Visualizing Tacit Knowledge in Cardiac Operating Room: A Need-Finding Study

Fluent team communications in the `Cardiac operating room (cOR) require significant preparation between a team of multiple disciplines. One of the key elements in effective communication during complex tasks such as those found in the cOR is tacit knowledge. Unlike other knowledge, tacit knowledge is not written, and is generally learned through experience. Our research tries to define tacit knowledge by establishing the needs of each discipline in the cOR, as follows: (i) define team communications among cOR team members, including surgeons, anesthesiologists, nurses, a perfusionist and technicians, and (ii) define what tacit knowledge-based tools can improve team communications. This need-finding study included a co-creation workshop to identify categories of needs, and in-depth interviews to better understand those categories. Our results highlight the need for (i) standardization of pre and post-operative processes, (ii) reliable tracking methods for supplies/equipment, (iii) adaptive training for new staff, (iv) physical layouts minimizing wasted movements, and (v) noise reduction. To further investigate our findings, we developed a team communication diagram for delineating tacit knowledge gaps of team communications among team members during pre-op-procedure. Of the tacit knowledge found in our studies, half are not addressed in the existing OR team training, motivating new design directions.