There is still much to be gained when it comes to how operating rooms (OR) are organised. Such advances would help to avoid medical errors. Researcher Annetje Guédon has succeeded in implementing several concrete technological improvements for the OR. On Tuesday, 5 July 2016, she will obtain her doctorate from TU Delft with research into this subject.

Patient safety

‘The objective of my research was to develop technology that could help health care professionals to improve patient safety and increase efficiency in operating rooms’, explains Annetje Guédon.
‘In practice, operating room assistants do their best to support OR processes. Everyone in the OR does absolutely everything they can, but when looking at how things are organised, we think that there is still much to be gained. One possibility is offering technological support. But such technology needs to mirror the assistance offered by operating room assistants – it cannot be rigid, but has to be capable of adjusting to change’. 

Concrete solutions

Guédon turned her attention to several aspects in practice: OR devices, the delivery process of surgical instruments and OR scheduling. During her research, she collaborated with the Reinier de Graaf hospital in Delft.
‘We firstly looked at devices in the OR, easily about 20 different ones’, says Guédon. ‘Of course, they all need to be working properly, tested and checked. Unfortunately, the system currently in use, using stickers, is quite old-fashioned. As you can imagine, stickers are not always checked in practice’.
‘That is why we worked together with a company called DoubleSense to develop a track and trace system. This system displays the status of all OR devices (and possible defects) at a single glance, and also keeps the overview up to date. This system was a success, it has already been marketed as a commercial product, and is in use in the hospital’. 

The research OR at the Reinier de Graaf hospital in Delft 


Secondly, Guédon researched the delivery process of surgical instruments, such as scalpels. They need to be sterilised after use, which represents a serious logistical challenge for the operating room and sterilisation department. ‘At the moment, if there is a problem with an instrument, it is replaced by the operating room assistants. They quickly arrange another instrument. But that can take a lot of their time and lead to stress situations – something that we would prefer to avoid. That is why we implemented a just-in-time system for the delivery of surgical instruments. This system has also already been successfully implemented in the Reinier de Graaf hospital’. 


‘The third part of my research is about operating room scheduling. It is important to know how a surgical procedure is progressing and (approximately) how long it will last. We have researched if it is possible to detect the progress of a surgical procedure based on the activity of surgical devices, which can be measured using a current sensor. ‘The results are interesting and promising. But we still have some way to go before this concept can be implemented in practice’.  


This third element of the research is one of the subjects that will be explored in more detail in DORA (Digital Operating Room Assistant), the multidisciplinary and umbrella project. ‘The Reinier de Graaf hospital and the TU Delft work together on setting up a research OR, a realistic operating room in which this type of data can be recorded. That is a huge step in the right direction. It is crucial that we continue to involve people from all disciplines in this research. 

Annetje Guédon (TU Delft doctoral candidate),, +31 (0)6 2422 5930.
Claire Hallewas (TU Delft Press Officer),, +31 (0)6 4095 3085.