Anne van Dalen

174 I Chapter 6 METHODS This study was part of a pilot study aiming to implement a video- and medical data recorder (MDR) in an OT, used as a tool for structured postoperative multidisciplinary debriefings to improve surgical safety (van Dalen et al 2020b). Thirty-four laparoscopic (gastro-intestinal) procedures were recorded with the MDR and debriefed with the entire OT team outside the OT (in a neutral environment), using the MDR outcome report (van Dalen et al 2020a). The Works Council (staff representation) and Hospital Directorate approved the study. All subjects gave their written informed consent for participation in the MDR procedures and the MDR debriefings. During the multidisciplinary debriefings of the MDR pilot study, the study coordinators hypothesised that the OT team members were often not able to remember the names of their peers and that miscommunication was one of the main topics during these debriefings (van Dalen et al 2020b). Name recall was therefore evaluated by asking the participants (i.e. the entire OT team) before start of each postoperative multidisciplinary MDR debriefing, to write down the names of all the participating teammembers with whom they had worked during the particular case. Sitting at a table, they noted their team members’ names and pairing role on a paper sheet. The completed sheets were returned to the study coordinator. Subsequently, their own name was written on a triangular name plate, so that all names were visible throughout the debriefing (see Figure 1). Moreover, the study coordinator was present in the OT during all 34 recorded procedures and noted whether or not an official introduction round was carried out with the entire team in the OT, according to the SSC (SURPASS = Surgical Patient Safety System) (de Vries et al 2008, WHO 2009). Following the results of the name recall evaluation, the theatre cap challenge was introduced by placing name and role sticker stations in the dressing rooms of the operating complex (November 2018), as shown in Figure 2. The OT staff was notified accordingly via email and asked to wear the name stickers on their surgical caps. Use of the name stickers was voluntary. Board members and team leaders acted as role models in wearing the name stickers.