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Assessing endovascular team performances in a hybrid room using the Black Box system : a prospective cohort study

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Abstract
BACKGROUND: The hybrid room (HR) is a complex, high-risk environment, requiring teams (surgeons, anesthesiologists, nurses, technolo-gists) to master various skills, including the 'As Low As Reasonably Achievable' principle of radiation safety. This prospective single center cohort reports the first use of the Operating Room Black Box (ORBB) in a HR. This medical data recording system captures procedural and audio-visual data to facilitate structured team performance analysis.METHODS: Patients planned for endovascular repair of an infrarenal abdominal aortic aneurysm (EVAR) or treatment of symptomatic iliac-femoral-popliteal atherosclerotic disease (Peripheral Vascular Interventions or PVI) were included. Validated measures and established assess-ment tools were used to assess (non-)technical skills, radiation safety performance and environmental distractions. RESULTS: Six EVAR and sixteen PVI procedures were captured. Technical performance for one EVAR was rated 19/35 on the procedure -specific scale, below the 'acceptable' score of 21. Technical skills were rated above acceptable in all PVI procedures. Shared decision making and leadership were rated highly in 12/22 cases, whereas surgical communication and nurses' task management were rated low in 14/22 cases. Team members rarely stepped back from the C-arm during digital subtraction angiography. Radiation safety behavior was scored below 'accept-able' in 14/22 cases. A median (interquartile range) number of 12 (6-23) auditory distractions was observed per procedure. CONCLUSIONS: The ORBB facilitates holistic workplace-based assessment of endovascular performance in a HR by combining objec-tive assessment parameters and rating scale-based evaluations. Strengths and weaknesses were identified in team members' (non-)technical and radiation safety practices. This technology has the potential to improve vascular surgical practice, though human input remains crucial. (NCT04854278)
Keywords
Cardiology and Cardiovascular Medicine, General Medicine, Surgery, Vascular surgery procedures, Endovascular procedures, Patient safety, Quality improvement

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MLA
Doyen, Bart, et al. “Assessing Endovascular Team Performances in a Hybrid Room Using the Black Box System : A Prospective Cohort Study.” JOURNAL OF CARDIOVASCULAR SURGERY, vol. 64, no. 1, 2023, pp. 82–92, doi:10.23736/s0021-9509.22.12226-3.
APA
Doyen, B., Soenens, G., Maurel, B., Hertault, A., Gordon, L., Vlerick, P., … Van Herzeele, I. (2023). Assessing endovascular team performances in a hybrid room using the Black Box system : a prospective cohort study. JOURNAL OF CARDIOVASCULAR SURGERY, 64(1), 82–92. https://doi.org/10.23736/s0021-9509.22.12226-3
Chicago author-date
Doyen, Bart, Gilles Soenens, Blandine Maurel, Adrien Hertault, Lauren Gordon, Peter Vlerick, Frank Vermassen, Teodor Grantcharov, and Isabelle Van Herzeele. 2023. “Assessing Endovascular Team Performances in a Hybrid Room Using the Black Box System : A Prospective Cohort Study.” JOURNAL OF CARDIOVASCULAR SURGERY 64 (1): 82–92. https://doi.org/10.23736/s0021-9509.22.12226-3.
Chicago author-date (all authors)
Doyen, Bart, Gilles Soenens, Blandine Maurel, Adrien Hertault, Lauren Gordon, Peter Vlerick, Frank Vermassen, Teodor Grantcharov, and Isabelle Van Herzeele. 2023. “Assessing Endovascular Team Performances in a Hybrid Room Using the Black Box System : A Prospective Cohort Study.” JOURNAL OF CARDIOVASCULAR SURGERY 64 (1): 82–92. doi:10.23736/s0021-9509.22.12226-3.
Vancouver
1.
Doyen B, Soenens G, Maurel B, Hertault A, Gordon L, Vlerick P, et al. Assessing endovascular team performances in a hybrid room using the Black Box system : a prospective cohort study. JOURNAL OF CARDIOVASCULAR SURGERY. 2023;64(1):82–92.
IEEE
[1]
B. Doyen et al., “Assessing endovascular team performances in a hybrid room using the Black Box system : a prospective cohort study,” JOURNAL OF CARDIOVASCULAR SURGERY, vol. 64, no. 1, pp. 82–92, 2023.
@article{8769201,
  abstract     = {{BACKGROUND: The hybrid room (HR) is a complex, high-risk environment, requiring teams (surgeons, anesthesiologists, nurses, technolo-gists) to master various skills, including the 'As Low As Reasonably Achievable' principle of radiation safety. This prospective single center cohort reports the first use of the Operating Room Black Box (ORBB) in a HR. This medical data recording system captures procedural and audio-visual data to facilitate structured team performance analysis.METHODS: Patients planned for endovascular repair of an infrarenal abdominal aortic aneurysm (EVAR) or treatment of symptomatic iliac-femoral-popliteal atherosclerotic disease (Peripheral Vascular Interventions or PVI) were included. Validated measures and established assess-ment tools were used to assess (non-)technical skills, radiation safety performance and environmental distractions. RESULTS: Six EVAR and sixteen PVI procedures were captured. Technical performance for one EVAR was rated 19/35 on the procedure -specific scale, below the 'acceptable' score of 21. Technical skills were rated above acceptable in all PVI procedures. Shared decision making and leadership were rated highly in 12/22 cases, whereas surgical communication and nurses' task management were rated low in 14/22 cases. Team members rarely stepped back from the C-arm during digital subtraction angiography. Radiation safety behavior was scored below 'accept-able' in 14/22 cases. A median (interquartile range) number of 12 (6-23) auditory distractions was observed per procedure. CONCLUSIONS: The ORBB facilitates holistic workplace-based assessment of endovascular performance in a HR by combining objec-tive assessment parameters and rating scale-based evaluations. Strengths and weaknesses were identified in team members' (non-)technical and radiation safety practices. This technology has the potential to improve vascular surgical practice, though human input remains crucial. (NCT04854278)}},
  author       = {{Doyen, Bart and Soenens, Gilles and Maurel, Blandine and Hertault, Adrien and Gordon, Lauren and Vlerick, Peter and Vermassen, Frank and Grantcharov, Teodor and Van Herzeele, Isabelle}},
  issn         = {{0021-9509}},
  journal      = {{JOURNAL OF CARDIOVASCULAR SURGERY}},
  keywords     = {{Cardiology and Cardiovascular Medicine,General Medicine,Surgery,Vascular surgery procedures,Endovascular procedures,Patient safety,Quality improvement}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{82--92}},
  title        = {{Assessing endovascular team performances in a hybrid room using the Black Box system : a prospective cohort study}},
  url          = {{http://doi.org/10.23736/s0021-9509.22.12226-3}},
  volume       = {{64}},
  year         = {{2023}},
}

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