CT scanner implementation at UHN

Healthcare Human Factors


Head and neck tumor surgery is challenging for even the most experienced surgeons since cancerous cells are often in close proximity to a complex architecture of critical structures. In order to help surgeons better navigate the surgical site, researchers at the University of Toronto and the University Health Network developed an intra-operative imaging system using cone-beam computed tomography (CBCT) technology. When this system was ready for a clinical trial, the researchers partnered with Healthcare Human Factors to identify potential workflow and usability issues associated with its use.

Human factors experts observed six head and neck tumor surgeries in the operating room. Other than observational data, interviews with the surgical teams were also conducted. In addition, the team measured the time taken to complete various tasks.

Various safety and efficiency issues were identified. For example, the roles and responsibilities related to use of the CBCT scanner were not always clearly communication to all staff participating in the case. This often resulted in delays as staff were not prepared to do the tasks required of them at the appropriate time (e.g., wear lead vest and press the foot pedal). It was also found that the use of the CBCT scanner added at least 24 minutes to each case.

In response to the issues identified, the researchers made several modifications to the workflow and worked with Healthcare Human Factors to develop a communication tool checklist. These changes were implemented in subsequent phases of the project to further improve the use of the CT scanner.