Surgical team perceptions of operating room environments during robot-assisted surgery
TimeWednesday, April 1412:30pm - 12:50pm EDT
DescriptionThe operating room (OR) is a complex network of interactions between multiple interdisciplinary teams. As complexity increases with the incorporation of technology, such as in robot-assisted surgery (RAS), this increases the possibility of errors, affecting workflow, and rendering team interactions more challenging. The growing adoption and implementation of RAS technology has significantly impacted the traditional OR layout. A key physical disruption is that the RAS equipment occupy more physical space. In addition to physical footprint, team interactions may be altered due to the separation between the surgeon at the robot console and the patient bedside. Many hospital facilities have retrofitted existing OR spaces to accommodate technological advances, but they have been required to do so without evidence-based recommendations for optimal physical OR layout. Modifying the current OR layout requires a detailed understanding of the existing challenges imposed on the work tasks by the current conditions and feedback from different stakeholder groups on OR layout. The overall goal of this work is to develop evidenced based guidelines for RAS layouts and provide hospitals nationwide customizable data-driven tools for RAS OR layout recommendations. As a first step toward this goal, an 28-item online survey was developed and disseminated through REDCap to elicit stakeholder perspectives on challenges faced with existing OR layouts and suggestions for layout redesign. The questions aimed to capture information about the survey respondent and information on the use of the existing OR space. To date, 17 participants from two academic medical centers have completed the survey (15 residents/surgeons, 1 bedside assistant, and 1 research fellow), with a range of 1 to 35 years of surgical experience. Most participants were either “Satisfied” (7) or “Partially Satisfied” with their current OR layout. One participant indicated being “Very Satisfied” and one was “Dissatisfied”. Communication and visibility of monitors were the components rated most important for enabling respondents to work well during RAS, whereas eye contact received the lowest average rating. No respondent reported having all required supplies in the room for all cases, with some reporting having all needed supplies only 0-25% of the time. The items most often missing are surgical instruments and sutures. The most commonly reported OR design challenges were the size of the equipment and thus having sufficient space in the OR to accommodate the robot and accompanying components, and a lack of clear pathways and equipment access. These results suggest that the existing OR layouts may not be optimized for RAS and that communication and monitor visibility should be prioritized when determining equipment arrangement. Surgical team members must also have sufficient space to complete their tasks and navigate around the environment.