Good logistics prevents crisis

A few weeks ago I observed 5 surgeries in the operating room. I had never been present at surgeries from start to end so this was an exciting experience for me. In the weeks before I had observed outpatient and nursing departments and I had been in the Operating Room Complex a lot, but being inside the OR made me realize that this is where everything comes together and, most importantly, it has to come together. There is little time for improvisation and a lot is at stake.

The atmosphere in the OR appeared both calm and tense to me. People seem to know when to keep silent, when concentration is required, but at times they were discussing their last holiday, at times when the surgery went smoothly or not everyone was constantly involved in the surgery. Intense concentration and waiting alternate.

There were some logistical issues, but nothing major for as far as I could see: for the large part the materials were there, the patient was there, the surgeon, the anesthesist, the OR assistants, anesthesist assistant, the equipment was working – except for one monitor who apparently failed but did not seem to be too critical. Still it was clear to me that everyone in the room was very aware of what might be required or happen, there seemed to be a collective concentration. In some surgeries there were some disturbances of concentration – the failing monitor, an anesthesist that had to come but who was busy in another OR room or a phone call to the surgeon about another patient. It was clear that these disturbances, although they appeared common, were enough to make people agitated for a moment. I found the atmosphere tense at times. I could be because of the ‘my first surgery’ experience, but I think surgery could be seen as the climax to which the entire supply chain is working towards, and that a certain tension will always be involved.  From this observation it became very obvious to me that in order to be able to do surgeries in a safe and effective way, the logistics has to be arranged very, very well. Otherwise the tension will easily go through the roof.

Some weeks after this, I had a logistics crisis of my own. Last week, when going to Greece for a family holiday we missed our plane. It turned out we were on the wrong Dusseldorf airport, where we discovered our mistake at the very moment we stepped into the airport building. From the moment we discovered this, we had one goal: to get to the right airport as soon as possible. That failed. Then, trying not to think about what a gigantic and stupid error we made, we had to find a way to save our trip. About 2 hours of enormous stress followed in which we tried to find another flight (googling on our phone), talk to the airport people (who apparently did not have the same flight options as our iphone) and try to comfort the children who were sad and shocked that this could even happen.

Later, when we reached our destination Athens – two days later and via Milan – I realized what working towards an event that has to go right the first time really means. Catching a flight and doing a surgery have to be prepared perfectly, there is only one time to do it right and there is extreme stress when something fails. It is easy to miss certain information, if you combine data in the wrong way (as we did), especially when you are distracted (as we were in the days before our flight due to work and other things on our mind). For surgeries this is even more crucial because someones health is at stake.


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