Surgical team’ sustainable employability in minimally invasive surgery

Abstract

Technological developments in the medical world introduce a shift in responsibilities of the surgical team members which might result in waste of talent and skills. The latter might result in disengagement and decreased productivity and thus in illness-related absenteeism. The people pillar of sustainability aims to create a healthy workplace and thus to manage illness-related absenteeism. The objective of this research was to optimise the responsibilities of the surgical team members in minimally invasive surgery (MIS) in order to achieve a balanced and sustainable employability of the surgical team to counteract waste of talent and skills. Empirical data was collected in two different steps. In the first place, an overview of the surgical phases during the MIS procedure and an overview of the tasks performed by the perioperative nurses were made. In the second place, two different methods were used to obtain data. First, seven video recordings of a laparoscopic gynaecological procedure were analysed to obtain the distribution of the responsibilities and the percentage of (technical) tasks for each phase and the entire MIS procedure. Second, interviews with fourteen perioperative nurses were conducted to map the peak moments of a MIS procedure and to evaluate the impact of the technological developments on the nurse's workload. As a result, a fluctuation of the total duration of all tasks during the procedure was shown. A percentage higher than 70% was measured in the start phase. The perioperative nurses experienced low peak moments during 66% of the entire surgical procedure. A high impact of the technological developments was experienced by the nurses. The physical activity for MIS and robot-assisted surgery (RAS) was lower than a conventional open procedure (OS). The total duration of the technical tasks was highest in the second phase of the MIS procedure. The nurses indicated that this phase took longer compared to the same phase in OS procedures because of the amount of equipment that has to be connected. In conclusion, an unbalanced employability was recognised during MIS and technological developments had a high impact on the activities of the perioperative nurses. This research has several recommendations. First, a more sustainable employability will be achieved when two perioperative nurses will be scheduled for three surgical procedures during 66% of the MIS procedure. Second, deployment of a technical perioperative nurse will decrease the amount of workload. Last, by giving the perioperative nurses more responsibilities in MIS, the talent and skills will not be wasted leading to a more balanced employability of the surgical team members.