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Excellent communication safeguards health, safety and
wellbeing within the Operating Room
Surgical models are changing, with the increasing reliance on technology,
from 3D imaging to robotics, enabling extraordinary innovation and life
changing intervention. However, while staff are embracing new skills
and ways to successfully interact with the technology, the changing
environment creates new stresses.
Collaboration between multi-disciplinary teams is essential but
eye contact is often not an option when individuals are reviewing
imaging, even working in separate cath labs. Add in the background
noise from equipment and colleagues, and vital communication
can be compromised. The adoption of wireless headset technology
is transforming the clinician experience – and improving patient
outcomes. Combining broadcast quality communication with noise
cancelling headsets ensures intelligibility, facilitating a calmer, less
stressful working environment and enabling the effective staff training
which is an essential component of new technology adoption.
Within an office environment, research suggests workers can be up to
66% less productive when exposed to just one nearby conversation;
within a high pressure environment such as an OR, the implications
of such noise related stress are even more significant. With falling
nursing and HCP numbers and nearly a third of registrants leaving the
profession saying that too much pressure leading to stress was their
main reason for discontinuing their registration, it is essential to grasp
any opportunity to minimise this.
Tom Downes, CEO, Quail Digital, explains the importance of immediacy
and clarity in OR communication.
In addition to improving the intelligibility of communication and
minimising extraneous noise, the use of wireless headsets also enables
the entire surgical team – many of whom are undertaking duties outside
the OR – to remain 100% engaged in the process while still undertaking
other tasks. Juggling multiple tasks without a clear timeline can be
hugely stressful – but with the entire team continuously linked through
one channel via the wireless headset anyone not required throughout
the entire process is able to maximise their time with confidence,
knowing they will be fully informed and ready when required.
Multi-discipline Collaboration
Improved Training
Over recent years, with the introduction of multi-disciplinary structural
and specialist valve clinics, there has been a dramatic increase in the
number of interventional procedures carried out for structural heart
disease. The use of 3D imaging technology and electrophysiology
(EP) have not only changed patient accessibility to surgery; they have
transformed the entire process.
With multiple team members collaborating not only over several hours
but often across multiple rooms, excellent, unambiguous communication
has become essential. From surgeons, healthcare professionals and
trainees within the OR to technicians and radiology technologists in
cath labs, everyone needs complete confidence in the ability to hear
and share critical information.
Yet ORs are far from quiet places. Equipment, technology and air
conditioning can create a significant noise level; while those undertaking
image and test reviews may be distracted by the noise of other HCPs.
When staff need to be 100% confident about the information received
and shared, this background noise is a very real concern. Furthermore,
with the increasingly multi-national expertise being sought to maximise
the use of innovative technology, miscommunication is a very real
concern. Given the risk of legal action should an instruction be
misheard, excellent communication has become a priority.
Intelligible Communication
In this highly charged environment, the traditional reliance on speakers
and microphones, even bulky headsets, is inadequate. A normal
microphone will pick up all the noise in the room and often cannot
be optimally positioned for sound. Not only is the sound unclear but
the actual experience can be disturbing because extraneous noise is
amplified. In addition to raising the risk of instructions being misheard
by clinicians, it is important to consider the experience of patients
who are often conscious during these procedures. Having every
interaction broadcast over the OR speaker is unlikely to provide the
calm environment required to maximise patient well-being.
For any procedure that requires two or more people who are not in eye
contact, a wireless headset is ideal. Unlike traditional headsets which
can be cumbersome and heavy, lightweight wireless solutions are easy
to wear, enabling hands free communication throughout any procedure.
Sound is at near broadcast quality, ensuring the essential clarity of
communication and intelligibility; while headsets also include noise
cancelling technology to ensure there are no external distractions.
Improved intelligibility also plays a critical role in supporting training
and education. With the rise in robotic surgery – from nanobots to unclog
arteries to catheter based robots, robot based valves and improved
holographic 3D vision – as well as AI and digital health, clinicians are
continually learning. In addition to adopting new technology, clinicians
are also adapting to the change in patient complexity. Robots can
now perform complex procedures with geometrical precision, even in
anatomical areas that are difficult to reach by surgeons – opening the
door to procedures even on the most complex, multi-risk patients.
In this evolving healthcare environment, it is vital that medical
education keeps pace with innovation, particularly when technological
advances evolve faster than curriculum development. The use of the
latest generation of wireless headsets allows the surgeon to extend the
OR into the field of medical education, describing these increasingly
complex processes in detail as they are undertaken. Improved
intelligibility over traditional methods now ensures that trainees can
hear exactly what has been said and able to question immediately if
additional clarification is required. With health innovation in the 21st
century having a particular emphasis on digital health, the ability for
trainees to learn in the field is key.
Conclusion
The adoption of innovative technology including robotics within the
OR is exciting, opening the door to previously impossible treatments,
especially for patients with complex, chronic conditions. But it also
increases the importance of excellent OR communication. With growing
numbers of invasive surgeries, including gastroenterology, increasingly
including 3D imaging as well as cameras, excellent communication
between multi-disciplinary teams has become a fundamental
component of the successful surgical process. Moreover, it can help
ensure the doctors of tomorrow train in an environment that is a clear
representation of the working world they will enter.
The intelligibility enabled by wireless headset technology is fast
becoming a priority to ensure both today and tomorrow’s clinician and
patient well-being.
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Furthermore, with a simple base station registration process, staff can
move between locations with the same headset. Essentially, whatever
the HCP’s role, from surgeon to imaging or operating robotic equipment,
the entire multi-disciplinary team can communicate with confidence.
Clinician Well-Being
The issue is not just patient wellbeing – although that is clearly key.
It is also clinician wellbeing. There is growing evidence that noise can
have a very detrimental impact on an individual’s performance and
wellbeing, from a lack of concentration to stress. Prolonged exposure
to noise can cause spikes in blood pressure and heart rate; and research
has shown that even intermittent exposure to loud noises can lead to
higher long term stress hormone levels and hypertension.
The Operating Theatre Journal
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Issue 346 July 2019
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