‘Hurry up’ syndrome harms surgical patients and staff

‘Hurry up’ syndrome in aviation, defined as any situation where a pilot's human performance is degraded by a perceived or actual need to hurry or rush tasks,¹ is a well-described, and often-preventable, contributor to aviation safety incidents.² In a notable study of ‘hurry-up’ errors in aviation by McElhatton and Drew using National Aeronautics and Space Administration (NASA) data, high workload (e.g., time compression due to delay, high-workload flight phase) produced the error in 80% of cases, physical or motivational predisposition to hurry in 73.6%, delay (e.g., due to aircraft maintenance or air traffic control clearance) in 55%, and social pressures (e.g., from gate agent/ground crew, peers or supervisors) in 38.4%.^1-3 Notably, it was concluded within the study that no single human behaviour is markedly more likely to result in a ‘hurry-up’ error than another, and that, crew resource management, which describes cockpit teamwork, interpersonal communication, leadership, and decision-making procedures,⁴ can prevent and reduce the occurrence of these errors. When comparing the airline industry and the operating theatre, it is important to consider two distinct differences: air travel is not rationed, and the airline industry has alarms when actions are too slow or incorrect. If work is conducted too slow in the health system, a significant number of people get no care at all, and a perfect operation done quickly is better than a perfect operation done slowly. However, parallels between ‘hurry up’ syndrome, and resultant adverse events, in the aviation industry and the surgical systems of care can still be drawn. However, despite this being intuitive, the phenomenon is not well-identified, or well-studied, within intraoperative or perioperative settings. Accordingly, likely-preventable errors and adverse events could be harming patient outcomes, in addition to the wellbeing of surgical staff.