Surgeons and pilots from across the U.S. shared safety ideas related to working in high-stakes environments with the goal of improving patient care at the 5th Annual Innovations in the Surgical Environment Conference (ISEC) in Baltimore June 26-27, 2008.
The conference is the brainchild of Adrian Park, M.D., head of general surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine, and director of the Maryland Advanced Simulation, Training, Research and Innovation (MASTRI) Center.
"At the University of Maryland, one of the things we've been doing is establishing our leadership in the emerging field that has been called the operating room of the future," Dr. Park said.
"We're now calling that area of focus Innovations in the Surgical Environment, because what we're speaking to are many elements that are important to operative function and to perioperative (pre- and post-surgical) flow and function, elements which impact directly on patient safety and outcomes," he added. "We have not attended to these up to this point in time. We train people in fairly traditional ways, but as techniques and technologies continue to burgeon, we've realized in many ways we have not looked at how to integrate those technologies into the perioperative environment."
Although there are many innovations to pursue, Dr. Park and his team are focusing on four main pillars:
"We now want to push forward the agenda to do more collaborative research, so we understand more about what defines surgical movement," he explained. "What is the optimal surgical movement? How do we better improve images, create smarter images to operate off, and improve the training of our surgeons? We’ve kind of taken the lead in this; it has been one of my main areas of emphasis since I've been here."
Dr. Park was quick to see the advantages of sharing the knowledge his team was gathering.
"I realized two or three years ago that what we're doing here is pretty cool and we've got to share it with the world," he said. "So we made this conference into a regional meeting a few years ago, and it's just continued to build. Hopefully this is our breakout year where we really spur the broader community to really collaborate on substantive issues. We're defining those issues and hopefully bringing the folks together to cross-pollinate and create real interdisciplinary, collaborative research."
As the ISEC has expanded, so have the subjects it covers. This year, the whole first day of the conference was dedicated to aviation and surgery and the lessons learned by both from performing in high-stakes environments.
"We needed a theme for this year's meeting, and my surgical fellow this year is an ex-Navy pilot, so when we started brainstorming about this, we thought this would be a prime time to look at this," Dr. Park explained.
The topic proved to be a popular one.
"Surgical educators were sitting here entranced during this session," said Dr. Park with a smile. "What I'd really like to see come out of a conference like this is working groups and white papers in these areas. So we can collaboratively establish a road map in those areas, to build the knowledge we don't now have."
Dr. Park noted the many similarities between the aviation and surgical environments.
“I think it’s been fascinating to hear how many parallels there are between performing in the high-stakes aviation environment and the high-stakes operating environment, and I think that it’s interesting to see that they are dealing with many of the challenges we are,” Dr. Park said. “They’ve standardized the operational and educational processes, and I think we can learn from that.”
Although Dr. Park says there is much that surgeons can learn from pilots, a surgeon’s job is no less complicated.
“Their system of briefing and debriefing is one that has had great impact on their performance and we can learn from that. But the machines that we perform in and operate on are different. No matter how technologically advanced a Hornet is, it still doesn’t hold a candle to the complexities of the pancreas.”
Other conference presenters included Stephen Kavic M.D., assistant professor of surgery at the University of Maryland School of Medicine; Carlos Godinez, M.D., a former Navy fighter pilot and a surgical fellow at the University of Maryland Medical Center; Erica Sutton M.D., a general surgery resident at the University of Maryland Medical Center; and astronaut David Williams, M.D., who discussed lessons learned from performing in space that may have application in the operating room.
Conference attendees also had the opportunity to tour the cockpits of a U.S.
Navy F/A-18 Hornet fighter jet, a Maryland State Police helicopter and a helicopter
used by Maryland ExpressCare.
By Caelie Hanes and Michelle Murray
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