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No Texting During Time Outs!
Eliminate electronic distractions from the surgical environment.
Peter Papadakos
Publish Date: May 22, 2014
OR Excellence
Peter J. Papadakos, MD Peter J. Papadakos, MD

Speaker Profile

  • An anesthesiologist and director of critical care at the University of Rochester Medical Center in upstate New York.
  • Professor of anesthesiology, surgery and neurosurgery at the University of Rochester.
  • Quoted in The New York Times as saying, "My gut feeling is lives are in danger," referring to distracted doctoring.

When Peter J. Papadakos, MD, stepped up to address OR Excellence's attendees last year, he didn't just request that they silence their smart phones. He also directed them to turn them over, face down on the table. And close their laptops, too. Out of sight, out of mind, right? Not quite. "Twenty percent of the audience said that made them feel uncomfortable," he recalled in a recent interview, marveling at the idea that 1 in 5 people attending a lecture spend the time looking at their phones. In "Is Your Staff Addicted (to Personal Gadgets and Devices)?" the director of critical care at the University of Rochester (N.Y.) Medical Center will explain why that question should concern healthcare administrators, and offers up strategies for eliminating electronic distractions from ORs.

  • Targeting distraction. A few years ago, I'd read an article in The New York Times about the increase in distracted driving incidents. I'd seen trauma patients from auto accidents at our hospital, but when I noticed how often our staff was checking their electronic screens — even during pre-op time outs, when they should have been paying attention and participating — I discovered the obvious: Distraction was happening in the surgical suite, too. Technology has come between us and the patient, and medicine is not a field where distraction is acceptable.
  • The scope of the problem. I find it amazing how socially acceptable the use of personal electronic devices has become. Professional organizations seem to be aware of the issue and its hazards, but people aren't. It's outrageous enough that I once conducted a pre-op assessment on a patient whose parents were both preoccupied with text messages on their phones. We're seeing the arrival of a generation of healthcare professionals who are so dependent on their devices that if you tell them they can't use their phones in the ORs, they react like spoiled teens. There's an app for everything. But do we need an app for everything?
  • Addiction and awareness. Changing the behavior of addiction first requires an awareness of that behavior. At the University of Rochester, we've educated our staff through a modified CAGE survey, the common alcoholism screening tool. We sub in the use of personal electronic devices (PEDs) for drinking, and ask our surgeons and staff, "Have you ever felt you needed to cut down on the use of your PED? Have people ever annoyed you by criticizing your use of your PED? Have you ever felt guilty about your overuse of your PED at work? Do you reach for your PED first thing in the morning?"
    It's a real eye-opener when healthcare professionals suddenly understand they just flunked the alcoholism test. The medical-legal liability they'll face if an adverse event occurs while they're distracted by their device — and, most likely, a time-stamped e-mail, text message or social media post — is also a bracing wake-up call.
  • Denise Wong, BSN, MS, CNOR, NE-BC
  • Code of conduct. With an awareness of their responsibilities, healthcare providers can become advocates for conscientious use of electronic devices in the surgical environment. At our center, we've developed a Code of E-Conduct. I'm not proposing we go back to the Stone Age, but no one ever taught us how to properly modulate this technology. People need to realize that they don't need the devices 24/7, especially when they risk taking focus away from patient care.

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