A Qualitative Study of Factors Contributing to Medical Errors in Cardiac Surgery: Perspectives of Iranian Specialists

Abstract

Background: Medical errors in cardiac surgery remain a major challenge for patient safety. These errors often arise from the interaction of individual fatigue, team communication problems, and organizational constraints. Exploring these factors qualitatively provides a deeper understanding for designing effective interventions. Objectives: The primary objective of this study is to identify and analyze the underlying factors of medical errors in cardiac surgery and to propose practical solutions for their reduction. Methods: This qualitative study was conducted in cardiac surgery departments of selected hospitals in Iran between March and September 2025. Semi-structured interviews were performed with cardiac surgeons only. Data were analyzed using thematic analysis, resulting in four main themes: individual factors, team-related factors, organizational factors, and consequences and solutions. A circular conceptual model was developed to illustrate the dynamic relationships among these domains. Results: Errors were found to be embedded within team dynamics and organizational structures rather than being solely individual. Participants emphasized fatigue, communication gaps, and restrictive policies as key contributors. The conceptual model demonstrated how these domains converge toward consequences and solutions, highlighting the systemic nature of medical errors. Conclusions: Preventing errors in cardiac surgery requires a multidimensional approach that integrates personal training, team communication, and organizational reforms. Sustainable improvement depends on systemic and cultural transformation within hospitals.