Operating at a Distance-How a Teleoperated Surgical Robot Reconfigures Teamwork in the Operating Room

This paper investigates how a teleoperated surgical robot reconfigures teamwork in the operating room by spatially redistributing team members. We report on findings from two years of fieldwork at two hospitals, including interviews and video data. We find that while in non-robotic cases team members huddle together, physically touching, introduction of a surgical robot increases physical and sensory distance between team members. This spatial rearrangement has implications for both cognitive and affective dimensions of collaborative surgical work. Cognitive distance is increased, necessitating new efforts to maintain situation awareness and common ground. Moreover, affective distance is introduced, decreasing sensitivity to shared and non-shared affective states and leading to new practices aimed at restoring affective connection within the team. We describe new forms of physical, cognitive, and affective distance associated with teleoperated robotic surgery, and the effects these have on power distribution, practice, and collaborative experience within the surgical team

Optimizing OR Efficiency through Surgical Case Forecasting with ARIMA Averaging

Operating rooms, often known as ORs, are among the most critical parts in hospitals, and their performance has a considerable bearing on how well the hospital functions as a whole. Uncertainty contributes significantly to the difficulty of an operating room. Credible forecasts are essential for operating room efficiency because they can provide signals for the monitoring of surgical overflows in periods of peak and trough demand for surgery; and minimize the related costs in equipment and workforce redundancy, and improve overall health care services. Optimizing the efficiency of the operating room has significant consequences for cost reductions, patient happiness, and the morale of the surgical department. Forecast averaging, also known as prediction combining, is a system for merging several predictions into a single prediction, which is often a better way than deciding which one forecast was best out of the available individual predictions. We applied the ARIMA Forecast Averaging method to demonstrate the surgical volume case predictions. We also showed that in forecasting surgical volume cases, the ARIMA models with lower AR and MA terms performed well in terms of different model selection criteria such as AIC. BC, and HQ. Medical care service problems are caused not just by a mismatch between resource demand and supply, but also by poor management. Operating rooms requires a significant investment of both time and money. Ineffective usage of operating rooms results in lost efforts and time, increased expenses, and a lower number of patients treated compared to what was originally anticipated. This cluster of problems leads to losses as well as a reduction in the level of satisfaction experienced by patients. We argued that the cost of usage of the operating room (OR) may be significantly decreased by increasing the predictive accuracy of the surgical case volume

Losing Touch:An embodiment perspective on coordination in robotic surgery

Because new technologies allow new performances, mediations, representations, and information flows, they are often associated with changes in how coordination is achieved. Current coordination research emphasizes its situated and emergent nature, but seldom accounts for the role of embodied action. Building on a 25-month field study of the da Vinci robot, an endoscopic system for minimally invasive surgery, we bring to the fore the role of the body in how coordination was reconfigured in response to a change in technological mediation. Using the robot, surgeons experienced both an augmentation and a reduction of what they can do with their bodies in terms of haptic, visual, and auditory perception and manipulative dexterity. These bodily augmentations and reductions affected joint task performance and led to coordinative adaptations (e.g., spatial relocating, redistributing tasks, accommodating novel perceptual dependencies, and mounting novel responses) that, over time, resulted in reconfiguration of roles, including expanded occupational knowledge, emergence of new specializations, and shifts in status and boundaries. By emphasizing the importance of the body in coordination, this paper suggests that an embodiment perspective is important for explaining how and why coordination evolves following the introduction of a new technology

How Does Robotic Surgery Influence Communication, Leadership, and Team Outcomes? A Multimethod Examination.

