Hospital tests ‘black box’ in operating theatre
Long used in aviation, black boxes are beginning to be used in another high-stakes location — the operating room.
The Ottawa Hospital is installing one as part of a research project aimed at improving communications and safety.
The research project is being led by Dr. Sylvain Boet, a scientist and anesthetist at The Ottawa Hospital and associate professor at the University of Ottawa.
Information gathered by the black box, which collects data from cameras, audio recorders, the patient’s vital signs and more, will be analyzed to help identify situations in which communication could be improved, Boet said.
Communication is key to safety in operating rooms (and on airplanes) but it has not traditionally been emphasized in medical schools.
When Boet went to medical school in France 15 or 20 years ago, “There was a lot of training on how to stitch a wound, how to insert a catheter, but almost nothing on non-technical skills such as teamwork.”
Those skills are key to safety. “Today medical staff receive more training in these areas, but we don’t know whether it’s making a difference to patient outcomes,” he said.
Research suggests that teamwork is a factor in up to two-thirds of surgical complications.
The purpose of the research project is to identify practices that could lead to complications.
“The goal is to learn from our current practices and see what we can improve.”
Black boxes are now in place at several Toronto hospitals. The Ottawa Hospital began using one during some operations at its General campus earlier this year. The research project is being done in conjunction with Dr. Teodor Grantcharov and his team at St. Michael’s Hospital in Toronto.
In Ottawa, Boet and his team used patient advisers to help them implement the black box program.
Maxime Lê, one of those advisers, said when he first learned about the project he wondered why there weren’t black boxes in all operating rooms.
That could come, although there are many logistics to be worked out, and analyzing the gathered data is expensive, said Boet, which is why it is being introduced as part of a funded research project.
Lê, who studied health sciences and communications, has had three surgeries in recent years, including one on his wrist after a jet-skiing accident, all of which informed his work as a patient adviser on the project.
The idea of a black box in an operating room offers confidence to patients, he said.
“The operating room is like a black box. We don’t necessarily know what is going on inside as patients when we are under the knife and anesthesia.”
The data will offer access to information if something goes wrong, he said.
“It is a good tool to help improve patient safety.”
Lê said he wanted to contribute to the hospital after undergoing several surgeries and was pleased to learn that the hospital uses patient advisers.
“I was really glad to learn The Ottawa Hospital is engaging in this sort of patient-oriented research strategy. The fact that as patients our voices were heard and we were respected gives us a sense of pride and we feel valued.”