Cameras in the OR

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Wanted to get an idea whether your hospital has cameras in every OR. We're at a small community hospital (150 beds) with 12 ORs. Administration wants cameras to increase OR efficiency and lower room traffic. OR desk can then monitor whether room is being set up between cases, and also whether drapes up or down, incision has been made, closing skin, etc. instead of going in and out of OR. Cameras won't record and won't have sound. Surgeons are very against it - saying it's violation of patient confidentiality and invasion of privacy.

Our department isn't really for or against. We understand the pros and cons. Just wanted to see what others have at their place. They had cameras in every OR where I trained 15 years ago, so this is nothing new. Any input is much appreciated.

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we have cameras at one of our hospitals at the main OR desk only. What is on the screen it is impossible to discern in detail what the proceduralist is doing. I don't know the cameras' zoom capabilities. Supposedly they don't record. Given those caveats, Our department doesn't see a problem. Don't forget the hospital doesn't want any liability issues generated by this.
 
We have cameras in every OR at my place. They’re all up in one corner of the room and you really can’t tell what’s going on in the room in any sort of detail, just broad strokes as noted above: are drapes up/down, is the room being turned over, etc.. I’m not sure if ours record, this thread has prompted me to find out, but based on previous responses I’m guessing probably not as we are part of a large multi-state hospital system.
 
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No cameras at my place but had them in fellowship. There was 2 giant screen TVs by the central board area that had a feed of each one. Refresh rate was maybe 3-4 frames per second, so choppy and grainy. Only able to see what above posters had mentioned.

I found it useful, but no more useful than a color coordinated main board with indicators like incision, CLOSING, pacu delay, pt out of room, etc.. which we had in residency.
 
I found it useful, but no more useful than a color coordinated main board with indicators like incision, CLOSING, pacu delay, pt out of room, etc.. which we had in residency.

Yeah, seriously. I don’t have a problem with low res no sound cameras, but since we already have a color coded epic status board, the only thing we need to get the same information as the cameras is for periop staff to update the board after coordinating with each other using a very advanced piece of technology called a telephone.
 
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If I was a patient, saw the camera, and hadn't been told they would he there, I would be pissed. How do I know the quality etc.
 
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We tried to put some temporary cameras in the OR to do some QI around hand hygiene for anesthesia providers. Nursing union caught wind and I was almost fired. Apparently it’s in their contract that they can’t be filmed (never mind that the cameras were trained on anesthesia, not the room/nurses/patient).
 
We tried to put some temporary cameras in the OR to do some QI around hand hygiene for anesthesia providers. Nursing union caught wind and I was almost fired. Apparently it’s in their contract that they can’t be filmed (never mind that the cameras were trained on anesthesia, not the room/nurses/patient).

You placed OR cameras without clearing it with hospital administration first?

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Still don't understand why they're needed, especially with the chance of them being recorded. Would love to see the malpractice suits, makes it hard to defend a case for any bad outcome when you've got any F up recorded. Just let the OR nurses do the usual charting on EMR with indicators for key events.
 
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You placed OR cameras without clearing it with hospital administration first?

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Well, when you put it like that…

It in actuality, we were just trying a brief proof of concept exercise to see if it would even work. We used an empty operating room and everything. Nevertheless, the work out out.
 
We have cameras in both hospitals. Projects to surgeon lounge and or desk. Makes it easy to tell when patient jn room, asleep or ready to be draped.

Also, you can bitch to the OR desk when your staff isn't doing anything or if someone is too close to the sterile field.
 
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We have cameras in both hospitals. Projects to surgeon lounge and or desk. Makes it easy to tell when patient jn room, asleep or ready to be draped.

Also, you can bitch to the OR desk when your staff isn't doing anything or if someone is too close to the sterile field.


So you have naked unconscious patients on the screen in the lounge?
 
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We have cameras in both hospitals. Projects to surgeon lounge and or desk. Makes it easy to tell when patient jn room, asleep or ready to be draped.

Also, you can bitch to the OR desk when your staff isn't doing anything or if someone is too close to the sterile field.

Begs the question...how close is too close?
 
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Wanted to get an idea whether your hospital has cameras in every OR. We're at a small community hospital (150 beds) with 12 ORs. Administration wants cameras to increase OR efficiency and lower room traffic. OR desk can then monitor whether room is being set up between cases, and also whether drapes up or down, incision has been made, closing skin, etc. instead of going in and out of OR. Cameras won't record and won't have sound. Surgeons are very against it - saying it's violation of patient confidentiality and invasion of privacy.

