Human Factors and Systems Integration in High Technology Surgery (HF-SIgHTS)

高技术手术中的人为因素和系统集成 (HF-SIgHTS)

• 批准号: 9982269
• 负责人: Jennifer Tash Anger
• 金额: $ 40万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-09-30 至 2023-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9982269
• 关键词: Human; Factors; Systems; Integration; Technology

PROJECT SUMMARY Surgery remains a high-risk endeavor, with upwards of 4000 “never” events per year, and multiple additional opportunities for accidental injuries. Though new surgical technologies are intended to benefit patients, they can introduce unexpected new complexities and error modes for which operating room (OR) teams and host organizations may be unprepared. One of the most ubiquitous exemplars of high-technology surgery is robotic assisted surgery (RAS), which has demonstrated benefit, but also introduces a range of new challenges that place additional stresses on communication, technical and procedural knowledge within the team, and the available space in the operating room. We will evaluate multiple interventions to address these specific challenges, testing new approaches to teamwork training, task design, and workspace management both individually and in combination, at 4 different hospital sites. The effects will be evaluated at individual (use of intervention; workload), process (surgical durations and disruptions) and systems (complications and safety culture) levels. Qualitative interviews and observations will be used to understand the implementation and spread of the interventions. Finally, data from the 680 planned surgical observations – the largest direct observation study ever conducted – will be used to model accident causation by exploring the mechanism by which small innocuous process problems concatenate into more serious risks and eventual injuries. This will fundamentally improve our understanding of how innovative surgical technologies can be safely deployed and integrated within complex clinical work systems.

项目概要 手术仍然是一项高风险工作，每年有超过 4000 起“从未发生过”的事件，并且还有多个额外的事件 意外伤害的机会。尽管新的外科技术旨在造福患者，但它们 可能会引入意想不到的新复杂性和错误模式，导致手术室 (OR) 团队和主持人 组织可能没有做好准备。高科技手术最普遍的范例之一是机器人 辅助手术（RAS）已被证明是有益的，但也带来了一系列新的挑战， 额外强调团队内部的沟通、技术和程序知识，以及 手术室的可用空间。我们将评估多种干预措施来解决这些具体问题 挑战，测试团队合作培训、任务设计和工作空间管理的新方法 在 4 个不同的医院地点单独或组合进行。效果将根据个人进行评估（使用 干涉;工作量）、流程（手术持续时间和中断）和系统（并发症和安全性） 文化）水平。将使用定性访谈和观察来了解实施情况和 干预措施的传播。最后，来自 680 次计划手术观察的数据——最大的直接手术观察 曾经进行过的观察研究——将用于通过探索机制来模拟事故因果关系 这些无害的小过程问题会导致更严重的风险和最终的伤害。这将 从根本上提高我们对如何安全部署创新外科技术的理解 集成到复杂的临床工作系统中。