Preliminary results highlight that intraoperative safety is influenced by a dynamic interplay between human, technological, and environmental factors. Common safety threats identified include communication breakdowns, workflow interruptions, and equipment availability issues, while key resilience supports involve anticipatory communication, team coordination, and the proactive use of safety technologies (such as radiofrequency sponge detection wands).

Cross-site comparisons reveal that certain institutional practices and technologies effectively mitigate recurring threats. Interviews underscore the importance of local culture and team dynamics in shaping resilience behaviors. Together, these findings suggest that enhancing intraoperative safety requires not only minimizing system vulnerabilities but also actively strengthening the adaptive capacities of surgical teams.