Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: a realist process evaluation protocol

Implementation Science

Alwyn Kotze⁷  Julie Croft³  Peter Gardner¹  Alan Pearman⁹  David Jayne⁴  Dawn Dowding²  Jon Hindmarsh⁶  Joanne Greenhalgh⁵  Rebecca Randell⁸ 

[1] Institute of Psychological Sciences, University of Leeds, Leeds LS2 9JT, UK;Center for Home Care Policy and Research, Visiting Nursing Service of New York, 5 Penn Plaza, New York, NY 10001, USA;Clinical Trials Research Unit, University of Leeds, Leeds LS2 9JT, UK;Leeds Institute of Biomedical and Clinical Sciences, University of Leeds, St. James’s University Hospital, Leeds LS9 7TF, UK;School of Sociology and Social Policy, University of Leeds, Leeds LS2 9UT, UK;Department of Management, King’s College London, London SE1 9NH, UK;Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds General Infirmary, Leeds LS1 3EX, UK;School of Healthcare, Baines Wing, University of Leeds, Leeds LS2 9JT, UK;Centre for Decision Research, University of Leeds, Leeds LS2 9JT, UK

关键词: Robotic surgery;    Realist evaluation;    Complex interventions;    Process evaluation;   

Others  :  802654
DOI  :  10.1186/1748-5908-9-52

 received in 2014-03-07, accepted in 2014-04-29,  发布年份 2014

【 摘 要 】

Background

Robotic surgery offers many potential benefits for patients. While an increasing number of healthcare providers are purchasing surgical robots, there are reports that the technology is failing to be introduced into routine practice. Additionally, in robotic surgery, the surgeon is physically separated from the patient and the rest of the team, with the potential to negatively impact teamwork in the operating theatre. The aim of this study is to ascertain: how and under what circumstances robotic surgery is effectively introduced into routine practice; and how and under what circumstances robotic surgery impacts teamwork, communication and decision making, and subsequent patient outcomes.

Methods and design

We will undertake a process evaluation alongside a randomised controlled trial comparing laparoscopic and robotic surgery for the curative treatment of rectal cancer. Realist evaluation provides an overall framework for the study. The study will be in three phases. In Phase I, grey literature will be reviewed to identify stakeholders’ theories concerning how robotic surgery becomes embedded into surgical practice and its impacts. These theories will be refined and added to through interviews conducted across English hospitals that are using robotic surgery for rectal cancer resection with staff at different levels of the organisation, along with a review of documentation associated with the introduction of robotic surgery. In Phase II, a multi-site case study will be conducted across four English hospitals to test and refine the candidate theories. Data will be collected using multiple methods: the structured observation tool OTAS (Observational Teamwork Assessment for Surgery); video recordings of operations; ethnographic observation; and interviews. In Phase III, interviews will be conducted at the four case sites with staff representing a range of surgical disciplines, to assess the extent to which the results of Phase II are generalisable and to refine the resulting theories to reflect the experience of a broader range of surgical disciplines. The study will provide (i) guidance to healthcare organisations on factors likely to facilitate successful implementation and integration of robotic surgery, and (ii) guidance on how to ensure effective communication and teamwork when undertaking robotic surgery.

【 授权许可】

   
2014 Randell et al.; licensee BioMed Central Ltd.

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