Study: Surgeons make significantly more mistakes when under stress

NEW YORK — Surgeons under stress are far more likely to make mistakes on patients in the operating room, even if the stress is caused by a trivial source and lasts briefly, a Columbia University study finds.

The research shows that all it takes is a negative thought or a loud noise in the room to trigger moments of short-term stress for doctors, according to lead author Peter Dupont Grantcharov, a master’s student at the Data Science Institute at Columbia.

For the study, Grantcharov had Dr. Homero Rivas, Associate Professor of Surgery at Stanford Medical Center, wear a high-tech “smart shirt” under his scrubs during 25 surgical procedures, most of which were gastric bypasses. The innovative shirt monitored electrical impulses from the doctor’s heart and recorded the variation in times between heartbeats, which indicated when he was experiencing heightened stress.

At the same time, another researcher documented any mistakes the surgeon made during each procedure and the exact time of each error. Grantcharov was alarmed to find that various moments of stress led to a higher likelihood of making a mistake by as much as 66 percent.

“I was surprised by that, as well as by the amount of distractions in the operating room,” says Grantcharov in a Columbia media release. “Many machines have alarms that go off periodically, equipment malfunctions, side conversations take place, people walk in and out of the OR – I could go on. My hope is that other researchers will build upon our work to make further strides in learning about the causes of stress on surgical personnel. If our study helps make the OR a safer place for patients, I’d be thrilled.”

The study, which was published September 27, 2018 in the open access journal BJS Open, could lead to new standards for operating rooms that would curb any potential disturbances and reduce stress for surgeons. Medical errors cause between 250,000 and 400,000 deaths annually in the U.S., with many of those occurring in the operating room.

“Personally, I feel we took a great leap in developing sound methods in studying the relationship between stress and surgical performance. That the actual results were so revelatory was a bonus for an exploratory study like this,” says Grantcharov. “It’s important to note that we did not study the potential stressors that could have affected the surgeon’s stress level and ultimately his performance, we solely focused on the association between the observed stress levels and surgical performance.”