A technology that draws on the principles of an aeroplane’s black box is being trialled by hospitals around the globe.
The OR (operating room) Black Box system tracks activity in hospital theatres in a bid to minimise risk and boost optimum patient outcomes.
In aviation, an aeroplane’s black box is the data recorder that stores all flight information and evidences the sequence of events for investigators should an accident occur.
Made up of sensor and software, the OR Black Box’s digital system is similar insomuch as it helps to determine the cause of any adverse event in surgery.
Creator Teodor Grantcharov MD, PhD, has hailed it as a gamechanger. He said: ‘Improving surgical care requires access to high-quality data from one of the most secretive environments in modern society – the operating room.’
He came up with the idea when he observed stark difference in skills using a virtual reality simulator.
Whilst patients ‘are not aircraft’, he believes much of activity inside an operating room – the methods applied, the culture and need for high levels of safety – is transferable,
Designed to be discreet, the OR Black Box’s an autonomous system of sensors and data recorders that operates in the background and is constantly running.
It is designed not only to assess the performance of a surgeon but also evaluate the efficacy of medical devices and tracks adverse events or near misses, observing, for example, any pattern of malfunctions over time before it results in patient injury or harm.
In a study published in Annals of Surgery in 2020, Dr Grantcharov and colleagues discovered ‘extraordinarily high’ number of distractions in the operating room and these included auditory interruptions that can impact a surgeon’s ability to carry out critical steps and lead to errors.
The conclusion they drew was that: ‘During elective laparoscopic operations, frequent intraoperative errors and events, variation in surgeon’ technical skills, and a high amount of environmental distractions were identified using the OR Black Box.’
Dr Grantcharov is Professor of Surgery at Stanford University and Associate Chief Quality Officer for Innovation and Safety at Stanford Healthcare. His clinical interest is the area of minimally invasive surgery, while his academic focus is in the field of surgical innovation and patient safety.
The Stanford Hospital in California, US, is the latest to join other sites around the globe already using the OR Black Box.
Dr Grantcharov hopes the concept, which aims to transform the safety culture in medicine and introduce modern safety management systems in the high-risk operating room environment, will be adopted across the globe to capture activity during surgical procedures to improve training and promote a culture of safety.
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Photo caption: A specialised camera behind Dr Grantcharov captures video and audio data. The output has all faces blurred to de-identify patients and the surgical team. Photo by Yuri Makarov.
