학술논문
Remote Assessment of Real-World Surgical Safety Checklist Performance Using the OR Black Box: A Multi-Institutional Evaluation.
Document Type
Academic Journal
Author
Riley MS; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Department of Surgery, Brigham and Women's Hospital, Boston, MA (Riley, Etheridge, Kaelberer, Smink, Brindle, Molina).; Etheridge J; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Department of Surgery, Brigham and Women's Hospital, Boston, MA (Riley, Etheridge, Kaelberer, Smink, Brindle, Molina).; Palter V; International Centre for Surgical Safety, St Michael's Hospital, University of Toronto, Toronto, ON, Canada (Palter).; Zeh H 3rd; Department of Surgery, UT Southwestern Medical Center, Dallas, TX (Zeh).; Grantcharov T; Department of Surgery, Clinical Excellence Research Centre, Stanford University, Stanford, CA (Grantcharov).; Kaelberer Z; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Department of Surgery, Brigham and Women's Hospital, Boston, MA (Riley, Etheridge, Kaelberer, Smink, Brindle, Molina).; Sonnay Y; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Smink DS; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Department of Surgery, Brigham and Women's Hospital, Boston, MA (Riley, Etheridge, Kaelberer, Smink, Brindle, Molina).; Brindle ME; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Department of Surgery, Brigham and Women's Hospital, Boston, MA (Riley, Etheridge, Kaelberer, Smink, Brindle, Molina).; Molina G; From the Ariadne Labs, Brigham and Women's Hospital, Harvard T.H. Chan School of Public Health, Boston, MA (Riley, Etheridge, Kaelberer, Sonnay, Smink, Brindle, Molina).; Department of Surgery, Brigham and Women's Hospital, Boston, MA (Riley, Etheridge, Kaelberer, Smink, Brindle, Molina).
Source
Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 9431305 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1190 (Electronic) Linking ISSN: 10727515 NLM ISO Abbreviation: J Am Coll Surg Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Large-scale evaluation of surgical safety checklist performance has been limited by the need for direct observation. The operating room (OR) Black Box is a multichannel surgical data capture platform that may allow for the holistic evaluation of checklist performance at scale.
Study Design: In this retrospective cohort study, data from 7 North American academic medical centers using the OR Black Box were collected between August 2020 and January 2022. All cases captured during this period were analyzed. Measures of checklist compliance, team engagement, and quality of checklist content review were investigated.
Results: Data from 7,243 surgical procedures were evaluated. A time-out was performed during most surgical procedures (98.4%, n = 7,127), whereas a debrief was performed during 62.3% (n = 4,510) of procedures. The mean percentage of OR staff who paused and participated during the time-out and debrief was 75.5% (SD 25.1%) and 54.6% (SD 36.4%), respectively. A team introduction (performed 42.6% of the time) was associated with more prompts completed (31.3% vs 18.7%, p < 0.001), a higher engagement score (0.90 vs 0.86, p < 0.001), and a higher percentage of team members who ceased other activities (80.3% vs 72%, p < 0.001) during the time-out.
Conclusions: Remote assessment using OR Black Box data provides useful insight into surgical safety checklist performance. Many items included in the time-out and debrief were not routinely discussed. Completion of a team introduction was associated with improved time-out performance. There is potential to use OR Black Box metrics to improve intraoperative process measures.
(Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)
Study Design: In this retrospective cohort study, data from 7 North American academic medical centers using the OR Black Box were collected between August 2020 and January 2022. All cases captured during this period were analyzed. Measures of checklist compliance, team engagement, and quality of checklist content review were investigated.
Results: Data from 7,243 surgical procedures were evaluated. A time-out was performed during most surgical procedures (98.4%, n = 7,127), whereas a debrief was performed during 62.3% (n = 4,510) of procedures. The mean percentage of OR staff who paused and participated during the time-out and debrief was 75.5% (SD 25.1%) and 54.6% (SD 36.4%), respectively. A team introduction (performed 42.6% of the time) was associated with more prompts completed (31.3% vs 18.7%, p < 0.001), a higher engagement score (0.90 vs 0.86, p < 0.001), and a higher percentage of team members who ceased other activities (80.3% vs 72%, p < 0.001) during the time-out.
Conclusions: Remote assessment using OR Black Box data provides useful insight into surgical safety checklist performance. Many items included in the time-out and debrief were not routinely discussed. Completion of a team introduction was associated with improved time-out performance. There is potential to use OR Black Box metrics to improve intraoperative process measures.
(Copyright © 2023 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.)