Developing a Systems-Based Observation Toolkit for Evaluating High-Fidelity Scenario-Based Simulation Testing in or Environments

Deborah Wingler (Clemson University)
Herminia Machry (The Center for Health Facilities Design and Testing)
Anjali Joseph (The Center for Health Facilities Design and Testing)

The operating room (OR) environment supports dynamic interactions between surgical team members, the tasks required to support their work, the technology and equipment used to perform surgical procedures, organizational and operational protocols, and the physical healthcare environment. Any change in one of these system components is likely to affect other component within the system. While physical mock-ups are increasingly being utilized by architecture firms as a means of engaging clinicians in the design process to receive user feedback, a systematic approach for evaluating design feedback when using physical mock-ups is not yet commonly practiced. This session will provide insight into the development of a systems-based observation toolkit for assessingsimulation-based physical mock-up evaluations of OR prototypes with clinical end users. As part of a 4-year multidisciplinary research project, a high-fidelity physical mock-up of an OR was designed through an iterative design process. To examine how the system components within the OR prototype function holistically during high-fidelity task-based simulation testing, a toolkit was developed by the research team using a systems- based observational approach to evaluate the effectiveness of alternative design options. The evaluation tool allowed for systematic documentation of design feedback to refine and facilitate comparison of different design interventions such as zone distribution, workstation configurations, and location, position and content of information displays, as well as the location of potential environmental hazards. Utilizing a systematic approach to evaluate task-based simulations in a physical OR mock-up facilitated clinical end users in providing proactive feedback to support more informed design decisions during the design process. The evaluation tool also promoted an increased collaboration between multidisciplinary clinical teams and a greater understanding within the care team of the impact design interventions can have on the dynamic interactions that occur between clinical end users and the physical healthcare environment during care processes.