Assessing speech communication in the operating room

Abstract

Smooth communication in the operating room (OR) is essential. However, its acoustic environment is typically composed of machine and human caused sounds such as patient temperature monitoring devices, systems, waste management systems, and irrelevant conversations that impede speech communication. These challenges are exacerbated by the need for combinations of facial protective equipment (FPPE) that both attenuate critical speech information as well as obviate relying on visual information for understanding speech. In order to faithfully capture the challenges to speech perception in this environment, we first recorded various interfering sounds based on a qualitative study of over 59 surgeries across different specializations. We analyzed their acoustic characteristics and obtained subjective measures of perceived interference from 60 surgical team members who all worked in the OR. In a follow up study, we assessed the acoustic consequences of different facial ppe combinations on produced speech. In both studies, we identified critical impediments to smooth OR communication. These include high decibel levels of interfering sounds, attention engaging irrelevant speech, and substantial attenuation of speech frequencies when using typical FPPE combinations. These studies constitute our preliminary steps to identifying and alleviating speech perception challenges in the OR.