scholarly journals Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework

2019 ◽  
Vol 8 (3) ◽  
pp. e000686 ◽  
Author(s):  
Nicole Etherington ◽  
Aya Usama ◽  
Andrea M Patey ◽  
Chantal Trudel ◽  
Antoine Przybylak-Brouillard ◽  
...  
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Video Recording ◽  
Theoretical Domains Framework ◽  
Black Box ◽  
Leadership Team ◽  
Senior Leadership ◽  
Team Members ◽  
Barriers And Enablers ◽  
Safety Research

BackgroundSystematically observing clinical performance in the operating room (OR) to support patient safety initiatives faces numerous logistical and methodological challenges. These may be solved by new audio-video recording technologies like the OR Black Box, which is a tool similar to black boxes in aviation. This study aimed to identify barriers and enablers that may influence patients’, clinicians’ and senior leadership team members’ support of the OR Black Box in order to guide its future implementation.MethodsPatients, clinicians and senior leadership team members were recruited to participate in semistructured interviews informed by the theoretical domains framework (TDF) to identify factors relevant to planning OR Black Box implementation. Deidentified interview transcripts were analysed in duplicate following a TDF coding structure.ResultsData saturation was achieved at 15 patients, 17 clinicians and 9 senior leadership team members. Seven domains were relevant for patients, nine for clinicians and four for senior leadership. Knowledge and Beliefs about consequences were barriers and enablers for all three groups. Memory, attention and decision processes and Social influences were enablers for both clinicians and senior leadership. Environmental context and resources, Emotion and Behavioural regulation were found to be barriers and enablers for both clinicians and patients. Social/professional role and identity and Reinforcement were enablers for patients only and Optimism and Intentions were barriers and enablers to clinicians.ConclusionsWhile most stakeholders were supportive of the OR Black Box, we identified many key areas that need to be addressed during its implementation. It is critical to ensure all stakeholders have adequate and accurate information about the OR Black Box system and research goals, and that the OR Black Box is positioned as a patient safety initiative for learning from and improving practice.

scholarly journals Barriers and enablers to effective interprofessional teamwork in the operating room: A qualitative study using the Theoretical Domains Framework

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249576
Author(s):  
Nicole Etherington ◽  
Joseph K. Burns ◽  
Simon Kitto ◽  
Jamie C. Brehaut ◽  
Meghan Britton ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Operating Room ◽  
Positive Emotions ◽  
Quality Care ◽  
Theoretical Domains Framework ◽  
Snowball Sampling ◽  
Team Members ◽  
Barriers And Enablers ◽  
Interprofessional Teamwork ◽  
Call Night

Background Effective teamwork is critical for safe, high-quality care in the operating room (OR); however, teamwork interventions have not consistently resulted in the expected gains for patient safety or surgical culture. In order to optimize OR teamwork in a targeted and evidence-based manner, it is first necessary to conduct a comprehensive, theory-informed assessment of barriers and enablers from an interprofessional perspective. Methods This qualitative study was informed by the Theoretical Domains Framework (TDF). Volunteer, purposive and snowball sampling were conducted primarily across four sites in Ontario, Canada and continued until saturation was reached. Interviews were recorded, transcribed, and de-identified. Directed content analysis was conducted in duplicate using the TDF as the initial coding framework. Codes were then refined whereby similar codes were grouped into larger categories of meaning within each TDF domain, resulting in a list of domain-specific barriers and enablers. Results A total of 66 OR healthcare professionals participated in the study (19 Registered Nurses, two Registered Practical Nurses, 17 anaesthesiologists, 26 surgeons, two perfusionists). The most frequently identified teamwork enablers included people management, shared definition of teamwork, communication strategies, positive emotions, familiarity with team members, and alignment of teamwork with professional role. The most frequently identified teamwork barriers included others’ personalities, gender, hierarchies, resource issues, lack of knowledge of best practices for teamwork, negative emotions, conflicting norms and perceptions across professions, being unfamiliar with team members, and on-call/night shifts. Conclusions We identified key factors influencing OR teamwork from an interprofessional perspective using a theoretically informed and systematic approach. Our findings reveal important targets for future interventions and may ultimately increase their effectiveness. Specifically, achieving optimal teamwork in the OR may require a multi-level intervention that addresses individual, team and systems-level factors with particular attention to complex social and professional hierarchies.

