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.