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Etherington N, Usama A, Patey AM, et al. Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework. BMJ Open Qual. 2019;8(3):e000686doi: 10.1136/bmjoq-2019-000686.
Etherington, N., Usama, A., Patey, A. M., Trudel, C., Przybylak-Brouillard, A., Presseau, J., Grimshaw, J. M., & Boet, S. (2019). Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework. BMJ open quality, 8(3), e000686. https://doi.org/10.1136/bmjoq-2019-000686
Etherington, Nicole, et al. "Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework." BMJ open quality vol. 8,3 (2019): e000686. doi: https://doi.org/10.1136/bmjoq-2019-000686
Etherington N, Usama A, Patey AM, Trudel C, Przybylak-Brouillard A, Presseau J, Grimshaw JM, Boet S. Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework. BMJ Open Qual. 2019 Aug 01;8(3):e000686. doi: 10.1136/bmjoq-2019-000686. eCollection 2019. PMID: 31428707; PMCID: PMC6683111.
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BMJ Open Qual. 2019 Aug 01;8(3):e000686. doi: 10.1136/bmjoq-2019-000686. eCollection 2019.

Exploring stakeholder perceptions around implementation of the Operating Room Black Box for patient safety research: a qualitative study using the theoretical domains framework.

BMJ open quality

Nicole Etherington, Aya Usama, Andrea M Patey, Chantal Trudel, Antoine Przybylak-Brouillard, Justin Presseau, Jeremy M Grimshaw, Sylvain Boet

Affiliations

  1. Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
  2. School of Industrial Design, Carleton University, Ottawa, Ontario, Canada.
  3. School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
  4. Department of Anesthesiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.

PMID: 31428707 PMCID: PMC6683111 DOI: 10.1136/bmjoq-2019-000686

Abstract

BACKGROUND: Systematically observing clinical performance in the operating room (OR) to support patient safety initiatives faces numerous logistical and methodological challenges. These may be solved by new audio-video recording technologies like the OR Black Box, which is a tool similar to black boxes in aviation. This study aimed to identify barriers and enablers that may influence patients', clinicians' and senior leadership team members' support of the OR Black Box in order to guide its future implementation.

METHODS: Patients, clinicians and senior leadership team members were recruited to participate in semistructured interviews informed by the theoretical domains framework (TDF) to identify factors relevant to planning OR Black Box implementation. Deidentified interview transcripts were analysed in duplicate following a TDF coding structure.

RESULTS: Data saturation was achieved at 15 patients, 17 clinicians and 9 senior leadership team members. Seven domains were relevant for patients, nine for clinicians and four for senior leadership. Knowledge and Beliefs about consequences were barriers and enablers for all three groups. Memory, attention and decision processes and Social influences were enablers for both clinicians and senior leadership. Environmental context and resources, Emotion and Behavioural regulation were found to be barriers and enablers for both clinicians and patients. Social/professional role and identity and Reinforcement were enablers for patients only and Optimism and Intentions were barriers and enablers to clinicians.

CONCLUSIONS: While most stakeholders were supportive of the OR Black Box, we identified many key areas that need to be addressed during its implementation. It is critical to ensure all stakeholders have adequate and accurate information about the OR Black Box system and research goals, and that the OR Black Box is positioned as a patient safety initiative for learning from and improving practice.

Keywords: healthcare quality improvement; implementation science; patient safety

Conflict of interest statement

Competing interests: None declared.

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