This isn't just about targeting errors and near-misses, right?
Exactly. We use the data to study successes in great detail, so we can
identify and reinforce positive behaviors. We're using the information
to coach surgical teams on ways to improve their performances, simi-
lar in many respects to how sports teams study videos and stats to
enhance how they play.
How can the technology improve teamwork in the OR?
It's easier to have constructive conversations with members of the
surgical team about things that might go wrong and also about how
they can work closely to have a positive work experience. It also
helps to flatten the hierarchy of the OR. When we first introduced the
black box at our hospital, some nurses thought it'd be used to play the
blame and shame game. But they quickly realized it provides informa-
tion that leads to open discussions about improving the performance
of their teams. It's led to a much healthier work environment.
Is there a place for the black box in every OR?
I think so. The most exciting aspect of the technology is that it's a
platform for change. Acceptance of the black box will require a sig-
nificant culture shift among surgical professionals. It's not going to
happen overnight, but I'm hopeful that the technology will eventual-
ly be used wherever surgery is performed.
OSM
Dr. Grantcharov (grantcharovt@smh.ca) is a surgeon at St. Michael's
Hospital in Toronto, Canada, and a professor of surgery at the University of
Toronto.
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