Dual Console Technology Robotic Platform Intraoperative Handoffs: “Near Miss” Prevention and Patient Safety Enhancement

Abstract

BACKGROUND: Dual Console Robotic training has been used in resident training and assessment as well as faculty development. A trans cockpit authority gradient coupled with poor communication skills during robotic arm handoffs contributed in several “near misses” over 6 years of dual console instruction and curriculum development and assessment. These events prompted development of an intraoperative handoff with verbal declaration followed by verbal confirmation. This mirrors current aviation cockpit safety models. Pre and post study Lickert questionnaires utilizing Lickert scale evaluated factors such as comfort levels of teacher and learner, arm assignment confusion, and apprehension. Near misses were tracked. Percentage of complete handoffs were tracked. This study outlines a safe, easily adopted communication and teaching skill that enhances patient safety and reduces near misses. METHODS: Analytic Observational Cohort Study. Lickert Pre and Post intervention. Setting: University Teaching Hospital. Patient Population: All from faculty practice associated with Medical School. All agreed to resident participation in their care. RESULTS: No interventions were required. No near misses in the study. No adverse events occurred during intraoperative handoffs. No confusion over control of robotic arms. There were incomplete surgical handoffs identified. DISCUSSION: Dual console robotic technology provides an unique teaching opportunity for surgical education. Aviation cockpit verbal handoffs are well documented to enhance aviation safety. The robotic intraoperative handoff can mimic this and is an easily adopted and useful teaching method to minimize confusion in co surgeons and minimize risks to patients in dual console robotic surgical procedures.