Personally I think those are bogus reasons. To do what they want, someone either has to watch the screens quite frequently, or they're going to be recorded (I don't care if they tell you they won't - the capability will surely be there which makes it suspect). Our EMR shows in room, out of room, incision, in PACU, etc. Not sure why cameras would add anything to that.

I'm surprised they'll even consider it if the surgeons are totally against it. That would be end of discussion at our place.

That being said - we do have a couple cameras at one of our surgeon-owned centers where the surgeons flip-flop between two rooms, just so the surgeons can see if their next patient is being prepped, etc.
 
We have them in every OR. And they can record video and audio.
When they had some scheme to record everyone, but only keep the recordings if there was a known unforeseen emergency everyone went crazy and it never happened. Though all level 1 traumas are recorded, reviewed, and archived forever.
 
We have them in every OR. And they can record video and audio.
When they had some scheme to record everyone, but only keep the recordings if there was a known unforeseen emergency everyone went crazy and it never happened. Though all level 1 traumas are recorded, reviewed, and archived forever.

Doesn't sound like a good idea. I used to work at a place where level 1 traumas were recorded, reviewed and deleted automatically after like 45 days.
 
They don’t delete them because they are afraid that in the event of litigation, the act of deleting the encounter will be argued to be done to hide errors or poor performance regardless of policy. They are actually very experienced and well practiced in the trauma bay. I can’t see any significant risk. No more than an EAR not allowing for the fantasy vitals that many used to chart.
 
Personally I think those are bogus reasons. To do what they want, someone either has to watch the screens quite frequently, or they're going to be recorded (I don't care if they tell you they won't - the capability will surely be there which makes it suspect). Our EMR shows in room, out of room, incision, in PACU, etc. Not sure why cameras would add anything to that.

I'm surprised they'll even consider it if the surgeons are totally against it. That would be end of discussion at our place.

That being said - we do have a couple cameras at one of our surgeon-owned centers where the surgeons flip-flop between two rooms, just so the surgeons can see if their next patient is being prepped, etc.

I should say some surgeons are against it - and they are quite vocal. It still has to be discussed among the entire surgery department at their next meeting.

Administration is trying different things to improve turnovers. One chronic issue is let's say case is over at 2:45 PM and staff leaves at 3:30. They will drag their feet for 45 minutes and not set up the next case. I'm sure this happens everywhere. At least with a camera the OR desk can see that nothing is happening and hunt down the staff. Hard for the charge nurse to walk in and out of every OR all day long. If this does improve issues like this, surgeons may change their mind.
 
I should say some surgeons are against it - and they are quite vocal. It still has to be discussed among the entire surgery department at their next meeting.

Administration is trying different things to improve turnovers. One chronic issue is let's say case is over at 2:45 PM and staff leaves at 3:30. They will drag their feet for 45 minutes and not set up the next case. I'm sure this happens everywhere. At least with a camera the OR desk can see that nothing is happening and hunt down the staff. Hard for the charge nurse to walk in and out of every OR all day long. If this does improve issues like this, surgeons may change their mind.

Could also improve turnover by telling the surgeons to operate faster :angelic:
 
I’m not sure you understand what “turnover” means.
True, but if I had a nickel for everytime I had to sit and wait >20 minutes for the surgeon (and/or associated learners) to show up after patient asleep and draped, I'd be appreciably wealthier than I am now, even though I'm only a CA3. If they're going to push for cameras in ORs to improve turnovers then that sword needs to cut both ways.
 
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True, but if I had a nickel for everytime I had to sit and wait >20 minutes for the surgeon (and/or associated learners) to show up after patient asleep and draped, I'd be appreciably wealthier than I am now, even though I'm only a CA3. If they're going to push for cameras in ORs to improve turnovers then that sword needs to cut both ways.
That can be a double edged sword



I’m in PP so I am appreciably wealthier because of all the time I’ve waited for a surgeon with an asleep patient in the operating room. And I’m poorer and fatter because of all the time I’ve spent stuffing my face in the lounge waiting for room turnover. It is indeed a double edged sword.
 
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At my hospital, the OR cameras were used to keep track of how many times anesthesiologists left the room to use the bathroom. The increased scrutiny has resulted in most of our group now using the trashcans for defecation. It works ok as long as you didn't have Mexican the night before.
 
