What are the behavioral categories that support perioperative staff adaptability and resilience to deliver individual and team-based safe care in the perioperative environment?
This qualitative thematic analysis of self-reported proactive safety behaviors included a convenience sample of perioperative staff from a tertiary care academic medical center who participated in a facilitated activity during a 6-month period in 2021. A total of 147 unique behaviors were identified, which were categorized into 8 non–mutually exclusive themes.
This qualitative study uses thematic analysis to describe clinician perspectives on proactive safety behaviors in the perioperative environment at a US tertiary care center.
The perioperative environment is hazardous, but patients remain safe with a successful outcome during their care due to staff adaptability and resiliency. The behaviors that support this adaptability and resilience have yet to be defined or analyzed. One Safe Act (OSA), a tool and activity developed to capture self-reported proactive safety behaviors that staff use in their daily practice to promote individual and team-based safe patient care, may allow for improved definition and analysis of these behaviors.
To thematically analyze staff behaviors using OSA to understand what may serve as the basis for proactive safety in the perioperative environment.
This qualitative thematic analysis included a convenience sample of perioperative staff at a single-center, tertiary care academic medical center who participated in an OSA activity during a 6-month period in 2021. All perioperative staff were eligible for inclusion. A combined deductive approach, based on a human factor analysis and classification framework, as well as an inductive approach was used to develop themes and analyze the self-reported staff safety behaviors.
Those selected to participate were asked to join an OSA activity, which was conducted in-person by a facilitator. Participants were to self-reflect about their OSA (proactive safety behavior) and record their experience as free text in an online survey tool.
The primary outcome was the development and application of a set of themes to describe proactive safety behaviors in the perioperative environment.
A total of 140 participants (33 nurses [23.6%] and 18 trainee physicians [12.9%]), which represented 21.3% of the 657 total perioperative department full-time staff, described 147 behaviors. A total of 8 non–mutually exclusive themes emerged with the following categories and frequency of behaviors: (1) routine-based adaptations (46 responses [31%]); (2) resource availability and assessment adaptations (31 responses [21%]); (3) communication and coordination adaptation (23 responses [16%]); (4) environmental ergonomics adaptation (17 responses [12%]); (5) situational awareness adaptation (12 responses [8%]); (6) personal or team readiness adaptation (8 responses [5%]); (7) education adaptation (5 responses [3%]); and (8) social awareness adaptation (5 responses [3%]).
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