SynthesisSurgical endoscopy2025
Impact of environmental factors on operative team performance: systematic review and guidance for optimising clinical practice.
Synthesis in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the range and impact of environmental factors on the operative performance of surgical teams.
backgroundOptimising surgical performance is critical for patient safety and clinical efficiency. Recent efforts have focussed on both individual (e.g. stress-management, situation awareness) and team (e.g. communication, leadership) factors. However, the influence of environmental conditions within the operating room remains underexplored.
methodsA systematic review was conducted using EMBASE, Medline, PubMed, and CENTRAL for studies examining the impact of lighting, temperature, humidity, noise, and music on the performance of surgical teams, following PRISMA criteria. Outcomes assessed include operative skills, cognitive workload, and patient outcomes that may be a proxy for operative performance.
resultsOf 9489 articles screened, 34 met inclusion criteria (n = 4159 participants). Fourteen studies assessed the impact of noise, eight of music, six of temperature, four of noise and music together, and two of lighting. No studies on humidity met the inclusion criteria. Noise regularly exceeded recommended standards and was associated with increased mental workload and incidence of complications. Although music increased decibels, it was viewed positively by participants, despite not objectively enhancing performance. Increased temperature was associated with less comfort, but not reduced technical or cognitive performance. Increased illumination reduced tiredness in some participants.
conclusionNoise consistently exceeds recommended thresholds, is linked to increased cognitive load, and has been associated with complications. In contrast, temperature is individual-specific and may require compromise between team members. There is very limited research on lighting and humidity, and more investigation is warranted before conclusions can be made on these factors. Surgeons should consider modifiable environmental factors as part of a systems approach to optimising operative performance, patient safety, and staff-wellbeing.
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