Human factors and anastomotic decision making
Surgeons’ personalities influence anastomotic decision making!
Related paper: The colorectal surgeon’s personality may influence the rectal anastomotic decision
An ACPGBI (Association of Coloproctologists of Great Britain and Ireland) Delphi Consensus group demonstrated that surgeons were less likely to make an anastomosis in the following situations:
- The surgeon had recently received criticism at a departmental audit meeting
- The anaesthetist was not their usual anaesthetist
- There were no anastomotic leaks in the surgeon’s patients for over one year
These ‘human factors’ could bring unwanted variation into clinical practice, encouraging risk-promoting or risk-averse practices to the detriment of our patients.
By involving the multidisciplinary theatre team in anastomotic decision making, the ESCP Safe-anastomosis checklist aims to share decision-making responsibility with other key care providers, improve situational awareness and allow objective reassessment of preoperative risk and any intra-operative events that may influence a surgeon’s decision.
However, the ultimate decision will always lie with the surgeon.