Anne van Dalen

104 I Chapter 3 As a result of the positive outcomes of this study, the OR Black Box® system is about to be implemented in full operational modus on multiple clinical operating theatres in our academic medical centre. The performance report is currently, with the help of machine learning software, continuously improving and can now be used for multiple purposes including open surgery in multiple medical centres. 63 Future studies have to determine the effect of including the recording of the entire procedure (start when patient enters the OR and stop when patient leaves the OR) and subsequent anaesthesiology data analysis feedback embedded in the performance report. Further building and incorporating deep-learning artificial intelligence software algorithms capable to process OR Black Box® data are going to provide more accurate assessment of false/true negative/positive events. 64 This may result in scalability of the model, feasibility of team debriefing and an even higher level of user satisfaction. Amulticentre study is to be advocated to assess if the OR Black Box® performance report in combination with the Black Box Debrief Model is culturally robust and able to guide discussion during postoperative multidisciplinary debriefings in other medical centres as well. Acknowledgements The authors would like to thank all the surgical residents, anaesthesiologists, anaesthesiology residents, operating nurses and anaesthesiology nurses for their participation in this project and the supervising assistants for scheduling the participating team members for the selected procedures. We would like to thank the OR Black Box® analysis centre for analysing the cases and providing the performance reports for the team debriefing sessions. We would also like to thank our technical team for making the installation of the OR Black Box® in our medical centre possible.