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  • TagTeamExploring Digital Toolsets for the Operating Room

    @BlueMetalDogheidi.evans@ryerson.cahevansbluemetaldogHeidi Evans

    Hospital operating rooms are, by nature, inefficient. There are unexpected delays and emergencies that arise during the day. Wasted time leads to frustration among staff, and wasted funds from empty operating rooms concern hospital administrators. Operating room efficiency has been well studied, and optimal flow continues to be a major issue among hospitals worldwide. This project explores the design and development of TagTeam, an Operating Room Relay Messaging service.

    TagTeam is a SMS system that originates from within the Operating Room to waiting surgical teams to let them know when theyre running behind. This gives the waiting teams the freedom to go about their day, without having to waste time waiting in the halls when the current procedure goes over time, or the ability to be ready when a procedure finishes early. A fluid scheduling system and relay notification system allows surgical teams to do more with their time and still be reachable.

    THE PROJECT It is generally expected that if one goes into the hospital, there will be delays. If its elective day surgery, depending on the hour scheduled, or if emergencies arise, a patient might even be rescheduled to another day. While frustrating for patients and their families to not know when their procedure might start, it is also an ongoing issue with staff who are typically forced to wait when surgical procedures preceding theirs runs overtime. Additionally, hospitals, in an effort to earn more revenue, do not like to see operating rooms sit empty1, nor staff be unnecessarily idle. The purpose of this project was to explore a digital solution to surgical wait times, or more specifically, to explore a more efficient and fluid way to schedule surgeries, so that there is less down time for operating room teams, and more patients can be treated.

    Scenario Dr. C., an Orthopaedic Surgeon, is tired of waiting in the hall to start his elective surgeries as he doesnt have clear communication of when the current procedure goes over time. He wants to make better use of his day, and have a better idea of how long hes going to have to wait. A large part of his day, when scheduled to perform surgery, is spent waiting. There is still the opportunity for him to do paperwork, but it is without a desk. Phone calls can be made, but there may be a lack of privacy. He wants to be able to do more with his day, and not spend his time waiting.

    SMS notification system that originates from within the Operating Room to waiting surgical teams This project explores the design and development of a possible solution, entitled TagTeam, an SMS notification system that originates from within the operating room directly to subsequent surgical teams, allowing for less down-time, better communication among staff including more refined awareness of where they are in the surgical queue, and an overall increase in procedure efficiency. This project combines both user research, and iterative design to create a working prototype for informal user feedback.

    Ideal Scheduling Scenarios from surveyed doctors: All cases start and end on time. The surgeon who schedules his/her day should schedule cases to fit within the allotted time slot.

    Able to schedule case based on how long it will take as opposed to the average time for certain procedure. There are patient and disease factors that are not allotted for in the average case time scenario.

    The OR environment is very complex especially at a General Hospital. We dont concentrate on just one or two different procedures. Factor in complex medical issues in some patients and this can cause huge variance in preparation for their operations. Also this has a huge impact on the length or surgery which is by far the greatest variance without much predictability. This is the main cause of OR delays - Operative time! It has little to do with personnel showing up on time. Im also not sure that the actual scheduling is the cause or contributes to the problem?

    Design and Development This prototype, focused on streamlining the notification process. Using a timer to alert staff that they are 30 minutes away from their scheduled close, allows for a circulating nurse to indicate yes or no if they are on time. If yes is indicated, then a timer counts down, and once at zero, sends out an SMS to the awaiting teams. This prototype allows for an override, and keeps the current team accountable for their time. From the hospital administration viewpoint, this provides data as to which teams are more efficient, as well as which procedures as well. This also can keep the waiting teams in the loop more, which as a simple SMS increases communication. As this prototype has not been user-tested as of this date, it is impossible to surmise whether surgical teams might tune out the SMS alerts and potentially miss the important ones.

    SUMMARY This project introduced TagTeam as a potential solution for operating room efficiency from a usage standpoint. It implements communication from source, relayed to surgical teams due to use the same room, and encourages optimized dialogue for more efficient hospital work flow. An Arduino board equipped with wifi and LCD screen was used to prototype a model whereby a team member in the operating room could quickly and easily communicate directly to subsequent teams their status via SMS (early, on time or delayed 15+ minutes) in increments, allowing better efficient use of time, better overall communication. Additionally, a messaging system via SMS allows for the surgical lead or OR manager to be aware of which team members have responded for increased team awareness.

    HEIDI EVANS began her career as a creative in advertising, and has over 15 years of advertising agency experience from small companies to

    multinational brands, in all facets of print advertising. She then, focused on

    digital, namely social media, content creation, as well as web-based startups.

    In her spare time shes been known to take a few photographs, make a little

    music and travel the world by car, plane or motorcycle.

    TAGTEAM DISPLAY COUNTS DOWN AND CHANGES COLOUR AS IT GETS CLOSER TO ZERO (final SMS is sent out to subsequent teams that the Operating Room will be vacated)

    OPPORTUNITY The timing for surgical procedures rarely goes as scheduled. Sometimes they run overtime, and on occasion, they finish early. Surgical teams for subsequent procedures end up waiting, or the Operating Room sits empty. This wastes time, money and leads to frustration among staff. While procedures are scheduled to the average of the last 10, emergencies and issues arise and cannot be planned.

    SOLUTION TagTeam is a messaging system that originates from within the Operating Room to waiting surgical teams to let them know when theyre running behind. This gives the waiting teams the freedom to go about their day, until their scheduled procedure without having to waste time by waiting in the halls when the current procedure goes over time.

    1. 2007 Annual Report of the Office of the Auditor General of Ontario: 3.09 Hospitals Management and Use of Surgical

    Facilities (pp. 204-231).

    FIGURES BASED ON ONTARIO HOSPITALS IN 2006/07