Exploring Healthcare Professional Paradoxes in Eradicating Errors in the Operating Room: An Enhanced Critical Incident Technique Study

This paper addresses the critical issue of errors, which remains a significant global challenge for healthcare systems and in particular operating rooms. It explores the paradoxical forces impacting error reporting and learning within operating rooms in a public acute general hospital in Malta. Paradox theory is adopted to explain how healthcare practitioners manage contradictory forces in balancing patient safety goals with operational efficiency demands. Data was collected through employing an Enhanced Critical Incident Technique (ECIT) approach and comprised 22 interviews and 16 participant diaries, involving nurses (scrub and anaesthetic nurses) and physicians (surgeons and anaesthetists) working in the operating room. The study recognises the importance of cultivating a learning-oriented culture and sustaining a psychologically safe culture where healthcare professionals feel empowered to report errors without fear of blame or retribution, while fostering continuous improvement. Our research contributes to the growing body of research applying paradox theory in healthcare and emphasises the need for proactive strategies that balance competing priorities.