Abstract
Introduction Surgical departments are discredited as guardians of traditional structures of hierarchy.
Hierarchy and working climate have a large share in human factor, being made responsible
for 70% of avoidable errors in medicine. Aim of this study was the assessment of these
topics amongst physicians in the field of orthopedics and traumatology.
Material and Methods A questionnaire of 10 questions was digitally handed to DGOU members. 799 questionnaires
were answered.
Results We found significant differences in the assessment of hierarchy and working atmosphere
amongst the physician groups. Working atmosphere was perceived as not appreciative
by registrars only. All groups were in favor of a hierarchy rather close to, but nut
absolutely on equal terms. All groups attach high influence of working atmosphere
on quality of daily work.
Discussion Literature shows that hierarchic differentiation can increase performance of a team,
while rigid hierarchy structures can lead to mistakes. Although hierarchy in orthopedics
and traumatology seems to be less pronounced than assumed, hierarchy has great influence
on daily work.
Conclusion In order to achieve a safety oriented medical environment, it will be of great importance
to define hierarchy structures in clinics and to utilize them efficiently as a part
of safety culture.
Key words hierarchy - working atmosphere - human factor - safety culture - error culture
