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Northwell First in the US to Pilot Black Boxes in Hospital ORs



Dr. Louis Kavoussi, chair of urology at Northwell Health, has been using Black Box technology during surgical procedures at LIJ Medical Center.

Technology allows surgical data to be analyzed for quality care review

By: Andrea Mineo

To advance quality outcomes for both patients and clinical staff, Northwell Health has started using black box technology in its operating rooms (OR) – the first US health system to use this technology. The initiative is currently being piloted with laparoscopic urologic and colon surgical teams at Long Island Jewish (LIJ) Medical Center, where two dedicated ORs have been fitted with equipment to capture information during surgeries.

Much like flight data recorders used in aviation, the OR Black Box® captures video and audio of the operative procedure, along with physiological data from the patient and the anesthesia monitor. Data is also captured using various sensors that are placed throughout the OR. The data then gets synchronized and reconstructed for quality care review and improvement. The OR Black Box does not capture any personal health information about the patient or images. The initiative is confidential and non-punitive.

“I think it is very innovative for Northwell to be the first health system in the United States to use this technology,” said Mark Jarrett, MD senior vice president and chief quality officer at Northwell Health. “The OR is the one place that nobody has ever really studied well. Yet, we know that surgical cases can be very complex and risky. The OR Black Boxes enables surgical teams to learn, minimize risk and improve care. It is a proactive approach to improving safety and replicating favorable practices. The data collected is all secure, and the names of the patients, surgeons and all the individual cases are not identified, so everybody’s privacy is protected.”

Dr. Kavoussi, LIJ Medical Center pilot new review process

Louis Kavoussi, MD, chair of urology at Northwell Health, was the first surgeon to use the OR Black Box. “I think this technology is important because it begins to dissect out potential issues that can adversely affect patient outcomes in the operating room — and the operating room itself has been a black box,” Dr. Kavoussi said. “This is an opportunity to start analyzing what happens in the operating room to see if there are ways of improving patient outcomes further.”

OR Black Black Box® technology was created by the Canada-based firm Surgical Safety Technologies in 2014. Surgeons there and in Europe have been using it over the past five years.

“I’m absolutely convinced that this will change the way we practice surgery and bring a level of openness, transparency and accountability,” said Teodor Grantcharov, MD, director of the International Center for Surgical Safety in Toronto, and the inventor of OR Black Box. “No one would question the value and the impact the black box has made in the aviation industry.”

From a personal standpoint, he added, “This technology has made me a better surgeon. When I was a resident, I used to look at my own surgeries on VHS tapes and I realized there were so many things that I could have done better. That’s when I realized that we need a better system of providing feedback that could help us critically reflect on our performance. Because this is the only way we can improve.”

Northwell Health is preparing to expand the technology to ORs at other hospitals across the health system.

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