A robust and non-obtrusive automatic event tracking system for operating room management to improve patient care
- 462 Downloads
Optimization of OR management is a complex problem as each OR has different procedures throughout the day inevitably resulting in scheduling delays, variations in time durations and overall suboptimal performance. There exists a need for a system that automatically tracks procedural progress in real time in the OR. This would allow for efficient monitoring of operating room states and target sources of inefficiency and points of improvement.
We placed three wireless sensors (floor-mounted pressure sensor, ventilator-mounted bellows motion sensor and ambient light detector, and a general room motion detector) in two ORs at our institution and tracked cases 24 h a day for over 4 months.
We collected data on 238 total cases (107 laparoscopic cases). A total of 176 turnover times were also captured, and we found that the average turnover time between cases was 35 min while the institutional goal was 30 min. Deeper examination showed that 38 % of laparoscopic cases had some aspect of suboptimal activity with the time between extubation and patient exiting the OR being the biggest contributor (16 %).
Our automated system allows for robust, wireless real-time OR monitoring as well as data collection and retrospective data analyses. We plan to continue expanding our system and to project the data in real time for all OR personnel to see. At the same time, we plan on adding key pieces of technology such as RFID and other radio-frequency systems to track patients and physicians to further increase efficiency and patient safety.
KeywordsLaparoscopic efficiency Patient safety Operating room efficiency Operating room management Emerging technology Wireless technology
We acknowledge Linda Moore from Houston Methodist for an interesting discussion on the ACS-NSQIP and potential correlation analysis with our SmartOR data. We also thank the Dunn OR team for their cooperation on the clinical study, and we express our gratitude to Michael Garcia for his interest, support, and feedback on our system.
Compliance with ethical standards
Albert Y. Huang, Guillaume Joerger, Remi Salmon, Vadim Sherman, Brian J. Dunkin, Barbara L. Bass, and Marc Garbey have no disclosures and no conflicts of interest.
- 4.Doryab A, Togelius J, Bardram J (2012) Activity-aware recommendation for collaborative work in operating rooms. In: Proceedings of the 2012 ACM international conference on intelligent user interfaces, pp 301–304Google Scholar
- 10.Procter L, Davenport D, Bernard AC, Zwischenberger JB (2010) General surgical operative duration is associated with increased risk-adjusted infectious complication rates and length of hospital stay. J Am Coll Surg 210(1):60-5.e1-2Google Scholar
- 12.Schuster M, Pezzella M, Taube C, Bialas E, Diemer M, Bauer M (2013) Delays in starting morning operating lists: an analysis of more than 20,000 cases in 22 German hospitals. Dtsch Artebl Int 110:237–243Google Scholar