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

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.

Development of a Model for Video-Assisted Postoperative Team Debriefing

“…The OR Black Box, a video and MDR, was implemented in one OR at our tertiary referral university medical center to use it as a data-driven quality improvement initiative for multidisciplinary debriefing. 18,19 In this pilot study, 35 laparoscopic abdominal cases were recorded, analyzed, and debriefed with the entire OR team. As the patient was not the main subject of this quality improvement study, institutional review board approval was not required.…”

“…20 The study subjects were voluntarily asked to give their formal written informed consent before participation. 19,21 The OR Black Box obtained all intraoperative data feeds, including audiovisual recordings in the OR, and depersonified patient physiological data. 22 The data feed combined views of the surgical field, nursing station, laparoscopic camera, and anesthesia station, including the anesthesia patient-monitoring device.…”

“…An example of the original standardized performance report is demonstrated elsewhere. 19 The developed debrief model was used to help lead the video-assisted Black Box team debriefings. The results of the pilot study concerning the satisfaction of the team with the use of the OR Black Box for team debriefing and what was actually discussed during the team debriefings are presented in another study.…”

“…The results of the pilot study concerning the satisfaction of the team with the use of the OR Black Box for team debriefing and what was actually discussed during the team debriefings are presented in another study. 19,24 Literature search and outcomes First, problems with the currently reported debrief methods were identified by a literature review. A comprehensive search for the peer-reviewed medical literature regarding debriefing for medical teams and in other industries with and without the use of video and medical data recording in a clinical setting was performed and updated on July 17, 2019.…”

“…The results regarding the team's satisfaction with the OR Black Box are presented in another study. 19 Descriptive data, including means (standard deviation [SD]), of the questionnaire answers related to the debriefing sessions itself, are presented in this study to provide more information on the validation of the debrief model.…”