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Archive ORX Session Previews 2020

Tap Into Technology to Improve Patient Safety

What if your OR had a data recorder similar to those installed in planes — the “Black Box” — that would provide a record of what happens during surgeries in the interest of refining a team’s performance and improving patient safety? General surgeon Teodor Grantcharov, MD, PhD, FACS, had that very idea, and created a cutting-edge medical data recorder called the OR Black Box. The platform captures comprehensive data parameters from multiple sensors to provide surgical leaders with unprecedented insights about how their ORs are run. Dr. Grantcharov will discuss how data-driven decisions can improve the way surgical teams operate and protect patients from harm.

What is the purpose of the OR Black Box?
The current model involves analyzing complications to determine what happened and make improvements. The Black Box provides very deep insights that allow surgical facilities to be proactive rather than reactive, and leverage data to prevent future mishaps and difficulties. It identifies common deviations from the perfect course of an operation, especially if there is a pattern. By recognizing those, you can make adjustments before a patient is harmed. We want to replace current practices based on tradition, emotions or gut feelings, and give leaders the info they need to make data-driven decisions.

Teodor Grantcharov, MD, PhD, FACS
Teodor Grantcharov, MD, PhD, FACS
  • Staff surgeon at St. Michael's Hospital and a Professor of Surgery at the University of Toronto
  • Completed his general surgery residency at the University of Copenhagen, and a doctoral degree in Medical Sciences at the University of Aarhus in Denmark
  • Internationally recognized as a leader in surgical education, patient safety and the impact of surgical performance on clinical outcomes

What kinds of data and analysis are captured?
We focus on system factors like communication, teamwork, safety processes, the physical environment and technology — things traditionally assembled retrospectively based on recall, or using human observers. The patient's identity, as well as those of everyone else in the room and the facility itself, is anonymized. The information generated by analysis of the captured data can be used for educational and process improvement purposes.

Do you experience any pushback against this idea?
Surgical professionals aren't used to this level of transparency. We have to convince them that the information gathered makes their ORs safer and more efficient. We're looking for facilities that have a commitment to improve quality and safety in a confidential and non-punitive fashion, as opposed to facilities where every failure has to be associated with blame and shame, or identifying individuals rather than system issues.

What about patient and staff consent, and malpractice exposure?
If the system is used for quality intervention instead of research, there's no need for anyone's consent. Facility leaders who want to improve how their facilities are run simply need access to data. With that in mind, all the data generated by the Black Box is anonymized, analyzed and then destroyed. It's very challenging to be accessed for litigation purposes, just because we don't keep it for that long and there are existing legal protections when the data is used for quality improvement. OSM

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