Anne van Dalen

186 I Chapter 7 ABSTRACT Background Despite numerous initiatives to improve quality and safety in the operating room (OR), the incidence of preventable surgical errors remains too high. An operating room Black Box® (ORBB), a medical data recorder, was therefore implemented in one OR of our tertiary referral centre. Its output was used as template underpinning structured postoperative team debriefings. In order to sustainably implement a quality and safety improvement initiative such as the ORBB, it is considered important to understand the attitudes, beliefs and perceptions concerning safety of all healthcare professionals involved. The aim of this study was 1) to assess OR staff’s attitudes towards patient safety culture in the OR specifically, and 2) to evaluate if working with an ORBB influences their perception of patient safety. Methods The Dutch version of the validated Hospital Survey on Patient Safety Culture was administered to all professionals working in the OR complex. Ten questions regarding the use of the ORBB were added. The mean and the positive response rates (PRR) of the 11 patient safety culture dimensions in the questionnaire were calculated. Results In total, 126 professionals completed the survey (response rate 24.18%). Overall perception on patient safety was scored with a mean of 3.06 (SD 0.46) on a 5-point Likert Scale). Safety dimensions achieved lower scores from the OR nurses compared to the other professionals in the OR. Overall, the attitude of OR professionals participating in team debriefings using ORBB is positively correlated with their perception on patient safety (P-value<0.024, 95%, CI 0.034-0.474, Bèta-coefficient 0.196). Conclusions There is a variety in perception of the safety culture in the OR between the different OR professionals. Professional participation in ORBB assisted debriefings may impact safety behaviour, as it provides the opportunity to discuss differences in perceptions concerning beliefs, opinions, needs and attitudes on improving surgical safety. The results of this study may help centres to implement this quality and safety improvement system more broadly and in a sustainable manner.