The practice of delivering surgical care has evolved to be less invasive to the patients undergoing surgery. Minimally-invasive surgery can be practiced through traditional laparoscopic methods as well as with robotic technology that displaces the surgeon from the operating table. Robotic surgery has been cited to be safer and more effective than traditional laparoscopic surgery; however, little research has endeavored to investigate the role of surgical modality upon aspects of teamwork. This dissertation contributes to the human factors and teamwork literature by evaluating how surgical modality may influence communication, shared leadership, and team outcomes. Multiple methods were employed to study robotic and non-robotic (i.e., open and laparoscopic) surgical teams. Teams were evaluated through video analysis of surgical procedures as well as questionnaire methods. The results of this research revealed very few modality-specific differences which may represent the adaptive nature of teams and individuals. Robotic surgical team members did not perceive a statistically significant difference in communication quality which may indicate that the impact of the closed console design may be relatively benign in this regard. While there were no statistically significant differences between the degree to which robotic and non-robotic teams shared or perceived shared leadership, there were interesting role and leadership behavior type differences. For instance, the assists conducted significantly more leadership in robotic surgery than in laparoscopic surgery. In the video data, sharing leadership to a greater extent led to shorter operative durations. In the survey data, higher perceptions of communication quality and communication behavior significantly predicted higher perceptions of team effectiveness, indicating a strong positive relationship between perceived communication and perceived effectiveness. As robotic surgical systems and practices continue to inevitably advance in the coming years, developers should be keenly aware of the interdependencies between all aspects of the sociotechnical system including the providers and recipients of care, the environment and organization, and the tools and technologies

Safety and Reliability - Safe Societies in a Changing World

The contributions cover a wide range of methodologies and application areas for safety and reliability that contribute to safe societies in a changing world. These methodologies and applications include: - foundations of risk and reliability assessment and management - mathematical methods in reliability and safety - risk assessment - risk management - system reliability - uncertainty analysis - digitalization and big data - prognostics and system health management - occupational safety - accident and incident modeling - maintenance modeling and applications - simulation for safety and reliability analysis - dynamic risk and barrier management - organizational factors and safety culture - human factors and human reliability - resilience engineering - structural reliability - natural hazards - security - economic analysis in risk managemen

Balancing User Experience for Mobile One-to-One Interpersonal Telepresence

The COVID-19 virus disrupted all aspects of our daily lives, and though the world is finally returning to normalcy, the pandemic has shown us how ill-prepared we are to support social interactions when expected to remain socially distant. Family members missed major life events of their loved ones; face-to-face interactions were replaced with video chat; and the technologies used to facilitate interim social interactions caused an increase in depression, stress, and burn-out. It is clear that we need better solutions to address these issues, and one avenue showing promise is that of Interpersonal Telepresence. Interpersonal Telepresence is an interaction paradigm in which two people can share mobile experiences and feel as if they are together, even though geographically distributed. In this dissertation, we posit that this paradigm has significant value in one-to-one, asymmetrical contexts, where one user can live-stream their experiences to another who remains at home. We discuss a review of the recent Interpersonal Telepresence literature, highlighting research trends and opportunities that require further examination. Specifically, we show how current telepresence prototypes do not meet the social needs of the streamer, who often feels socially awkward when using obtrusive devices. To combat this negative finding, we present a qualitative co-design study in which end users worked together to design their ideal telepresence systems, overcoming value tensions that naturally arise between Viewer and Streamer. Expectedly, virtual reality techniques are desired to provide immersive views of the remote location; however, our participants noted that the devices to facilitate this interaction need to be hidden from the public eye. This suggests that 360$^\circ$ cameras should be used, but the lenses need to be embedded in wearable systems, which might affect the viewing experience. We thus present two quantitative studies in which we examine the effects of camera placement and height on the viewing experience, in an effort to understand how we can better design telepresence systems. We found that camera height is not a significant factor, meaning wearable cameras do not need to be positioned at the natural eye-level of the viewer; the streamer is able to place them according to their own needs. Lastly, we present a qualitative study in which we deploy a custom interpersonal telepresence prototype on the co-design findings. Our participants preferred our prototype instead of simple video chat, even though it caused a somewhat increased sense of self-consciousness. Our participants indicated that they have their own preferences, even with simple design decisions such as style of hat, and we as a community need to consider ways to allow customization within our devices. Overall, our work contributes new knowledge to the telepresence field and helps system designers focus on the features that truly matter to users, in an effort to let people have richer experiences and virtually bridge the distance to their loved ones