Silent Operating Theater Optimization System (SOTOS): A New Noise Reduction and Information Management System—Effects on Stress, Concentration, Well-being, and Communication of OT Crews

Objectives: Operating theaters are noisy workplaces, threatening patients' and surgery crews' health and crew performance. We describe the Silent Operating Theater Optimization System (SOTOS) developed at the University Medical Center Göttingen to reduce noise and ensure the information flow in the OT and its effects on crew and surgery professionals' stress and their cognitive, team, and communication performances.

Now that preliminary tests conducted and reported by Friedrich et al have shown clear, positive results that the SOTOS system markedly reduces noise pollution in the OT, our present aim is to investigate the finer-grained quantitative and qualitative questions regarding the impact that SOTOS has on staff members' stress, cognitive performance, and their team work and communication behavior during surgeries.

Methods: We have conducted studies in two samples: open-heart surgery (N = 22) and Da Vinci system robot assisted prostatectomies (N = 32). In a quasi-experimental design, we compared two conditions – surgeries conducted in concert with the SOTOS (experimental condition) and surgeries conducted without the SOTOS (control condition). Before and after each of the surgical operations, OT crew members were surveyed via questionnaires regarding their subjective stress perception, concentration, well-being, and perceived team work efficiencies. Heart rates of each OT crew members were recorded throughout the surgical operations and their cortisol in saliva levels were measured before, during and after each surgical operation. The communication was audiotaped, transcribed, and speech rates and speech patterns were analyzed. Sound volume levels in each of the OT rooms (those with and those without the SOTOS) and the resulting volume levels transmitted into the ears of each of the crew members (manipulation check) were measured. The bacterial load in each of the OT rooms (rooms housing each of the experimental conditions surgeries and rooms housing each of the control conditions surgeries) was also measured pre- during- and post-surgeries.

Result: SOTOS is well accepted in the OR as a new helpful tool. It decreases the stress of OT crew members, and thereby improves/alters their cognitive and teamwork performance.

Conclusion: Additional analyses planned for this study—how the SOTOS impacts OT crew member communication—are currently run and will be reported to an extent that would allow conclusions about the full functionality of the SOTOS.

Publication History

Article published online:
19 February 2021