团队合作
患者安全
对接(动物)
病人护理
医学
机器人
机械人手术
过程(计算)
计算机科学
外科
医学物理学
医疗急救
风险分析(工程)
模拟
医疗保健
人工智能
护理部
操作系统
经济增长
经济
法学
政治学
作者
Lucy Cofran,Tara N. Cohen,Myrtede Alfred,Falisha Kanji,Eunice Choi,Stephen J. Savage,Jennifer T. Anger,Ken Catchpole
标识
DOI:10.1007/s00464-020-08258-0
摘要
The introduction of new technology into the operating room (OR) can be beneficial for patients, but can also create new problems and complexities for physicians and staff. The observation of flow disruptions (FDs)-small deviations from the optimal course of care-can be used to understand how systems problems manifest. Prior studies showed that the docking process in robotic assisted surgery (RAS), which requires careful management of process, people, technology and working environment, might be a particularly challenging part of the operation. We sought to explore variation across multiple clinical sites and procedures; and to examine the sources of those disruptions.Trained observers recorded FDs during 45 procedures across multiple specialties at three different hospitals. The rate of FDs was compared across surgical phases, sites, and types of procedure. A work-system flow of the RAS docking procedure was used to determine which steps were most disrupted.The docking process was significantly more disrupted than other procedural phases, with no effect of hospital site, and a potential interaction with procedure type. Particular challenges were encountered in room organization, retrieval of supplies, positioning the patient, and maneuvering the robot.Direct observation of surgical procedures can help to identify approaches to improve the design of technology and procedures, the training of staff, and configuration of the OR environment, with the eventual goal of improving safety, efficiency and teamwork in high technology surgery.
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