Technology


How digital tools can advance surgical performance


CSJ spoke to Charles Pallandt, chief commercial officer at Incision, to find out how digital tools for education and training could support operating theatre teams to improve performance, reduce delays and improve safety.


Surgical training has been severely impacted by the pandemic. According to the ‘COVID-19 impact on Surgical Training And Recovery’ (COVID-STAR) survey, course cancellations were reported in 80% of cases, while a complete loss of training activity in elective operations (69.5%), outpatient clinics (67.3%), endoscopy (69.5%), specialty-specific accreditations (72%) and simulation training (68%) were also reported.1


This has led to calls


for innovative approaches to support training, including the use of digital technologies – from simulation and VR solutions, to digital Apps. In August 2022, the Royal College of Surgeons published a set of recommendations, which stated that: “Technology enhanced training solutions with evidence to demonstrate educational effectiveness should be considered for integration into surgical training. These should augment and not replace hands-on training.”2 At the same time, there is an urgent need


to improve efficiency and increase capacity in operating theatres, as the NHS battles to reduce waiting times and a backlog of over seven million. Digital technologies could have a vital role to play in: l Tackling the backlog by reducing pre- and intra-operative delays


l Providing resources to support training for operating theatre teams


l Tackling variation in performance l Standardising surgical approaches in line with best practice


l Reducing complications


“There is limited time for in-service training, theatre teams are extremely busy, and the backlog has added to the pressures – yet healthcare has been slow to adopt digital technology that could help the NHS address operating theatres’ key challenges. In other sectors, digital transformation has been much faster and more advanced,” commented Charles Pallandt, chief


commercial officer, Incision. He points out that that 50% of surgical complications in the operating theatre are avoidable3


and there is wide variation in


performance between best-in-class centres and the not so well performing centres.


A digital educational platform Against this backdrop, Incision has sought to develop a platform for surgical professionals to exchange knowledge and skills to improve surgical care. The technology, which is designed to convey information in a visual way – through animation, augmented reality, or illustration – aims to ensure that patients get the best possible outcome and care, in the most efficient way. Pallandt explains that one of the key areas


Charles Pallandt 24 www.clinicalservicesjournal.com I April 2023


where digital technology could help to drive improvement is around operating theatre preparation: “Surgical teams are not always optimally prepared, and surgeons are trained to educate through the ‘apprenticeship model’, i.e. ‘see one, do one, teach one’. This means that every surgeon may execute the procedure differently depending on how they have been taught by their predecessor. For the team preparing for surgery,


this makes it very hard to standardise.” Pallandt points out that this can lead to


delays, frustration, and complications. The patient may not be positioned correctly, or the right materials/ instruments may not be present, for example, leading to a delayed start of the procedure. Incision’s internal research shows that 2 out 3 procedures do not start on time. Ultimately, this can have a significant impact on the bottom line. Furthermore, these avoidable delays do not help healthcare providers in their efforts to tackle the current backlog. Another key issue experienced by the NHS


relates to significant shortages of staff – this is proving to be an increasing challenge. A Freedom of Information request has suggested that the number of operations cancelled by the NHS in England due to staff shortages has doubled in three years. In fact, an estimated 30,000 operations did not proceed due to a lack of staff to perform them.4 “Speaking to Trusts and hospitals, we hear


that rates of staff turnover can be up to 25%,” commented Pallandt. “These gaps are being filled with locum staff – in some cases this is up to 40%.” Pallandt asserts that the key to productivity and safe care in the operating theatre starts with


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