Introduction: Fromthe workplace engineering sciences, it is evident that work efficiency,
measured by the criteria efficiency and effectiveness of therapy, economy and patient
safety, is determined mainly by staff acceptance of new technology and reengineered
workflows. Accordingly, the aim of this study was to ascertain and assess differences
in terms of the acceptance of alternative types of prosthesis instrument configurations,
oriented around the research question: “Which product features and process effects
determine a high level of employee acceptance of use?”
Materials and Methods: This study is designed as a before-and-after comparison,
based on the usability engineering approach. In the first study phase, 46 employees
participating in the process of providing instruments for a total knee arthroplasty (TKA)
procedure were asked to examine the current working situation, using a standard
instrumentation set, in terms of instrument handling, work burden, proneness to errors,
patient risks, process efficiency, and effectiveness. In the second study phase, 20
weeks after having implemented a size-specific instrumentation set, the same 46
individuals were surveyed on the identical questions. Additionally, in both study phases
the time needed to perform the sub-processes related to instrumentation logistics inside
the operating room (OR) was measured, in order to identify process efficiency and
cost-saving effects.
Results: By using standard sets only 30% perceived a need for improvement. After
20 weeks, only 8% of the employees were satisfied with the previous equipment
and 69% regarded the standard set as being relatively error-prone, endangering
patient safety. In addition, 85% regarded the effectiveness of the standard process as
limited. Finally, 75% considered the effectiveness of the reengineered process to be
significantly higher, and 69% drew attention to the reduction of handling disadvantages.
Furthermore, the time needed for instrumentation logistics inside the OR estimated at
about 13min less when using size-specific sets. This effect on process efficiency cost
savings or the generation of additional revenue by performing additional procedures.
Based on these findings, an ergonomic decision-making model has been developed.
Conclusion: Innovative medical products such as size-specific instrumentation
sets contribute to lower procedure costs and improved process efficiency in the
operating room (OR). However, employee motivation to use a new technology as
part of an optimized workflow organization, is crucial to achieving an enhanced
level of effectiveness, efficiency and patient safety. Hence, it is advisable to enhance
change-management efforts in order to reduce resistance to change and ensure the
new technology is successful