Anne van Dalen

146 I Chapter 4 Challenging patient management Clinicians express difficulty in managing the patient throughout the case (Ex. airway) Challenging anatomy Physical/anatomical characteristics of the patient that may exacerbate the difficulty of a task (potentially unknown to team until surgery is underway) Disruptions Unnecessary verbal interruption Communication delivered to an operating surgeon/working clinician (inappropriate timing); engaging a preoccupied clinician in an unnecessary discussion Other case interruption Another case requires attention of clinical team, draws attention away from present case (Ex. Clinician must leave to attend another OR); Clinicians discuss details of another patient TOOLS AND TECHNOLOGY Sub-category Code Description Lack of Familiarity Unfamiliar configuration/setup Tool/instrument/techconfigured inawaythatisunusual/unfamiliar to user Unfamiliar tool Cliniciansareusingatool/ instrument/equipmentthatis differentfrom their usual tool/is new/isunfamiliar Substandard Functionality/ Utility Malfunction Unanticipated malfunction/failure of tool/equipment during use (Ex. stapler, grasper, camera, monitor) Assembly failure A multi-part tool/instrument comes apart while in use