Qual Saf Health Care 16:135-139 doi:10.1136/qshc.2006.019711
  • Error management

Quantifying distraction and interruption in urological surgery

  1. A N Healey,
  2. C P Primus,
  3. M Koutantji
  1. Imperial College, London, UK
  1. Correspondence to:
 Dr A N Healey
 Department of Biosurgery and Surgical Technology, Clinical Safety Research Unit, Imperial College, University of London, 10th Floor QEQM, St Mary’s Hospital, Praed Street, Paddington, London W2 1NY, UK; a.healey{at}
  • Accepted 27 January 2007


Background: To enhance safety in surgery, it is necessary to develop a variety of tools for measuring and evaluating the system of work. One important consideration for safety in any high-risk work is the frequency and effect of distraction and interruption.

Aim: To quantify distraction and interruption to the sterile surgical team in urology.

Methods: Observation of the behaviour of the surgical team and their task activity determined distraction and interruption recorded. Using an ordinal scale, an observer rated each salient distraction or interruption observed in relation to the team’s involvement.

Results: The frequency of events and their attached ratings were high, deriving from varying degrees of equipment, procedure and environment problems, telephones, bleepers and conversations.

Discussion: With further refinement and testing, this method may be useful for distinguishing ordinal levels of work interference in surgery and helpful in raising awareness of its origin for postoperative surgical team debriefing.


  • Competing interests: None declared.