tailieunhanh - Safer Surgery part 46

Safer Surgery part 46. 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. | 424 Safer Surgery met with resistance. Like many physicians I had prided myself on believing I was competent and I think I actually was competent. and again like many physicians I was not overly keen to delve into human error in medicine and team performance in healthcare. For many of us that topic feels just a little too close to home at least at first take. Rather I focused most of my interest and efforts on our work in aviation safety. I learned about CRM training which by that time had ceased to be a controversial topic in aviation and by then had become the standard of practice for any good airline. Rather than defining CRM and developing training programmes for aviation our lab s efforts at that time were focused on in-flight data collection - trying to understand what worked and what did not in the cockpit on what practices the good pilots demonstrated and what we thought the rest should try and emulate. These were the early days of LOSA - the Line Operations Safety Audit. The University of Texas LOSA programme involved sending observers from our lab group out onto aircraft flight decks to watch crews at work as they flew routine flights recording crew behaviours and errors and noting their responses to safety threats Helmreich et al. 2002 . Our experience was showing us that when LOSA audits went ahead without management support then resources were scarce and the projects tended to stall. When senior management pushed for an audit but the pilots were mired in labour disputes or felt they were being used as scapegoats for problems on the flight line observers from our lab were greeted with suspicion in the cockpit and again safety audits stalled. When everyone in the organization was on board and when both senior management and pilot unions were enthusiastic supporters of the safety audit the process was typically a major success and the organizations would devour the findings produced by the audit. There was a sense that everything was moving forward as it