Research Areas

Robot-assisted operations involve a complex operating room environment with significant physical and cognitive demands, posing threats to patient safety and efficiency. Over 80 robot-assisted operations were observed for workflow disruptions (deviations in the natural progression of a task) to identify systemic vulnerabilities and develop data-driven solutions. Challenges associated with coordination, instrument retrieval and setup and robot docking have been identified. These findings guided the development of interventions to reduce disruptions and enhance safety and efficiency in robot-assisted surgery. Ongoing, grant-funded research evaluates ergonomics in robot-assisted surgery, seeking opportunities to reduce physical and mental strain and improve surgeon wellbeing.

The time required to clean and prepare an operating room (OR) between two surgical cases, commonly referred to as turnover time, has been the subject of numerous research articles and OR committee discussions for several years. Turnover times are a common performance metric used to study OR efficiency, representing a necessary but non-income-generating time in a highly sophisticated environment with highly trained staff, leading to high fixed costs. The Gewertz, Cohen and Jain Lab are using a systems approach to identify all areas contributing to inefficient operating room turnover by exploring current operational processes, tasks, technologies, tools and the environment and individuals involved.

SNM devices are complex and lead to significant patient issues related to understanding procedural risks, post-operative expectations and device interactions. Patients undergoing SNM device placement for overactive bladder were evaluated, and data, including patient pre-operative preparedness, satisfaction, perceived usability and barriers impacting patient experience, were collected. Patients had difficulty understanding the risks of the procedure, did not know what to expect post-operatively and were dissatisfied with pre-operative materials. Interventions were developed, including a pre-procedure educational video and informational sheet, detailed discharge instructions and a nursing in-service. Pre-operative preparedness, post-operative satisfaction and perceptions of usability increased significantly after the intervention.

Team cohesion is critical for the quality and safety of patient care delivery. An escape room, a novel practice-based application for team-building experiences, was developed and utilized to study teamwork and its determinants. Sixty-two teams, with a total of 280 participants, engaged in the escape room activity. Participants demonstrated increased levels of perceived group cohesion immediately following participation in the activity and at the one-month follow-up. This work offers insights into the utility of using escape rooms as team-building interventions among interprofessional healthcare teams.

A prior analysis identified missed opportunities to learn from intra-operative deaths, as well as the significant emotional burden of these events on operating room team members. As a result, a multidisciplinary team developed an intra-operative mortality debrief tool built upon three aims: (1) a focus on providing support for all individuals involved; (2) a clear structure; and (3) identification of systems facilitators and barriers that might not otherwise be captured. This focused debrief emphasizes the safety and mental health of all staff.