ISR 66 - Monitoring Operating Room(or) Traffic. Automated vs. Direct Observation

Background: Excessive OR traffic could predispose to surgical site infections (SSI), especially longer clean surgeries with implants. OR traffic disrupts airflow in the OR and increases particle counts. Direct observation of the OR traffic could provide information and opportunity for education and feedback. However, direct observation is time-consuming. The aim of the study was to establish automatic OR traffic monitoring and compare it to direct observation.

Methods: The study was performed in an academic medical center OR using direct observation and automated counters. Direct observations were collected during neurosurgical procedures. Direct observation included OR traffic, hand hygiene observation, and additional information related to the type of healthcare worker and the reason for traffic. Automated monitors collected time-stamp data of the number of people crossing the sensor and in which direction they went.

Results: During the 10 hours of direct observation, the OR door opened 174 times, an average of 18.1 times per hour. On average, there were 3 minutes and 18 seconds between when the door closed and opened again. While the door was open, 19.3 people entered or exited per hour. Going to get supplies, perform hand hygiene, or having an observed task made up 39% of the reasons for entering or exiting. The sensor counted 568 people entering and exiting during the 20 hours of data collection. On average, 27.2 people entered or exited the OR per hour. Through both methods, the number of people entering and exiting ranged from 10.5 to 47 times per hour.

Conclusions: OR traffic monitoring with an automated counter is an objective measure of quality of care that is inexpensive and allows for extended monitoring. Direct observation is the gold standard for traffic monitoring, yields more meaningful information to act on, and could be used to investigate SSI clusters or if there is increased traffic.