Table 2.

Operating Room (OR) Blackbox Project Implementation Process

Implementation Phases	Descriptions
(1) Project team assembly	The core team was comprised of administrative leaders, surgeons, and research experts. Other team members were brought in when their expertise was required for the ongoing project phases and were dispersed as these phases were complete.
(2) Committee approvals	The project team initially selected to follow the research approval process out of 2 distinct institutional approval routes for new equipment and technology implementation: research and practice. However, the team navigated a hybrid practice and research approval process as the project progressed because of the hybrid nature of the project (eg, data collected by the OR Blackbox would be used for both quality improvement and research purposes). The team worked closely with teams in legal, patient privacy, risk assessment, and information technology to ensure patient and provider privacy, data confidentiality and internet security.
(3) Change management	The team socialized the project among clinical leaders, partners, and OR staff. The team communicated openly and consistently, encouraged “influencers” to advocate for the project, addressed the “resisters” concerns adequately, and prepared for publicity, despite that publicity was not intended.
(4) System installation and go-live	Once de-identified institutional OR device-based patient data from various institutional electronic health record systems were verified to ensure successful system initiation, all equipment was purchased, delivered, and installed in the 3 identified ORs. Information technology experts were engaged for automated data capturing setup, initial system validation and process set up. Sequentially, data collection started and continued 24/7 as soon as the system went live. The first artificial intelligence-generated report was available for viewing by providers, faculty, and staff 2 weeks post-go-live.