Impact of the headset tool SOTOS on communication in heart surgeries in a randomised field study

Purpose Communication is crucial for the performance of surgical teams and thus patient safety. This field study aims to investigate how the Silent Operating Theatre Optimisation System (SOTOS), a technical noise reduction and communication system, influences communication during surgery. Design/methodology/approach In 22 heart surgeries (11 with SOTOS = experimental; 11 without = control), i.e. coronary bypass grafting and valve replacements, communication of 46 team members was recorded, transcribed, segmented and coded for the last two of five surgical phases, the critical Phase 4 and the routine Phase 5. All 47,387 communication units were coded as case-relevant-communication (CRC) or case-irrelevant-communication (CIC). Communication was analysed statistically via multilevel models. Findings The SOTOS led to less communication compared to regular operations (F(1, 21.39) = 11.33, p = 0.003). Concerning CRC, no difference was found between treatment conditions across both phases (F(1, 21.69) = 1.40, p = 0.249), but a post hoc test revealed a significantly higher CRC mean for the experimental group compared to the control group in the critical phase 4 (F(1, 20.92) = 4.47, p = 0.047). No difference in CIC in routine Phase 5 between the treatment conditions was found (F(1, 20.30) = 0.6, p = 0.446). Research limitations/implications The SOTOS led to less communication compared to regular operations, F(1, 21.39) = 11.33, p = 0.003, b = −1.23 segments/minute, 95%-CI[−2.00; −0.46]. Concerning CRC, no difference was found between treatment conditions across both phases, F(1, 21.69) = 1.40, p = 0.249, b = 0.08 proportion of CRC, 95%-CI[0.60; 0.71], but a post hoc test revealed a significantly higher CRC mean for the experimental group compared to the control group in the critical Phase 4, F(1, 20.92) = 4.47, p = 0.047, b = 0.08 proportion of CRC, 95%-CI[0.00; 0.16]. No difference in CIC in routine Phase 5 between the treatment conditions was found, F(1, 20.30) = 0.6, p = 0.446, b = 0.02 proportion of CIC, 95%-CIxD;xA;[−0.04; 0.09]. Originality/value In sum, team members communicated less with the SOTOS, which reduces the microbial load and more CRC in critical Phase 4 and a constant CIC-level in the critical and the routine Phases were found in the SOTOS group. These results hint at SOTOS enhancing information sharing and team climate, while reducing distractive effects.