Human reliability analysis: a new method to quantify errors in cataract surgery

Abstract

To describe the application of human reliability analysis (HRA) as a tool to quantify errors that occur during small incision cataract surgery. Sixteen consecutive phacoemulsifications performed by one surgeon were assessed using HRA. Although there were no complications or adverse outcomes associated with any of the operations, 84 errors, which could potentially have caused a complication were noted. The commonest single error was difficulty in 'cracking' the nucleus. HRA attempts to recognise all errors that occur during a procedure rather than just the ones that result in a complication. As such it is a sensitive and prospective method of assessment of surgical performance. It would appear to be of value in the training and assessment of cataract surgery.