的CIC频率保持不变，而社交CIC在各阶段显著增加。在外科医生评估为高难度的手术中，社交CIC的观察频率较低，与评估为难度较小的手术相比，在主要阶段观察到的与工作相关的CIC较少。
与工作相关的CIC比例较高表明手术团队在手术期间处理其他任务。手术团队根据手术程序的要求调整CIC。医院政策应支持这些调整，而不是试图完全抑制CIC。
