M Birchall1, J Blazeby2,3, N Blencowe3, J Donovan3, D Elliott3, M Jepson3, P Hutchinson4, D Jayne5, A Skilton3. 1. Ear Institute, Faculty of Brain Sciences, UCL, London, UK. 2. NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, Cambridge, UK. 3. Population Health Sciences, University of Bristol, Cambridge, UK. 4. Cambridge Neuroscience, University of Cambridge, Cambridge, UK. 5. Faculty of Medicine and Health, School of Medicine, University of Leeds, Leeds, UK.
EditorCOVID-19 presents an unquantified risk for operating theatre teams, and surgeons have some of the highest mortality rates for healthcare staff exposed to the virus. It is unclear how teams should function, how risk is distributed by specialty, procedure and technology, and how risk is mitigated. What is clear, however, is that in these situations, surgeons and teams are often creative and innovative.It is well recognized that innovation can occur during adversity. Sharing good ideas and lessons learnt from novel solutions to overcome risk will disseminate good practice. Currently, guidelines are emerging that are valuable. We propose that qualitative interviews about these complex situations will provide important and rich insights into surgical teams' experiences of current practices. This will complement and add to the evolving guidance.We are undertaking a focused and dynamic qualitative project to understand current experiences in the National Health Service (NHS) as they evolve, and the international response by surgical teams, with the aim of improving outcomes for staff and patients. We will conduct ‘virtual interviews’ with a multidisciplinary cohort of surgeons, theatre nurses, operating department practitioners and anaesthetists. This will take the form of semi-structured interviews to explore experiences, perceptions of risk and responses/innovations to reduce risk. These valuable discussions will generate themes around the main challenges, concerns and potential solutions. The international theatre team response will be particularly important in identifying how ‘best practice’ has evolved outside the UK, particularly in those nations ‘ahead of the curve’. We will also generate hypotheses to be tested by high impact, targeted follow-on interventional research.The work will be led by the Surgical Innovation Theme of the Bristol National Institute for Health Research Biomedical Research Centre (NIHR BRC) in collaboration with the NIHR Academy Incubator for Robotic and Minimally Invasive Surgery, the NIHR Surgical MedTech Co-operative, and the Royal College of Surgeons of England. It will collaborate with other groups (for example Operation COVID) to share findings and optimize emerging guidance in real-time.