The integrated OR Efficiency and effectiveness evaluation after two years use, a pilot study

Abstract

Objectives: Technology evaluation of integrated/digital OR is needed since very little literature has been published on the subject. The integrated OR is a technological solution intended for minimally invasive surgery where the surgeons have complete control of the environment, devices and image distribution. Before such an investment, Health Technology Assessment can be used as a method to evaluate what vendors' state, i.e. the fact that the integrated OR is a very effective and efficient solution. Then a follow-up evaluation could be useful after the installation to test the users' satisfaction and give suggestions to the community about real- experienced integrated OR advantage.

Methods: A multiple answer questionnaire has been handed to 17 surgeons and 9 scrub nurses form Varese Town and University Hospital to evaluate the degree of satisfaction after 2 years of use of integrated ORs.

Results: Surgeons and scrub nurses agree that the integrated OR can be very effective in increasing quality, risk reduction and surgery time reduction through the use of digitalized video acquisition system, boom-mounted devices and multiple displays. Scrub nurses are a little bit more confident than surgeons that medical device control could reduce the confusion inside the OR and reduce the number of setting errors. A very positive judgment was given to the system's teaching capabilities, but both surgeons and scrub nurses agree that a great degree of education and a cultural change are needed to use the system in a correct and complete way.

Conclusions: Results show that there is a deep appreciation of the system which proved to be efficient (reducing surgery time and enhancing surgical quality) and effective. This is a pilot study based on few collected data, but the questionnaire could be handed to many hospitals where integrated ORs are present, in order to achieve a significant degree of assessment and find common topics to be considered fundamental especially in the evaluating phase.