Helping Teams Adapt in the Operating Room: Recommendations for Effective Adaptation to Different Robotic-Assisted Surgery Systems

Background Integration of robotic-assisted surgery (RAS) systems into modern surgical practice requires operating room teams to effectively adapt to a rapidly evolving array of technologies. There are many RAS systems with varied designs and features in clinical use around the world. As healthcare organizations are increasingly integrating new systems into surgical practice, operating room teams must maintain flexibility in their practice and adapt to different systems that require different setups, communication, and coordination strategies. Therefore, the goal of this perspectives paper is to provide recommendations to facilitate effective adaptation to different systems. Method This perspectives paper draws from the wider human factors and teamwork literature to provide actionable, preliminary recommendations to guide clinicians and healthcare organizations as widespread adoption of multiple RAS systems becomes more common. As the extant literature on team adaptation to different RAS systems is limited, this paper is not a formal, systematic review. As the evidence base expands, a systematic review to determine evidence-based best practices will be meaningful, but in the mean time, these recommendations can be used to guide multi-RAS system integration. Results We recommend: (1) engaging in team reflexivity through structured discussions and reflections before, during, and after surgical procedures involving a new system, (2) integrating team process training as a whole team or cross-training alongside technical training for the new system, and (3) studying team adaptation process and outcomes for research and outlining system-specific or multi-system credentialing and continuing professional development by healthcare organizations and governing bodies. Conclusion Integrating the human factors and teamwork literature, we provide recommendations for effective adaptation to different RAS systems. We hope that this paper ignites a discussion and roadmap for practice, research, and policy in using different RAS systems to safely and efficiently deliver the surgery. In the future, when the evidence base allows, a systematic review of best practices is recommended.