A simulation approach for human reliability analysis in an orthopaedic operating room

Surgical context is characterized by a strong human component with low probability of human error occurrence but high consequences. A human operator can make a mistake that has both a social implication, from the point of view of patient's safety, and economic, from the point of view of the costs incurred. For these reason, the last few years have seen growing interest in a wider range of human reliability techniques used in other industries applied in healthcare environments. In this study, the Simulator for Human Error Probability Analysis (SHERPA) has been applied for modelling and simulating the activities performed by a surgical team during the reconstruction of the Achilles tendon following rupture. The proposed simulation approach provides for the evaluation of the human reliability on the result of an orthopaedic procedure, in terms of errors committed and time taken to perform it. This simulation approach has been verified and validated through a statistical analysis, which showed its applicability to real scenarios for the improvement of the orthopaedic operating team's performance.