The case for better OR communication

The rapid evolution of technology, not least robotics, is inspiring the next generation of ergonomic design to better understand the human / technology interaction. Within the OR, the development of 3D imagery, precise robotics, even protective garments with in-built air supply, are changing not only the type of procedures that can be considered but also the processes and the need for effective interaction between multiskilled teams. From situational awareness to decision making, teamwork and coping with stress, in an increasingly technology dominated OR, team members’ cognitive and social skills are recognised to contribute to safe and efficient task performance. 

However, as surgical teams are increasingly reporting, while the innovation is compelling, technology led procedures are raising challenges – not least with the quality and timing of essential team communication.1 With a growing reliance on data, imagery, graphics and cameras, individuals are rarely looking at each other or even directly at the patient. Indeed, many individuals are moving around within, but also in and out of, the OR. Not only are they blind to the progress of the procedure, but they can also struggle to share essential information with the rest of the team. Furthermore, as technology takes an increasingly dominant role, there is a risk that clinical teams feel they have only a supportive role and potentially lose engagement.

In his study Improving communication in robotic-assisted laparoscopic surgery, Ziv Tsafrir makes it clear: “Unlike the conventional OR setting, robotic surgeons must rely primarily on auditory means of communication, unaided by visual cues. In addition, studies have shown that increased noise during surgery was associated with a greater risk for postoperative complications.” This latter point is due to the increase in ambient noise within the OR; clearly, the potential implications for errors, impaired safety and efficiency are very concerning