Developing an emergency robotic undocking protocol using simulation

Abstract

Emergent undocking of the surgical robot is a high-acuity low-frequency event that requires knowledge and proficiency to optimize patient safety. Simulation was used to codify sequential processes, roles, and responsibilities. This quality improvement project aimed to develop a protocol for use during emergent undocking of the surgical robot. A pre-post interventional design was used. One pre- and two post-intervention simulation performances of interprofessional teams were observed during intraoperative crisis events. Educational sessions provided instruction on roles and responsibilities and emergent undocking procedures. Interprofessional simulation training sessions allowed staff to refine and practice emergent robotic undocking. Timed endpoints notably improved. Participant confidence in the emergent undocking of the surgical robotic improved. Adherence initially improved then declined to pre-intervention levels. Project outcomes showcase the utility of emergent robotic undocking procedures, and demonstrate the effectiveness of conducting simulations to codify and refine the process of emergency robotic undocking. • Interdisciplinary simulation activities allowed assessment of team performance. • Repeated simulation scenarios improved emergent robotic undocking processes. • Mean times for vital signs identification decreased from 40 s to 20 s. • Undocking speed decreased by 46 s after two simulation periods. • Interprofessional in-situ simulation exercises led to improved confidence scores.