Human Factors Analysis of Vendor-Induced Flow Disruptions in Orthopedic Surgery: Implications for Workflow Integration and System Safety.

OCCUPATIONAL APPLICATIONThis study found that vendors were involved in nearly one-third of all observed flow disruptions during orthopedic surgery, with a disproportionate share linked to coordination issues and protocol failures, including breaches of the sterile field. While vendors provide critical technical expertise on equipment and implants, their involvement can unintentionally blur role boundaries and disrupt team coordination in high-stakes environments. For ergonomics and human factors practitioners, these findings underscore the importance of designing systems that support clearer role delineation, structured integration of non-clinical participants, and improved communication protocols in surgical teams. Practical applications include developing vendor orientation programs, establishing explicit boundaries on clinical versus technical responsibilities, and training OR staff to effectively leverage vendor expertise without over-reliance. Addressing these challenges can improve team resilience, reduce safety risks, and optimize workflow efficiency in surgical and other complex, multidisciplinary work settings.