A protocol for the implementation of new technology in a highly complex hospital environment: the operating room

Navin Sewberath Misser,Joris Jaspers,Johan Versendaal,Hein Gooszen,Bas Van Zaane

doi:10.1504/ijnvo.2020.105543

Abstract

Medical equipment is implemented in highly complex hospital environments, such as operating rooms, in hospitals around the world. In operating rooms (ORs), technological equipment is used for surgical activities and activities in support of surgeries. The implementation of government policies in hospitals has resulted in varying implementation activities for (medical) equipment. These result in varying lead times and success rates. An integral and holistic protocol for implementation does not yet exist. In this study, we introduce a protocol for the implementation of (medical) equipment in ORs that consists of implementation factors and implementation activities. Factors and activities are based on data from a systematic literature review and an explorative survey among surgical support staff on factors for the successful implementation of technological and (medical) equipment in ORs. The protocol consists of five factors and related implementation activities: the establishment of a project plan, organisational preparation, technological preparation, maintenance, and training.

Highlights

Operating rooms (ORs) or operating theatres are examples of highly complex and dynamic environments where technological equipment is used before, during and after surgeries
We compose a protocol for implementation based on a systematic literature review
This protocol is based on a systematic literature review and an explorative survey that was conducted among surgical support staff

Summary

Introduction

Operating rooms (ORs) or operating theatres are examples of highly complex and dynamic environments where technological equipment is used before, during and after surgeries. In the Netherlands, the Dutch Hospital Association (NZA) has agreed upon a set of rules with regard to the implementation of new medical devices in hospitals: the Covenant Medical Technology (CMT). This agreement provides policy guidelines throughout the lifecycle of (medical) equipment – with regard to its acquisition, implementation, use, and disposal – to ensure patient safety (Dutch Hospital Association, 2016). Locally-defined policies have resulted in hospital-specific methods of implementing (medical) equipment and in a variety of implementation activities This variety has resulted in different implementation outcomes and increased implementation lead times, which can result in the increased use of resources, such as implementation time, funds, and involved members (Wickramasinghe et al, 2008). We conducted research on necessary factors for the implementation of new (medical) devices in highly complex hospital environments, with a specific focus on ORs, to answer the following research question: Which factors for successful implementation can be identified to compose a protocol for the implementation of (medical) equipment in ORs?

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Conclusion