Anne van Dalen

2 Development of a model for video-assisted postoperative team debriefing I 59 In this pilot study, 35 laparoscopic abdominal cases were recorded, analyzed, and debriefed with the entire OR team. As the patient was not the main subject of this quality improvement study, institutional review board approval was not required. However, this study was formally approved by the Hospital Directorate and Works Council (staff representation). To ensure the privacy of all participants, the research protocol was checked to be compliant with applicable privacy, legal, and regulatory requirements by conducting an official Privacy Impact Assessment. 20 The study subjects were voluntarily asked to give their formal written informed consent before participation. 19,21 The OR Black Box obtained all intraoperative data feeds, including audiovisual recordings in the OR, and depersonified patient physiological data. 22 The data feed combined views of the surgical field, nursing station, laparoscopic camera, and anesthesia station, including the anesthesia patient-monitoring device. Recording began just after the patient was being put to sleep and ended after skin closure, just before the drapes were removed. The multisource data recorded by the OR Black Box are automatically analyzed with the help of artificial intelligence (AI) and machine learning software. 23 The data, multisource and synchronized on capture, were used to generate the standardized OR Black Box performance report that included video segments of all identified safety threats and resilience support events, coded according to the validated Systems Engineering Initiative for Patient Safety model. 24 The video segments included qualitative descriptions of the event. An example of the original standardized performance report is demonstrated elsewhere. 19 The developed debrief model was used to help lead the video-assisted Black Box team debriefings. The results of the pilot study concerning the satisfaction of the team with the use of the OR Black Box for team debriefing and what was actually discussed during the team debriefings are presented in another study. 19,24 Literature search and outcomes First, problems with the currently reported debrief methods were identified by a literature review. A comprehensive search for the peer-reviewed medical literature regarding debriefing for medical teams and in other industries with and without the use of video and medical data recording in a clinical setting was performed and updated on July 17, 2019.