Anne van Dalen

The influence of working in a Black Box monitored operating room on safety behaviour I 189 7 The ORBB Highly performing teams working in the OR need to have a proactive attitude towards error reporting, management and prevention to improve surgical safety, but need to be provided the tools to do so. 11 The ORBB was therefore introduced in one OR and used as a tool to support structured postoperative team debriefing with the aim to improve safety behaviour. 5,12 Details on implementation of the ORBB, legal considerations and the results of the pilot study itself are presented in previous articles. 1,5,6,13 An explanatory summary on the use of ORBB was created after completion of the ORBB trial is visually presented in an online publicly available video named “A Black Box in the operating theatre. Good idea?” (https://www.youtube.com/watch?v=_Vu2AQa10NY ). Participation in this video was voluntary and it was created for a congress about the ORBB at our centre. Whilst implementing the ORBB, there was a lot of resistance from the OR staff, as they presumably did not believe in the outcomes of the ORBB and were afraid their privacy could not be protected. Yet, those who did decide to participate, based on positive experiences shared by their peers, reverted their opinion when they came to better understand how their privacy was protected and consequently experienced the benefits first-hand. 5 The positive compliance of the OR team members who chose to participate was previously demonstrated in another study. 5 Outcomes and data collection In order to improve the surgical safety culture, it may be considered important to start with understanding the current safety behaviour of those working in the OR (i.e. why do they do things or why do they think about problems this way?). 11,14,15 The primary aim of this study was therefore to evaluate the attitudes of all healthcare professionals working at the OR complex of one tertiary referral centre. The secondary outcome was to evaluate if implementing ORBB for team debriefing purposes is of influence on staff’s perception towards patient safety. The survey was digitally administered (by e-mail) to all the healthcare professionals, by the OR manager, with approval of the heads of all the departments. The