For the first time, researchers detailed how the OR Black Box (ORBB) was used in monitoring checklist adherence, staff participation, and overall surgical quality. Operative checklists have been linked to better patient outcomes. Compliance monitoring is labor-intensive. Most reports state that either no attempt was made to examine checklist compliance or a quick assessment was made in person. The ORBB is an innovative data analytic platform powered by artificial intelligence that allows checklist compliance to be evaluated with minimal interference to the surgical process. 

They looked back at ORBB data that was obtained in the future. Some surgical procedures performed were elective procedures in a tertiary care facility. Each case was broken down into 2 categories: before the policy shift (9 months) and after it (last 9 months). Checklist adherence, participant participation, and product quality were all evaluated. In the time period between August 15, 2020, and February 20, 2022, a total of 3,879 instances were carried out and checked for checklist adherence. Compliance was at 81%, employee engagement was at 84%, and quality was at 67%. 

Time-out received perfect marks across the board but just 61% for quality when the phases were broken down. Compliance was rated at 81%, engagement at 98%, and quality at 66% during the debriefing phase. The compliance, engagement, and quality debrief scores all increased after a hospital policy shift (85% P<0.001; P<0.001; 88%; P<0.001; 71%). With ORBB, engagement and quality in surgical care and compliance with safety checklists can be evaluated for the first time ever. By employing this technology, compliance can be evaluated in near-real-time, and potential safety hazards can be addressed in a way that is both effective and efficient.