A novel Surgical Suite Management Technology including Automatic Surgery Steps Tracking and a Large Collaborative and Informative Display

Juliette Rambourg, Guillaume Joerger, Brian J Dunkin, MD, FACS, Marc Garbey, PhD. Houston Methodist Hospital

INTRODUCTION

Operating room (OR) complexity and costs continue to increase while technologies used for scheduling and management of the OR workflow remained unchanged. To address this need, we developed SmartOR, an array of sensors placed at key points in the OR to automatically track activity, and BoardProbe, an electronic whiteboard which supports organization and collaborative activity within the surgical suite (Fig1). We describe in this abstract the process of linking these technologies to bring situational awareness to the board runner and the surgical team and facilitate OR workflow.

METHODS AND PROCEDURES

First, we conducted job task analysis with the leadership of 6 different OR suites to determine need and understand work flows. Second, we linked in-room activity to real-time evaluation of what is written on the OR whiteboard at the front desk. To do this, the SmartOR was installed in 6 ORs to capture in-room activity. Simultaneously, camera recordings of surgical suite staff working at the whiteboard were captured and the synchronization of information between the OR actual state and what is written on the whiteboard compared. Third, in an effort to develop a methodology to acquire and transmit actionable OR activity data to staff for real-time resource management, the effectiveness, efficiency and user satisfaction of BoardProbe was evaluated by having two nurses/board runners perform 10 tasks using simulation.

RESULTS

The job task analysis clarified workflows in multiple OR suites and revealed that our management system would be most effective in larger suites running 10 or more ORs.

Whiteboard Data Discrepancies

By analyzing one week of surgeries we realized that time differences between OR actual state (as recorded by the SmartOR) and whiteboard updates are significant:

Patient in the room: 14min difference on average (13min SD)
Patient out of the room: 11min difference on average (7min SD)

Such asynchronous information promotes a misunderstanding of true room state, decreasing efficiency (e.g. delay in cleaning the room). Linkage between the BoardProbe and the SmartOR could avoid these costly delays by providing accurate, real-time information, delivered at the right moment to the right people.

Board Probe Usability Tests in Simulation

Effectiveness: All usual whiteboard tasks were performed using BoardProbe. The participants used 100% of BoardProbe's features, with a success/failure ratio of 95%.

Results of BoardProbe's users' efficiency (users=2, tasks=10)
Task duration	Learning Time	#Failed commands	#Time-consuming commands	#Help requests	Time spent on non-productive activities
10” to 2’41”	2-5’	5	0	1	0

User Satisfaction: The System Usability Scale (SUS) results give an average score of 80. A prototype with a SUS score above 68 is considered above average.

CONCLUSION

Combining SmartOR and BoardProbe delivers real-time information and alerts about OR activity to the surgical staff using a familiar and efficient whiteboard form factor. We believe this will improve resource utilization and communication. Future work will install BoardProbe in a real surgical suite, connected to the SmartOR, and evaluate its use.