Learning new technical and interpersonal routines in operating room teams The case of minimally invasive cardiac surgery

This study investigated operating room teams confronted with learning a radically new technology for performing cardiac surgery. Implementing new technology in hospitals is challenging because of the perceived risk to human life of trying something new when current approaches meet widely accepted standards of care. Understanding the learning and adoption process is therefore critical, both for innovators introducing new technologies and for hospitals seeking to adopt them. Past research in medicine has found that cumulative experience using new techniques leads to improvement but has not investigated organizational and group characteristics that may facilitate obtaining the right kinds of experience and ultimately facilitate successful adoption of new approaches. This paper begins to address this gap by examining organizational and group characteristics that vary across operating room teams learning a new technology. A specific barrier to learning that these teams faced was the highly precise routines characterizing the conventional surgical procedure; the new technology disrupted these routines, requiring the operating room teams to relearn how to work together. We report on data collected in 165 interviews with members of the operating room and others associated with the cardiac surgery process at 16 hospitals.