Medica2015_Mittwoch

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ISO 13485:2003 Visit us at Hall 9 Stand D41 Thermasonic_MEDICA_2015_102715-A.qxp_EuropeanHospital - MEDICA2015 10/27/15 12:09 PM Page 1 WWW.HEALTHCARE-IN-EUROPE.COM 18NOVEMBER 2015 In addition to the expense of install- ing and maintaining sterile video cameras, videotape reviews would create their own set of issues and costs. Who would review? What pro- tocols would be used to identify and report possible problems? At a time of lean budgets, from where would funding come to pay for this? These are unanswered ques- tions, but video cameras in surgery are making the news. Characterising ‘near miss’ events in complex lapa- roscopic surgery using video analysis Teodor P Grantcharov MD PhD, a professor of surgery at the University of Toronto and a staff surgeon at St. Michael’s Hospital in Toronto, Ontario, has been recording his sur- geries with a ‘black box’ he designed that works with laparoscopic proce- dures. The device records conversa- tions in the operating theatre and records the video feed from the sur- gical camera being used, as well as a wide-angle view of activities within the room. Dr Grantcharov, also the Canada Research Chair in Simulation and Surgical Safety, meets with his surgical colleagues at St. Michael’s Hospital every week to review the collected data. ‘Root cause analysis of surgical complications are of high importance to ensure surgical quality, but spe- cific details on technical causes often remain unclear,’ Dr Grantcharov said. ‘Near misses – situations that have the potential to result in an injury or adverse outcome – may not be captured by retrospective reviews of archived charts or malpractice claims. However, by identifying them, they allow protective measures to be taken to avoid future adverse events.’ Dr Grantcharov and colleagues conducted a study to analyse 54 unedited recordings of bariatric lapa- roscopic procedures. Their findings have been published in BMJ Quality and Safety. 66 events in 38 surgeries were identified, the majority of which were minor bleeding and haema- toma. Bariatric surgeons rather than trainees caused the majority of these events and the most common injuries were due to basic surgical tasks. ‘The opportunity to learn from errors represents a valuable source of information that can be used to teach surgical decision making, risk management, and error recov- ery mechanisms. The current study highlights the benefits of detailed video analysis to create a database of common injury mechanisms and video clip repository that can be used in tailoring future training interven- tions, the study authors wrote, add- ing that understanding the casual relationship between minor errors and intraoperative events is essential to be able to develop effective error rescue mechanisms for future cases. The ARIBO Project: a French study recording OR staff behaviours to reduce infection In France, a multicentre prospec- tive study is underway to record the behaviour of medical staff per- forming surgeries in 20 operating suites in 12 healthcare facilities used for cardiac and orthopaedic surgery. Motion tracking, using a video track- ing system, is being used to assess the behaviours of surgeons, anaes- thesiologists, nurses, and other clini- cians entering operating rooms to determine their impact on surgical site infection risk during surgical site procedures. Surgical site infection is a major public health problem, which sub- stantially increases the severity of illness, length of hospital stay, mor- tality risk to patient, and related costs of treatment. The study’s principal investigator Dr Gabriel Birgand of the University Paris Diderot and colleagues are try- ing to determine if movement in and out of the operating room during a surgical procedures and specific behaviours of clinical staff may be linked to the source of contamina- tion of a surgical wound. High-tech video tracking systems can obtain comprehensive and sys- tematic data that is impossible to col- lect by human observers. However, the tracking systems do not actually record videos of the surgical proce- dure but rather the positions of the surgical staff. The number and length of times doors are opened and shut are also being analysed. The study’s objectives are to assess best-practice guidelines in a surgical suite, to assess correlations between movements of the surgi- cal team and surgical site infection risk, and to assess the correlation between the particle count and the microbiological contamination in the air. Additionally, the researchers are observing changes in practice by clinical staff when they know their movements are being videotaped. Government legislation aims to protect patients from surgical errors The introduction of video cameras in operating theatres could also be the result of government legislation designed to protect patients from accidental errors made during sur- gery. In April 2015, a bill requiring hospitals to install video cameras in Should video cameras record surgical procedures? Athletes and sports teams review videotapes of their performance to learn how to make improvements. Could surgeons and operating theatre teams use videotapes for quality improvement and to increase patient safety and clinical outcomes by identifying and reducing errors or bad practice? Or would this be an intrusion, a distraction for a surgical team? European Correspondent Cynthia E Keen reports S P E C I A L I S S U E : M E D I C A L , T E C H N I C A L , P H A R M A C E U T I C A L , I N D U S T R I A L N E W S DUSSELDORF • WEDNESDAY • 18 NOVEMBER 2015 @ MEDICA 3 Breakthrough law to insist on video cameras Troubleshooting ‘near miss’ surgery St.Michael’sHospital,Toronto,Ontario Continued on page 2 Thermasonic_MEDICA_2015_102715-A.qxp_EuropeanHospital - MEDICA2015 10/27/1512:09 PM Page 1

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