Anne van Dalen

4 Analyzing and discussing human factors affecting surgical patient safety I 151 No cover when absent Extra personnel are not called upon/are not available to cover/ complete/supporttherequired tasksofateammemberwhen absent from theOR Failure to standardize Failure to standardize safety/ efficiency enhancing behaviour/ procedure/protocol Ineffective Staff Management Staff change Nursing/anaesthesia/surgery shift change/new clinician joining team while case is in progress Staffing communication failure Staffing issues/changes are inadequately communicated to OR team Traffic High traffic in the OR, personnel entering/exiting excessively Inadequate Provision of Training Inadequate training provided Lack of organizational provision of training to clinical staff EXTERNAL ENVIRONMENT Sub-category Code Description Latent External Threats Budget constraint Hospital budget constraints result in unavailability of preferred tools/ resources Regulatory process Regulatory process is delaying the procurement of required/desired equipment/instrumentation