Improving the Safety and Efficiency of Robotic Surgery
This project examines teamwork and learning in robotic surgery, which depends on elements other than surgical technique alone, including the operation type, the surgeon's prior experience with open surgery and the surgeon's laparoscopic skills. The goal of the Gewertz and Cohen Lab is to apply the principles of human factors research to robotic surgery to better understand where care is inefficient or suboptimal and apply human factors principles to improve the design of and training for surgical robotic systems.
Investigating Work-System Processes Using Simulation
Improving the Efficiency of Operating Room Turnover
The time required to clean and prepare an operating room (OR) between two surgical cases, commonly referred to as the turnover time, has been the subject of numerous research articles and OR committee discussions for several years. Turnover times are a common performance metric utilized to study OR efficiency, as they represent a necessary but non-income-generating time in a highly sophisticated environment with highly trained staff leading to high fixed costs. The Gewertz and Cohen Laboratory is using a systems approach to identify all areas that contribute to inefficient operating room turnover by exploring the current operational processes, tasks, technologies and tools available, and environment and individuals involved.
Improving Patient Experience with Surgery
In this project, the Gewertz and Cohen Lab aims to improve patient experience and overall satisfaction with certain surgical procedures by improving preprocedure education, reducing barriers to user satisfaction (associated with technology that patients must use before and after their procedures) and minimizing inefficient processes that patients may experience.
Investigating Physician Resilience, Satisfaction and Success
The Gewertz and Cohen Laboratory is studying nontechnical factors that affect physician success at various points in their career. In one project, the lab is exploring the role of emotional intelligence as it relates to resident success. In another project, we are exploring a number of work-system factors as they may relate to physician burnout.
Exploring the Effects of Team Composition and Cohesion on Performance
Because of the complex nature of healthcare systems, teams in this context are commonly forced to function with multidisciplinary team members, extreme time pressures, ambiguous information and, oftentimes, in high-risk situations. It is imperative, therefore, that healthcare teams perform optimally. The Gewertz and Cohen Lab is exploring the value of a unique team-building experience (an in-house escape room) for studying the processes that are important for effective teamwork. The lab hopes to use this project to gain a better understanding of the compositions that are more likely to function optimally.
Modeling Safety Decision Making
There is a critical need to understand why safety policies and procedures known to work are not adhered to and how new processes can lead to behavioral change. The challenge is to understand the relationship between clinical naturalistic decisionmaking, care processes and organizational pressures. By comparing different models of behavioral intention and compliance, the lab is exploring how to provide safer care for patients by understanding how existing and new procedures elicit behaviors within broader process, organization and systems contexts.
Cedars-Sinai Healthcare Innovation Network
Through the Gewertz and Cohen Laboratory's work with the U.S. Department of Defense during the last five years, Cedars-Sinai has assembled a multidisciplinary team of surgeons, psychologists and industrial engineers to quantitatively and qualitatively analyze the efficiency of medical care. The lab now proposes to offer this type of analysis and corrective action to other healthcare institutions through a collaborative healthcare innovation network. In doing so, the lab acknowledges that each hospital may face different challenges. The Gewertz and Cohen Lab plans to help hospitals master a process by which they can identify and test solutions specific to their environment. The laboratory then works with hospitals to develop interventions and supportive resources in safety and efficiency to further these goals. The Gewertz and Cohen Laboratory anticipates that the greatest need will be in midsize and smaller hospitals, where experience in and resources for performance improvement are less robust.