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BMJ 2003; 326 doi: (Published 01 March 2003) Cite this as: BMJ 2003;326:030357
  1. Lachlan Clark, fifth year medical student1,
  2. Simon Bann, specialist registrar2
  1. 1Guy's, King's, and St Thomas's School of Medical, London
  2. 2Lee Edwards, director, virtual theatre project, Ara Darzi, professor of surgical oncology and technology, Imperial College, London

Lachlan Clark, Simon Bann, Lee Edwards, and Ara Darzi explain how recording information in operating theatres could revolutionise analysis of our mistakes and how we work and train as healthcare professionals

Imagine you, a medical student, are observing a surgical procedure and everything is going to plan. In fact, it's one of those times when you are not concentrating fully and your mind is wandering, “What am I going to do this Friday night?” Suddenly the anaesthetist is looking a bit panicky and is beginning to inject more drugs, trying to adjust the endotracheal tube, and decipher the monitors at the same time. Meanwhile, the surgeon, his assistant, and the surgical senior house officer are huddled around the patient, rapidly muttering commands at each other and ordering increasing numbers of instruments from the theatre nurse. The nurse, in turn, is asking other nurses in the operating theatre to get more equipment from other theatres and supply cupboards. The patient's condition is deteriorating; the staff are becoming more agitated. A more senior anaesthetist is called to help improve the patient's critical situation; and still confusion is apparent in the operating theatre.

The life of the patient seems to be at risk, but you don't know how this happened and what information was available and in what order. Was it a failure of equipment, a lack of communication, or a failure of the system? What if a technological solution could provide the data to allow some of these questions to be answered? A solution that might also be used to: allow analysis and feedback during surgical team training; allow research into staff interaction; …

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