Robotic Surgery and the Operating Room Team

2005 ◽  
Vol 49 (11) ◽  
pp. 1070-1073 ◽  
Author(s):  
Fuji Lai ◽  
Eileen Entin
Keyword(s):  
Patient Safety ◽  
Robotic Surgery ◽  
Human Factors ◽  
Operating Room ◽  
New Technologies ◽  
Improve Patient Safety ◽  
Robotic Systems ◽  
Team Members ◽  
Operating Room Team ◽  
Full Benefit

Robotic surgery has the potential to revolutionize the field of surgery and improve patient safety. However, despite the advantages robotic surgery can offer, there are multiple human factors-related issues that may prevent these systems from realizing their full benefit. This study identified some of the salient human factors issues and considerations that need to be addressed for integration of new technologies such as robotic systems into the Operating Room of the future. We conducted in-depth interviews with operating team members and other stakeholders who have experience with robotic surgery to identify workflow, teamwork, training, and other clinical acceptance issues. Addressing these and other human factors issues will help the integration of surgical robotic systems into use for the ultimate goal of improving patient safety and healthcare quality.

scholarly journals Exploring patient safety in Swedish specialised home healthcare: an interview study with multidisciplinary teams and clinical managers

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e024068 ◽  
Author(s):  
Marléne Lindblad ◽  
Maria Flink ◽  
Mirjam Ekstedt
Keyword(s):  
Patient Safety ◽  
Communication Systems ◽  
Qualitative Content Analysis ◽  
Patient Safety Culture ◽  
Home Healthcare ◽  
Multidisciplinary Teams ◽  
Team Members ◽  
Individual Interviews ◽  
Safety Research ◽  
Quality Assessments

ObjectiveHome healthcare is the fastest growing arena in the healthcare system but patient safety research in this context is limited. The aim was to explore how patient safety in Swedish specialised home healthcare is described and adressed from multidisciplinary teams’ and clinical managers’ perspectives.DesignAn explorative qualitative study.SettingMultidisciplinary teams and clinical managers were recruited from three specialised home healthcare organisations in Sweden.MethodsNine focus group interviews with multidisciplinary teams and six individual interviews with clinical managers were conducted, in total 51 participants. The data were transcribed verbatim and analysed using qualitative content analysis.ResultsPatient safety was inherent in the well-established care ideology which shaped a common mindset between members in the multidisciplinary teams and clinical managers. This patient safety culture was challenged by the emerging complexity in which priority had to be given to standardised guidelines, quality assessments and management of information in maladapted communication systems and demands for required competence and skills. The multiple guidelines and quality assessments that aimed to promote patient safety from a macro-perspective, constrained the freedom, on a meso-level and micro-level, to adapt to challenges based on the care ideology.ConclusionPatient safety in home healthcare is dependent on adaptability at the management level; the team members’ ability to adapt to the varying conditions and on patients being capable of adjusting their homes and behaviours to reduce safety risks. A strong culture related to a patient’s value as a person where patients’ and families’ active participation and preferences guide the decisions, could be both a facilitator and a barrier to patient safety, depending on which value is given highest priority.

scholarly journals Microanalysis of video from the operating room: an underused approach to patient safety research

2016 ◽  
Vol 26 (7) ◽  
pp. 583-587 ◽  
Author(s):  
Jeff Bezemer ◽  
Alexandra Cope ◽  
Terhi Korkiakangas ◽  
Gunther Kress ◽  
Ged Murtagh ◽  
...  
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Safety Research

scholarly journals Assessing the similarity of mental models of operating room team members and implications for patient safety: a prospective, replicated study

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Ivana Nakarada-Kordic ◽  
Jennifer M. Weller ◽  
Craig S. Webster ◽  
David Cumin ◽  
Christopher Frampton ◽  
...  
Keyword(s):  
Patient Safety ◽  
Mental Models ◽  
Operating Room ◽  
Team Members ◽  
Operating Room Team

Analisis Faktor Yang Berhubungan Dengan Penerapan Surgical Safety Checklist Di Kamar Operasi Rumah Sakit Kota Batam

2019 ◽  
Vol 4 (3) ◽  
pp. 456
Author(s):  
Endang Yuliati ◽  
Hema Malini ◽  
Sri Muharni
Keyword(s):  
Patient Safety ◽  
Operating Room ◽  
Work Experience ◽  
Improve Patient Safety ◽  
Standard Procedure ◽  
City Hospital ◽  
Chi Square ◽  
Cross Sectional ◽  
Surgical Safety Checklist ◽  
Surgical Safety

