5. Discussion
The expert team applied this new synergistic methodological approach to
ergonomic research in surgery during the analysis of surgeons activities
from vascular, orthopedic, and neurosurgical clinics of the Clinical
Center in Nis, in cooperation with experts in ergonomics, computer
engineering, and safety.
Experts from different fields of research compare factors for activity
analysis with more precision when using linguistic variables. Fuzzy
numbers allow describing particular linguistic variables using a set of
values from a certain range. Group decision-making reduces the
subjectivity of the decisions of individual experts. A selection of
appropriate experts (information processing, ergonomics, safety, and
medicine) allows better problem assessment.
Based on the results of final ranking, shown in Table 6, the following
can be concluded: the highest ranked group of factors is “Operating
room properties” (O), followed by “Non-technical skills” (N) and
“Surgeons’ capabilities” (S). Among the factors, the highest ranked
factors belong to groups Operating room properties (O) and Non-technical
skills (N). Among them, the most important are: Tool handle design,
Indoor environment standardization, and Communication. The experts
emphasized the importance of effective communication and coordination of
activities during the surgical operations, helping surgeons during
effective performing of tasks, activity coordination, and performing
activities during adverse events in the OR.
In the ORs, surgeons use different operating tools, mechanical or
special devices. Their physical properties (dimensions, tool handle
shape) and vibrations affect surgeons working activities, define steps
and outcomes of surgical procedures, and determine the rate at which
surgeons get tired in the ORs. The operating tool ergonomics and
user-friendliness increase work comfort and reduce the probability of
errors. They can also affect the surgeons’ performance improvement.
Indoor environment quality, simply described by adequate air supply and
optimal temperature, defines acceptable operating conditions and reduces
likelihood of adverse events in the OR due to the lack of fresh air and
increased room temperature.
The significance of the research of ergonomic aspects in surgical
activities consists of the definition of approach describing the
improvement of surgeons’ capabilities. It also leads to improvement of
surgeons’ non-technical skills, more humane OR design, quantification of
communication efficiency, and overall OR team work efficiency.