Title: Participatory design: implementation of time out and debriefing in the operating theatre

Authors: Linda S.G.L. Wauben, Connie M. Dekker-Van Doorn, Jan Klein, Johan F. Lange, Richard H.M. Goossens

Addresses: Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628 CE Delft, The Netherlands; Department of Surgery, Erasmus University Medical Center, Postbox 2040, 3000 CA Rotterdam, The Netherlands. ' Institute of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands; Department of Anaesthesiology, Erasmus University Medical Center, Postbox 2040, 3000 CA Rotterdam, The Netherlands. ' Institute of Health Policy and Management, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA Rotterdam, The Netherlands; Department of Anaesthesiology, Maasstad Ziekenhuis, Postbox 9100, 3007 AC Rotterdam, The Netherlands. ' Department of Surgery, Erasmus University Medical Center, Postbox 2040, 3000 CA Rotterdam, The Netherlands. ' Faculty of Industrial Design Engineering, Delft University of Technology, Landbergstraat 15, 2628 CE Delft, The Netherlands; Department of Neuroscience, Erasmus University Medical Center, Postbox 2040, 3000 CA Rotterdam, The Netherlands

Abstract: Surgical patients are at risk of avoidable damage. A |time out procedure| plus debriefing (TOPplus) to check relevant operative items systematically with all team members was designed for five Dutch hospitals in order to reduce avoidable damage during and after a surgical procedure. The overall aim of this study was to evaluate if participatory design (PD) was an appropriate method for designing TOPplus. The study consisted of two parts: 1) designing TOPplus by means of PD; 2) testing the design|s content and usability. Design of TOPplus with a multidisciplinary design-expert-team and adapting it to its local context with the hospital-expert-teams proved to be valuable, fast and easy. In most hospitals, PD reduced the resistance to change and PD was effective in engaging the hospital-expert-team. In order to design product and processes for healthcare that meet the users| specific needs it is recommended to include more users from the different system levels and allow more time and more moments for contextualisation.

Keywords: participatory design; time out procedure; non-technical skills; contextualisation; dialogue-based; catalyst; errors; communication; teamwork; human factors; healthcare management; operating theatres; debriefing; design research; The Netherlands; surgical procedures; surgery; multidisciplinary design; hospital teams; resistance to change; process design.

DOI: 10.1504/JDR.2011.041391

Journal of Design Research, 2011 Vol.9 No.3, pp.220 - 240

Received: 29 Jul 2009
Accepted: 06 Aug 2010

Published online: 16 Oct 2014 *

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