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I’m not sure you understand what “turnover” means.

Im familiar with what turnover is. The point I was making was that they're so concerned with reducing turnover time to avoid overtime pay for OR staff that they dont see the that the biggest waste of time is waiting for surgeons or super slow surgeons. Doing a 20 minute turnover vs. a 15 minute turnover isnt going to make a big difference if youre waiting 30 minutes for the surgeon or if the surgeon takes 2 hours to do a lap chole instead of 45 minutes.
 
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Wanted to get an idea whether your hospital has cameras in every OR. We're at a small community hospital (150 beds) with 12 ORs. Administration wants cameras to increase OR efficiency and lower room traffic. OR desk can then monitor whether room is being set up between cases, and also whether drapes up or down, incision has been made, closing skin, etc. instead of going in and out of OR. Cameras won't record and won't have sound. Surgeons are very against it - saying it's violation of patient confidentiality and invasion of privacy.

Our department isn't really for or against. We understand the pros and cons. Just wanted to see what others have at their place. They had cameras in every OR where I trained 15 years ago, so this is nothing new. Any input is much appreciated.

We have cameras in every OR - up in the corner, wide-angle view with very limited zoom, no recording, no sound.

It's invaluable for timing case flow, breaks, timing/location of upcoming cases, seeing how a case is progressing without calling/disturbing.

People on here like "YoU cAn SeE NaKeD PaTiEnTs FrOm ThE LouNge" gotta grow up.
 
They don’t delete them because they are afraid that in the event of litigation, the act of deleting the encounter will be argued to be done to hide errors or poor performance regardless of policy. They are actually very experienced and well practiced in the trauma bay. I can’t see any significant risk. No more than an EAR not allowing for the fantasy vitals that many used to chart.

This was a part of an official document document destruction policy. No different then auto deleting emails after a few monoliths (unless you archive). Very common in corporate America.


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We have cameras in every OR - up in the corner, wide-angle view with very limited zoom, no recording, no sound.

It's invaluable for timing case flow, breaks, timing/location of upcoming cases, seeing how a case is progressing without calling/disturbing.

People on here like "YoU cAn SeE NaKeD PaTiEnTs FrOm ThE LouNge" gotta grow up.

This is an odd jaded outloook on privacy. I think you’re just lucky patients haven’t found out yet. I would love to see the reaction to someone claim that broadcasting naked women in their lounge helped with breaks and room turnover on the news.
 
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This is an odd jaded outloook on privacy. I think you’re just lucky patients haven’t found out yet. I would love to see the reaction to someone claim that broadcasting naked women in their lounge helped with breaks and room turnover on the news.

You're telling on yourself here.
 
I wanted to add that we had a lecture I attended from our risk management and hospital legal not long ago and in the meeting they said very clearly, and more than once, that everything is discoverable, texts, emails, etc. and they should not be actively deleted, however if you have your phone set to auto delete every month, etc. that is perfectly fine. They actually seemed to be encouraging it.
 
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I wanted to add that we had a lecture I attended from our risk management not long ago and in the meeting they said very clearly, and more than once, that everything is discoverable, texts, emails, etc. and they should not be actively deleted, however if you have your phone set to auto delete every month, etc. that is perfectly fine. They actually seemed to be encouraging it.

Emails and texts on personal phone or work phones?
 
Emails and texts on personal phone or work phones?
They give us work phones so I assume it’s fine. They implied email can be recovered if deleted if they want them, but texts cannot. Or at least can’t unless it’s the NSA doing the recovering. So don’t text, and auto delete if you do. Our emails are archived, allegedly, for 20 years.
The point was don’t text and email about misadventures. Face to face discussions are preferred, but should also be avoided if there’s litigation potential, excepting Department QI.
 
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Our malpractice carrier said be very wary if the cameras record. These recordings can be used against the anesthesiologist, surgeon, and/or hospital in litigation. They said live feeds pose minimal liability risk. They also recommended adding a line to the surgical consents so that patients are informed.

Based on this, I relayed to administration that recording doesn't really seem to benefit any party. Plus we won't be adding cameras to the anesthesia consents. Let's see what administration and the surgeons decide. Like I said, we see the pros and cons. Just no recording.
 
The one big academic place I know about uses cameras to speed up room turnover, and for other pertinent live information (and decreasing the likelihood of doing bad things when people know they are watched). There is NO recording.
 
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