Managing nonroutine events in anesthesia: the role of adaptive coordination

MJ Burtscher, J Wacker, G Grote, T Manser - Human factors, 2010 - journals.sagepub.com
Human factors, 2010journals.sagepub.com
Objective: This field study aimed at examining the role of anesthesia teams' adaptive
coordination in managing changing situational demands, such as in nonroutine events
(NREs). Background: Medical teams' ability to adapt their teamwork (eg, their coordination
activities) to changing situational demands is crucial to team performance and, thus, to
patient safety. Whereas the majority of previous studies on the matter have focused on
critical but rare events, it has recently been pointed out that the effective management of …
Objective
This field study aimed at examining the role of anesthesia teams’ adaptive coordination in managing changing situational demands, such as in nonroutine events (NREs).
Background
Medical teams’ ability to adapt their teamwork (e.g., their coordination activities) to changing situational demands is crucial to team performance and, thus, to patient safety. Whereas the majority of previous studies on the matter have focused on critical but rare events, it has recently been pointed out that the effective management of NREs is a key challenge to medical teams. Hence this study investigated the relationship between coordination activities, NRE occurrence, and team performance.
Method
We videotaped 22 anesthesia teams during standard anesthesia induction and recorded data from the vital signs monitor and the ventilator. Coordination was coded by a trained observer using a structured observation system. NREs were recorded by an experienced staff anesthesiologist using all three video streams. Checklist-based team performance assessment was also performed by an experienced staff anesthesiologist.
Results
We found that anesthesia teams adapt their coordination activities to changing situational demands. In particular, the increased occurrence of NREs caused an increase in the time the teams spent on task management. A stronger increase in the teams’ task management (i.e., more adaptive coordination) was related to their performance.
Conclusion
Our results emphasize the importance of adaptive coordination in managing NREs effectively.
Application
This study provides valuable information for developing novel team training programs in health care that focus on adaptation to changing task requirements, for example, when faced with NREs.
Sage Journals
以上显示的是最相近的搜索结果。 查看全部搜索结果