Frogs in the OR - Participatory Ergonomics and Design of Hospital’s Workplaces

Objectives: Objectives are the analysis and optimization of Anaesthesia work places and work processes in an operating room (OR) facility of an University Hospital. The project was carried out by a professional ergonomist (human factors engineer). Method: 1. Analysis of the status quo, 2. Team, tasks and link analysis with the FIT-System (computerized event recording), 3. Semi-structured interviews between expert(ergonomist) and users(anaesthetists), 4. Presentation-Discussion with visualization and reflection of problem-interpretations, 5. Stepwise and cooperative work place redesign Results: 1. The analyzed work system shows ergonomic mismatches in work place layout and equipment design which causes: • problematic and time consuming procedures for to attach and detach the lines between the patient and the devices of monitoring and anaesthesia respirator, • distractions of the anaesthesiologist’s attention for the patient care and the surgical field 2. The FIT-System event recording shows: • The tasks related to the electronic equipment needs as much task time as those related to the patient, • A high frequency and diversify in tasks, links and in the allocation of tasks (comparing different anaesthesia teams) 3. The semi-structured interview shows difficulties in situation awareness and problem understanding for both parties (ergonomist and users). 4. The Presentation-Discussion shows the implementation of a mutual learning process and a decision taking by the user’s themselves. 5. The redesign process leads to product innovations: The Monitor-Frog, an device for the ergonomic positioning of the anaesthesia monitor in the OR and a tool for to structure the spaghetti-salad of lines, cables and tools. Conclusion: Participation is at first a process of mutual learning and of disseminating information between different parties (ergonomist - physicians and nurses in a complex and risk-loaded environment of high technology). This leads to a basis and a consensus of problem comprehension before cooperation in problem solving and designing starts and this basis guarantees ergonomic and sustainable system changes