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. 2021 Mar;35(3):1406-1419.
doi: 10.1007/s00464-020-07526-3. Epub 2020 Apr 6.

Implementing structured team debriefing using a Black Box in the operating room: surveying team satisfaction

A S H M van Dalen  1 , M Jansen  1 , M van Haperen  2 , S van Dieren  3 , C J Buskens  4 , E J M Nieveen van Dijkum  1   4 , W A Bemelman  4 , T P Grantcharov  5 , M P Schijven  6
Affiliations

Implementing structured team debriefing using a Black Box in the operating room: surveying team satisfaction

A S H M van Dalen et al. Surg Endosc. 2021 Mar.

Abstract

Background: Surgical safety may be improved using a medical data recorder (MDR) for the purpose of postoperative team debriefing. It provides the team in the operating room (OR) with the opportunity to look back upon their joint performance objectively to discuss and learn from suboptimal situations or possible adverse events. The aim of this study was to investigate the satisfaction of the OR team using an MDR, the OR Black Box®, in the OR as a tool providing output for structured team debriefing.

Methods: In this longitudinal survey study, 35 gastro-intestinal laparoscopic operations were recorded using the OR Black Box® and the output was subsequently debriefed with the operating team. Prior to study, a privacy impact assessment was conducted to ensure alignment with applicable legal and regulatory requirements. A structured debrief model and an OR Back Box® performance report was developed. A standardized survey was used to measure participant's satisfaction with the team debriefing, the debrief model used and the performance report. Factor analysis was performed to assess the questionnaire's quality and identified contributing satisfaction factors. Multivariable analysis was performed to identify variables associated with participants' opinions.

Results: In total, 81 team members of various disciplines in the OR participated, comprising 35 laparoscopic procedures. Mean satisfaction with the OR Black Box® performance report and team debriefing was high for all 3 identified independent satisfaction factors. Of all participants, 98% recommend using the OR Black Box® and the outcome report in team debriefing.

Conclusion: The use of an MDR in the OR for the purpose of team debriefing is considered to be both beneficial and important. Team debriefing using the OR Black Box® outcome report is highly recommended by 98% of team members participating.

Keywords: Black Box; Medical data recorder; Operating room; Surgical safety; Team debriefing; Training.

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Conflict of interest statement

Dr. Grantcharov holds intellectual property ownership of Surgical Safety Technologies Inc., is the founder of the OR Black Box®, and is supported by research grants from Medtronic Canada, Ethicon Canada, Baxter Canada, Olympus Canada, Takeda Canada, and Intuitive Canada. Dr. Schijven has no conflict of interest, but was supported by a research grant from Olympus the Netherlands. Dr. Schijven has recently (dec 2019) been appointed as affiliate scientist to the Li Ka Shing Knowledge Insitute of St. Michael’s Hospital, Toronto. Miss van Dalen, Drs. M. Jansen, Drs. van Haperen, Dr. van Dieren, Dr. Buskens, Dr. Nieveen van Dijkum, and Dr. Bemelman have no conflict of interest or financial ties to disclose.

Figures

Fig. 1
Fig. 1
Overview of the operating theatre including position of the ceiling-mounted cameras and OR Black Box® microphones, attached to the operating theatre monitors
Fig. 2
Fig. 2
Example of the OR Black Box® performance report, including video clip, used in the postoperative team debriefings
Fig. 3
Fig. 3
Total mean scores of the questions (Q0, Q1, Q2, Q5, Q6, Q7, Q13, Q14a, Q14b, Q15, Q16, Q17) included in factor 1 representing the team member’s attitude towards the value of team debriefing with the OR Black Box®, per role in the operating theatre
Fig. 4
Fig. 4
Total mean scores of the questions (Q2, A14b, Q19b, Q20, Q25) included in factor 2 representing satisfaction with the OR Black Box® performance report, per role in the operating theatre
Fig. 5
Fig. 5
Total mean scores of the questions (Q0, Q7, Q8, Q9, Q10, Q11, Q12, Q20) included in factor 3 representing the team member’s attitude towards benefits of team debriefing with the OR Black Box®, per role in the operating theatre
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