Amro M Abdelrahman, MBBS1, Bethany R Lowndes, PhD, MPH1, Hunter J Hawthorne, BA1, Nibras E El-Sherif, MBBS2, M. Susan Hallbeck, PhD, PE, CPE1. 1Mayo Clinic, 2Michigan State University/Hurley Medical Center. Mayo Clinic
INTRODUCTION: Intraoperative microbreaks with exercises may address surgeon work-related musculoskeletal symptoms. Most of the surgeons (87%) in a recent multi-site study wanted microbreaks incorporated into their operating room (OR) routine. However, previous microbreaks were associated with low disruption levels. Identifying the effects of updated intraoperative microbreaks delivered through an internet application (web-app) on workload and workflow were needed. This study aimed to evaluate the impact of a web-app to guide intraoperative microbreaks with updated exercises on surgeon workload, fatigue and workflow.
METHODS: General surgeons at a tertiary medical institute consented to test the microbreaks web-app in ORs. Microbreaks are short periodic intraoperative exercises (~1 minute) aimed at counteracting strain due to surgeon’s assumed OR postures. Each surgeon chose an appropriate time interval between exercises (between 20 and 55 minutes). When the interval elapsed, an escalating alarm sounded. Surgeons could use the “snooze” feature to postpone exercises at inopportune times, or choose to perform exercises without breaking scrub. Microbreaks were tested on operative days where minimum operative duration was 1.5 hours, and the participating surgeon completed > 70% of each procedure. At the end of each surgical day, surgeons completed a survey focused on workload and microbreaks' primary and secondary outcomes. Workload questions were modified NASA Task Load Index (physical demand, mental demand, and complexity) and procedural difficulty on 0-10(10=maximum impact) scales. Primary outcomes were the impact of microbreaks on surgeons’ physical performance, mental focus, pain/discomfort and fatigue with checkboxes for improved, no change and diminished. Secondary outcomes were microbreaks impact on distraction level and workflow disruption using a 0–10(10=maximum impact) scale. Descriptive statistics were calculated for median and interquartile ranges (IQR) of these responses.
RESULTS: Seven surgeons (3 male, 4 female), with a median (IQR) surgical experience of 8 (5.5, 17) years, completed ten surgical days with a median (IQR) operative duration of 367 (283, 533) minutes/surgical day. The median number of microbreaks/surgical day was 6. The median (IQR) for mental demand, physical demand, surgical complexity and difficulty are shown in Table 1. Following each surgical day, surgeons reported 10/10 improved physical performance, 9/10 improved mental focus with one reporting no change, 10/10 improved pain/discomfort and 10/10 improved fatigue. Surgeons’ reported median (IQR) microbreaks impact was 0.5 (0, 1.75) on distraction and 1 (0, 1.5) on the OR workflow disruption.
CONCLUSIONS: Web-app microbreaks helped reduce body pain/discomfort, fatigue and improved mental focus and physical performance with minimal disruption.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88386
Program Number: P762
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster