Healthcare professionals’ perception of safety culture and the Operating Room (OR) Black Box technology before clinical implementation: a cross-sectional survey

Abstract

IntroductionComprehensive data capture systems such as the Operating Room Black Box (OR Black Box) are becoming more widely implemented to access quality data in the complex environment of the OR. Prior to installing an OR Black Box, we assessed perceptions on safety attitudes, impostor phenomenon and privacy concerns around digital information sharing among healthcare professionals in the OR. A parallel survey was conducted in Canada, hence, this study also discusses cultural and international differences when implementing new technology in healthcare.MethodsA cross-sectional survey using three previously validated questionnaires (Safety Attitudes Questionnaire (SAQ), Clance Impostor Phenomenon Scale, Dispositional Privacy Concern) was distributed through Research Electronic Data Capture to 145 healthcare professionals from the OR (July to December 2019). Analysis of variance and analysis of covariance were used to test for differences.Results124 responded (86%): 100 completed the survey (69%) (38 nurses, 10 anaesthesiologists, 36 obstetricians/gynaecologists, 16 residents). Significant variability in all six SAQ domains, safety climate and teamwork being the lowest ranked and job satisfaction ranked highest for all groups. The SAQ varied in all domains in Canada. Moderate to frequent impostor phenomenon was experienced by 71% predominantly among residents (p=0.003). 72% in the Canadian study. Residents were most comfortable with digital information sharing (p<0.001), only 13% of all healthcare professionals were concerned/heavy concerned compared with 45% in Canada.ConclusionsThe different healthcare professional groups had diverse perceptions about safety culture, but were mainly concerned about safety climate and teamwork in the OR. Impostor phenomenon decreased with age. All groups were unconcerned about digital information sharing. The Canadian study had similar findings in terms of impostor phenomenon, but a variety within the SAQ and were more concerned about data safety, which could be due to medical litigation per se and is not widespread in Scandinavia compared with North America.

Learning from experience: a qualitative study of surgeons’ perspectives on reporting and dealing with serious adverse events

“…Up to 50% of perioperative adverse events are considered preventable, which makes the occurrence of adverse events a systemic issue. [32][33][34][35][36][37] Implementation of incident reporting systems with feedback loops to the hospital institutions and bodies responsible for external inspection or accreditation of the healthcare services is reckoned a key effort to reduce the number of adverse events, and this is mandatory in Norwegian hospitals. Health professionals are expected to report adverse events through these systems, and managers are required to do comprehensive follow-up analysis to reveal potential embedded risks and thereby contribute to prevent similar events.…”

“…Several studies have demonstrated that adverse events rates among hospitalised patients remain high despite significant efforts to improve quality and safety. Up to 50% of perioperative adverse events are considered preventable, which makes the occurrence of adverse events a systemic issue 32–37. Implementation of incident reporting systems with feedback loops to the hospital institutions and bodies responsible for external inspection or accreditation of the healthcare services is reckoned a key effort to reduce the number of adverse events, and this is mandatory in Norwegian hospitals.…”

Enhancing surgical performance in cardiothoracic surgery with innovations from computer vision and artificial intelligence: a narrative review

“…Installing cameras to monitor operations is becoming more commonplace with the use of ‘operating room black boxes’, but it is possible that such initiatives could result in resistance. In a cross-sectional survey of Danish healthcare professionals [ 88 ], on average, opinions toward using a black box were neutral or positive, with little concern over data safety. Conversely, in a similar study conducted in Canada [ 89 ], there were more significant concerns over data safety and the potential for litigation, highlighting the importance of considering any concerns within a societal, cultural and legislative context.…”

Operating room black box: GIMMICK or a patient safety tool?

“…The Operating Room Black Box (ORBB) allows direct observation and continuous recording of the intraoperative technical as well as non-technical data; this allows a detailed analysis of efficiency, safety and adverse events. 1 It also acts as a teaching tool in surgical training as it may be used to provide feedback to trainees. Surgeons, thereby increasing transparency in the operating room and improving patient safety.…”