An integrated OSH risk management approach to surgical flow disruptions in operating rooms

Surgical flow disruptions (SFDs) are the deviations from the natural progression of an operation in the operating rooms (ORs). Some tools and methodologies have been proposed in the literature for the systematic assessment of the SFDs especially for the cardiac surgeries. However, they lack a clear connection with the Occupational Safety and Health (OSH) risks for the surgical team and the risks for the patient safety. In this paper, an integrated OSH risk management methodology adapted from International Labor Office (ILO) approach is proposed to account for the SFDs, surgical flow disruption effects (SFDEs), and the OSH risks by using the fuzzy cognitive mapping (FCM) as a tool for the risk prioritization. To the best of our knowledge, this is the first paper which proposes an integrated OSH risk management methodology in the surgical environments by using the FCM that incorporates the SFDs and other factors such that the critical SFDs and the critical OSH risks can be identified. Then, the respective preventive and protective measures (PPMs) can be put into effect for eliminating, controlling or minimizing the OSH risks for a safe OR environment for both the surgical team and the patient. The methodology is not limited to the surgical environments or the healthcare industry; rather, it can be adapted to different work environments for an integrated OSH risk management. The methodology has been illustrated by using the hypothetical data, the limitations and the improvement potentials of the methodology have also been discussed in detail for further research.