Operating Room Best Practices for Human Factors Study

Contextual inquiry (CI) is a systematic study of people, tasks, procedures, and environments in their work places. It is a commonly used method in user-centered design as the basis for product decisions and strategy.

Recently, the book Contextual Inquiry for Medical Device Design by Mary Beth Privitera (Elsevier 2015) was published to guide medical device design practitioners and students in CI methodology. I had the privilege of contributing a chapter to the book on operating room (OR) etiquette.

Observing in the OR is a privilege with responsibility. Being prepared and knowledgeable about how to look and act is critical for two reasons:

  1. Lacking in preparation and knowledge poses a risk for you, the hospital staff, and most importantly, the patient.
  2. You represent those who will come after. Making a bad impression could force the unit or hospital to ban third-party admittance, adversely affecting future studies and products.

Keeping that in mind, here are a few tips from the book to start you on the right path for keen OR observation:

  1. Prepare in advance. Prior to the visit, be sure to find out how many observers are allowed in the OR at any given time. You may have to take turns with a colleague or sales rep or even view through a window.
  2. Know in advance what you can and cannot take inside the OR with you. This ranges from a notepad or video camera to your personal belongings. If you unexpectedly learn that you cannot take something valuable inside the OR with you, you may be forced to leave it unsupervised.
  3. Learn the OR staff. Be knowledgeable in regards to the different roles (surgeon, physician’s assistant, resident, scrub nurse, circulator, anesthesiologist, and so on) within the OR and act respectfully toward each.
  4. Introduce yourself. Once in the OR, introduce yourself to the circulator and share your purpose. If the circulator is not immediately available, wait against the wall until approached. Provide a business card so the circulator can document your information without having to take the time to record it personally.
  5. Stay out of the way. Often the OR staff will not know where to position you until the patient is draped. Once invited into the OR, stand against a wall out of the sterile field (three feet radius of draping) unless otherwise directed.  Likely you will be given direction where to position yourself, but if you do not, ask only when appropriate. Sometimes it can be hard to get a camera shot or ideal view, but remember that the surgical team and patient must come first.

These are a sampling of advice and tips regarding OR best practices within the book. In addition to OR best practices, Contextual Inquiry for Medical Device Design offers advice on how to plan, execute, analyze, and document an effective CI study. The book also provides numerous case studies that convert theory to practice. Happy reading!

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