tailieunhanh - Safer Surgery part 35

Safer Surgery part 35. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 314 Safer Surgery Table Utterances related to the team and the problem-solving process Category Thematization of the relationship Reflection emotional utterances Process Total Mean Minimum 0 0 1 4 Maximum 22 10 32 47 Quality of Communication in Critical Situations Quality of Communication as Evaluated by the Behavioural Markers How well do the participants fulfil the expectations concerning good communication that we formulated as behavioural markers The number of behavioural markers confirmed in the utterances of each participant showed a rather weak performance. In fact only 58 percent of the expected behaviours were shown with an inter-rater reliability of 83 percent . For example in 61 percent of all scenarios the anaesthetists did not explicitly seek agreement with the surgeon we also repeatedly found this in OR observations before important steps in the process. Clinical Experience and Quality of Communication What role does clinical experience play in the quality of communication Based on our observations in the OR we expected that senior anaesthetists would not necessarily perform better because simply working longer in the setting hospital does not seem to imply learning more about good communication. This was exactly what we found when looking at the behavioural markers. Communication Skills and the Quality of Medical Problem Solving Based on the literature on human factors we expected a substantial correlation between the evaluation of medical management and the quality of communication as captured in the behavioural markers. We found a surprisingly high correlation of r .57 p .001 t df 31 see Figure . Those doctors who communicated most adequately also performed best. Interestingly the quality of medical management is not connected with the total number of things said r p .1 . Talking a lot during a medical crisis is not useful in itself what is important is the quality of communication. Observing Team Problem .