Battling the Barriers in EP/Cath Labs

The following is a guest blog post by Tom Downes, CEO of Quail Digital.

Clear and unambiguous communication between team members is an essential component of any surgical environment. It’s particularly important – and indeed particularly challenging – in cath labs and electrophysiology (EP) labs where physicians and clinical staff in interventional cardiovascular and other minimally-invasive therapeutics are typically spread across multiple rooms and physically separated by lead-lined doors.

But as patient demand continues to rapidly grow, the inherent complexities of the surgical environment are presenting significant communication challenges between the surgeons, clinicians and nurses. These restrictions are creating great stressors for the whole operating team as they strive to continue to deliver a proficient patient service.

Creating Clear Communication

Stress amongst hospital staff is not just a recognised problem, it’s an escalating one. A study evaluating burnout among surgeons has found that 80% of surgeons agree burnout and stress are issues they should be monitored for. In light of this, it’s clear that maintaining the well-being of healthcare professionals is a challenge, and one that needs to be addressed quickly.

Previous studies have revealed that a number of potential stressors can compromise performance in the OR, including team interaction and extreme noise. It is therefore clear that problems with communication is one of the main barriers that needs to be broken down in order to achieve a tranquil, organized environment that will alleviate pressure in the operating room. The chatter of workmates, the hum of the air conditioning and the relentless drone of essential technology, combines to create a high-stress clinical environment where the multidisciplinary teams’ need for serenity is commonly confounded by practical necessities they cannot change.

Implementing clear and immediate communication will be a positive step towards reducing the complexities of the clinical space. Failure to do this risks squandering the undoubted benefits of surgical innovation; the patient implications of an avoidable clinical error due to miscommunication could, in the worst extremes, be catastrophic. Fortunately, communication technology has evolved to present a simple, affordable solution.

Adopting a Wireless Approach

Traditionally, facilities have adopted primitive measures to deliver communication between the OR and the monitoring suite, including basic hand gestures and microphones in each room. But this approach comes with challenges, for example, the likelihood of mishearing and misreading a fellow surgeon, or instruction, is naturally increased which could then delay the procedure and cause frustration. Another thing to consider is that all the medical team will be equipped with masks, making it difficult to hear and see dated visual and auditory clues.

By adopting wireless headset technology, physicians can transform the OR, EP and cath lab experience, as well as the working environment for the whole team involved in the procedure. The technology, which operates on high quality digital frequencies and is encrypted to avoid interference from other devices or emissions in the OR, enables multidisciplinary teams to collaborate and communicate – hands-free – in the interventional OR or hybrid suite, at monitoring stations, through adjacent control rooms and ancillary areas. A lack of clarity can create stress and blame amongst the operating team, but with the ability to hear instructions clearly in every clinical environment this ambiguity can be avoided. Additionally, the pressures placed upon surgeons will be drastically reduced as they have the confidence of knowing that every member of staff is able to perform their role in a more assured manner.

And as it has been suggested that high-quality teamwork among operating room professionals is key to efficient and safe practice, implementing a system that initiates better communication between staff will be extremely beneficial to the clinical environment. Creating a more attentive, focused team will also be vital to reducing significant stress-levels and enabling greater levels of workflow. Associate Professor and Director of the Robotic and Minimally Invasive Cardiac Surgery program at the University of Chicago Medicine, Dr Husam H Balkhy, has first hand experience of using wireless headsets in a surgical setting, he comments, “My ability to communicate quickly and effectively with other members of the robotic team including the table-side first assistant, the anaesthesiologist, the perfusionist and nursing staff, has led to increased efficacy and patient safety in these complex procedure.”

Balkhy isn’t the only one to have benefitted from these tools, Dr Ziv Tsafrir, a Fellow in Minimally Invasive Gynecology at Henry Ford, adds: “Using wireless headsets during robotic procedures certainly contributed to better patient outcomes by creating a calmer environment for clinicians and staff.”

The Next Steps

As patient demand grows, and the global use of EP and robotics surgery increases, wireless headset technology will be an essential companion to ensure optimal, efficacious and cost-effective communications. Combine this communication tool with the below practices and clinicians will be able to further enhance the surgical environment to not only create more effective workflows and treatment, but to increase positive patient outcomes.

  • Ensuring the surgical team have a focused team discussion prior to surgery to assign roles, establish expectations and anticipate outcomes, will enable each member of the team to be prepared for any scenario that may play out. This will be beneficial to the patient’s experience and will reduce the level of stress to a minimum.
  • Whilst a briefing before the operation is an extremely important part of the medical process, a debriefing post-op is just as vital. This discussion gives the whole team the opportunity to explore the problems that occurred during the procedure and how these can be overcome before the next operation.
  • Good communication is also vital outside the cath / EP lab and amongst the rest of the hospital staff. Lack of clarity about responsibility for care and decision-making is a major contributor to medical errors and could have an extremely negative impact on the operating room.
  • In a medical setting, the person who is supposed to act on information isn’t always clearly identified. Therefore, team members should communicate clearly, both at the beginning and throughout the operation, who this person is.

By working together and communicating clearly to one another before, during and after the procedure,  the stress levels of the entire surgical team and the patient can be significantly reduced.

About Tom Downes
Tom Downes founded Quail Digital in 1995 to design headset systems for ‘team’ communication. The philosophy being that the easier and more freely a team can speak with each other in the workplace, the better their outcomes, wellbeing and productivity. Quail Digital designs and manufactures systems for the healthcare, retail and hospitality sectors, and has offices in Dallas, TX and London UK. Quail Digital is the leading provider of communications systems in the OR, and a sponsor of Healthcare Scene.