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What’s New in the
Patient Safety World
February 2024
Both Sides of the
Black Box
The Boston Globe recently ran an interesting article about Mass General Brigham Faulkner Hospital implementing the Black Box video recording system in its OR’s (Freyer 2024). Our regular readers know we are big advocates of such recording from a patient safety perspective.
But the Globe article does a nice job of discussing both the pro’s and con’s of using such systems. Faulkner is piloting the system in 2 of its 16 OR’s. Interestingly, nurses and others who work in the operating room uniformly object to the OR Black Box, according to the article. Despite the fact that the videos are immediately de-identified (faces blurred, bodies distorted so no one can tell who was there) and all recordings are erased after 30 days, staff are concerned about patient privacy, liability, and whether the data could be used in disciplinary actions or that the recordings could be subpoenaed in a malpractice case.
The hospital’s lawyers and malpractice insurers have studied the question of liability and are not concerned, but a Boston malpractice lawyer said he would definitely attempt to obtain Black Box recordings if they were relevant to a malpractice case, and he believes he might succeed. The article, though, says the company that makes the Black Box has yet to be brought into such suits.
We’re surprised by the nurses’ negative views about the Black Box recording. Constructive review of OR recordings can greatly improve communication and teamwork in the OR setting, improving the workplace environment. The patient safety aspect can significantly be improved when it demonstrates, for example, gaps in compliance with the surgical timeout or the surgical counts.
Our many columns listed below have emphasized the many potential benefits of OR Black Box video recording. (See for example our March 17, 2020 Patient Safety Tip of the Week “Video Recording in the OR” for a good compilation of those benefits). We hope the Faulkner staff will eventually come around and appreciate the recording, as have staff at many other hospitals. Its potential impact on communication, teamwork, safety culture, and patient safety are huge.
Some of our previous columns discussing video recording:
September 23, 2008 “Checklists and Wrong Site Surgery”
December 6, 2010 “More Tips to Prevent Wrong-Site Surgery”
November 2011 “Restricted Housestaff Work Hours and Patient Handoffs”
March 2012 “Smile...You’re on Candid Camera!”
August 27, 2013 “Lessons on Wrong-Site Surgery”
March 17, 2015 “Distractions in the OR”
November 24, 2015 “Door Opening and Foot Traffic in the OR”
March 2019 “Another
Use for Video Recording”
March 17, 2020 “Video Recording in the OR”
June 2023 “WSJ on Video Recording in the OR”
References:
Freyer FJ. Shining a glaring light on surgery: technology that records every move aims to improve safety. Faulkner Hospital is trying out a system called the “OR Black Box,” which collects data to pinpoint missteps during operations. Boston Globe 2024; January 13, 2024
https://www.bostonglobe.com/2024/01/13/metro/ai-surgery-blackbox-brigham-boston/
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