<p><em><em>The use of the Surgical Safety Checklist (SSC) is associated with improving patient care according to nursing process standards includes the quality of work of the operating room nurse team. The form of professionalism in the operating room is how the application of a surgical safety checklist as the standard procedure for patient safety in the operating room. This study aims to determine the relationship of characteristics, knowledge, and motivation of nurses in the application of the surgical safety checklist in the operating room of a Batam city hospital. This research is quantitative using an observational analytic research design. This study was conducted on 67 nurses who were taken by total sampling. This research was conducted in three Batam City Hospitals, with hospital accreditation at the same level. Data were analysed by univariate and bivariate using the chi-square test. The results of the study found that most nurses had education at diploma level, with a working period experiences of &gt; 6 months (82%); good knowledge (53.7%) with low motivation (57.7%). There is a relationship between education (p = 0.042); length of work experience (p = 0.010); knowledge (p = 0.002); and motivation (p = 0.05) with the application of SSC. It is expected that health services carry out SSC following the applicable SOPs in the Hospital so that it can reduce work accident rates and improve patient safety.</em></em></p><p><em><br /></em></p><p><em>Penerapan Surgical Safety Checklist (SSC) berhubungan langsung dengan kualitas asuhan keperawatan yang termasuk adalah bagaimana perawat menerapkan fungsi sebagai bagian dari kamar operasi. Bentuk profesionalisme ini menjadi standar bagaimana kemampuan perawat menerapakan SSC. Tujuan penelitian adalah mengetahui hubungan karakteristik perawat, pengetahuan dan motivasi dengan penerapan SSC di kamar operasi. Penelitian ini menggunakan desain kuantitatif Cross Sectional dengan jumlah sampel 67 orang perawat kamar operasi. Data dianalisa dengan distribusi frekuensi dan uji hubungan bivariat. Didapatkan penerapan SSC perawat kota Batam masih kurang baik, dengan faktor yang mempunyai hubungan adalah Pendidikan, pelatihan dan pengetahuan. Diharapkan perawat mampu menerapkan SSC sesuai dengan Standar pelaksanaan fungsi perawat dikamar operasi.</em></p>

scholarly journals An evaluation of the implementation of quality improvement (QI) in primary care dentistry: a multi-method approach

2021 ◽  
Vol 10 (2) ◽  
pp. e000839
Author(s):  
Heather Cassie ◽  
Vinay Mistry ◽  
Laura Beaton ◽  
Irene Black ◽  
Janet E Clarkson ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Improvement ◽  
Case Studies ◽  
Quality Care ◽  
Theoretical Domains Framework ◽  
Team Members ◽  
Knowledge And Skills ◽  
Scottish Government ◽  
The Impact

ObjectivesEnsuring that healthcare is patient-centred, safe and harm free is the cornerstone of the NHS. The Scottish Patient Safety Programme (SPSP) is a national initiative to support the provision of safe, high-quality care. SPSP promotes a coordinated approach to quality improvement (QI) in primary care by providing evidence-based methods, such as the Institute for Healthcare Improvement’s Breakthrough Series Collaborative methodology. These methods are relatively untested within dentistry. The aim of this study was to evaluate the impact to inform the development and implementation of improvement collaboratives as a means for QI in primary care dentistry.DesignA multimethod study underpinned by the Theoretical Domains Framework and the Kirkpatrick model. Quantitative data were collected using baseline and follow-up questionnaires, designed to explore beliefs and behaviours towards improving quality in practice. Qualitative data were gathered using interviews with dental team members and practice-based case studies.ResultsOne hundred and eleven dental team members completed the baseline questionnaire. Follow-up questionnaires were returned by 79 team members. Twelve practices, including two case studies, participated in evaluation interviews. Findings identified positive beliefs and increased knowledge and skills towards QI, as well as increased confidence about using QI methodologies in practice. Barriers included time, poor patient and team engagement, communication and leadership. Facilitators included team working, clear roles, strong leadership, training, peer support and visible benefits. Participants’ knowledge and skills were identified as an area for improvement.ConclusionsFindings demonstrate increased knowledge, skills and confidence in relation to QI methodology and highlight areas for improvement. This is an example of partnership working between the Scottish Government and NHSScotland towards a shared ambition to provide safe care to every patient. More work is required to evaluate the sustainability and transferability of improvement collaboratives as a means for QI in dentistry and wider primary care.

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