QUALITY IMPROVEMENT
Introduction of the OR Black Box in a hybrid angiosuite
Published on
June 29, 2020
Physica Medica
Overview
The OR Black Box® technology, originally used in laparoscopy to improve patient safety, has been successfully adapted for use in a hybrid angiosuite for endovascular procedures. This implementation aimed to evaluate surgeons' radiation safety, technical performance, and non-technical skills. The system captures audio-visual data from multiple sources, including cameras, microphones, and medical monitors. In a pilot analysis of an elective endovascular aneurysm repair, the ORBB provided valuable insights into radiation exposure, safety-related behaviors, technical skills, and non-technical performance of the surgical team.
This innovative data capture platform shows promise in identifying safety-related errors and areas for improvement in endovascular procedures. By providing a comprehensive evaluation of surgical performance, including radiation safety practices, technical expertise, and non-technical skills, OR Black Box in the hybrid angiosuite setting may lead to targeted educational interventions and ultimately enhance patient safety in endovascular surgery.
Results
The system captures Audio-visual data from four ceiling-mounted cameras, three ceiling-array microphones, the fluoroscopy screen and anaesthesia monitor. After patient and team consent, an elective endovascular aneurysm repair was successfully analysed. Dose-Area-Product and Air Kerma were 71094 mGy.cm2 and 270 mGy, respectively. Behavioural analysis revealed deficiencies in stepping back and radiation safety communication. Technical skill assessment was feasible: GRS: 29/40; 'PRS': 27/35; EVARATE: 29/35. Non-technical analysis highlighted surgeons' leadership qualities.
