Editorial Views  |   January 2018
Vigilance Research and Just Culture Principles: Challenges for a Connected Perioperative World
Author Notes
  • From the Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, New York.
  • Corresponding article on page 44.
    Corresponding article on page 44.×
  • Accepted for publication August 28, 2017.
    Accepted for publication August 28, 2017.×
  • Address correspondence to Dr. Reich: david.reich@mountsinai.org
Article Information
Editorial Views / Patient Safety
Editorial Views   |   January 2018
Vigilance Research and Just Culture Principles: Challenges for a Connected Perioperative World
Anesthesiology 1 2018, Vol.128, 6-7. doi:10.1097/ALN.0000000000001960
Anesthesiology 1 2018, Vol.128, 6-7. doi:10.1097/ALN.0000000000001960
THE publication by Jason M. Slagle et al.1  in this issue of Anesthesiology is a behavioral analysis of tasks and workload in an operating room (OR) environment at a single academic medical center. The scientific investigation continues the seminal investigations by the senior author, Matthew Weinger, which began at another institution. The “nature and incidence of potentially distracting non–patient care activities during anesthesia care” were observed and categorized during a data collection period (2007 to 2009) with ubiquitous OR computer workstations with internet access but that pre-dated the era of smartphones. The authors found that self-initiated distractions were very common (54% of cases). These occurred mainly during maintenance of anesthesia, accounted for only 2% of case time, and were short in duration (median 2.3 s). Personal internet use was the most common distraction. A concerning finding was that 3.4% of cases where distractions were observed were temporally associated with nonroutine events, but the authors judged these not to be causal. The authors concluded that clinicians’ judgment in managing distractions was not associated with an increased risk of adverse events. Similarly, another investigation reported that use of the OR computer workstation for purposes other than electronic anesthesia recordkeeping activities was not associated with hemodynamic aberrations.2 
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