Analysis of Tasks and Human Factors in Anesthesia for Coronary-Artery Bypass

Feingold, Alfred; Wiener, Earl L.; Hosek, Ronald S.

doi:10.1213/00000539-197605000-00020

Cited by 40 publications

(15 citation statements)

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“…The results on variations in action density also fit very well with research on workload in anaesthesia (Gaba andLee 1990, Weinger et al 2004b). When focusing on the composition of anaesthetists' activity patterns during the different phases of anaesthesia, the results of this study are in line with previous task analysis studies in anaesthesia (Kennedy et al 1976, Boquet et al 1980, McDonald and Dzwonczyk 1988, Manser and Wehner 2002.…”

Section: Activity Patterns Over the Different Phases Of Anaesthesiasupporting

confidence: 88%

“…An approach based on (behavioural) task analysis is proposed as a first step to gain a better understanding of the similarities and differences between simulation environment and clinical work settings in anaesthesia. Task analysis methods have already been applied successfully in studies on human factors issues in the performance of anaesthesia in the clinical setting (Kennedy et al 1976, Boquet et al 1980, Weinger et al 1994, Weinger and Slagle 2002. In a previous field study using task analysis, the authors observed distinct variations in anaesthetist's activity patterns depending on the anaesthetic procedure, the phase of an anaesthetic procedure and the occurrence of non-routine events (Manser and Wehner 2002).…”

Section: Methodsmentioning

confidence: 99%

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Comparison of anaesthetists' activity patterns in the operating room and during simulation

et al. 2007

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This study investigated the behavioural aspects of ecological validity of anaesthesia simulation environments using a task analysis approach. Six anaesthesists were observed during two cases performed in the operating room (OR), one routine and two critical incident simulation scenarios. A two-way MANOVA for repeated measures was performed with the independent variables Case (OR/SIM-R/SIM-CI) and Phase Induction/ Maintenance (Emergence), the latter being a repeated measure. Dependent variables were the proportion of each phase spent on each of the observation categories. Statistically significant main effects for Phase concerning communication, monitoring, manual tasks and documentation, for Case concerning communication and documentation, and a significant interaction effect for Phase x Case concerning manual tasks and other were found. Increased action density (i.e. amount of co-occurring activities) was observed during Induction, Emergence and the Management of simulated critical events. The similarities and differences in anaesthetists' activity patterns identified in this study will help to further improve the ecological validity of simulation environments as research settings.

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Section: Activity Patterns Over the Different Phases Of Anaesthesiasupporting

confidence: 88%

Section: Methodsmentioning

confidence: 99%

Comparison of anaesthetists' activity patterns in the operating room and during simulation

et al. 2007

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“…Fifteen percent of anesthesiologists intraoperative time is dedicated to compiling handwritten records. [1][2][3] Automation of this task can reduce the time devoted to completing anesthetic records [4][5][6] while increasing the quality of data contained in them. [7][8][9][10] Anesthesia information management system (AIMS) technology was once the domain of an enthusiastic minority, but use is increasing.…”

Section: Résumémentioning

confidence: 99%

A randomized comparison between records made with an anesthesia information management system and by hand, and evaluation of the Hawthorne effect

Edwards

Hagen

Hannam

et al. 2013

Can J Anesth/J Can Anesth

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Purpose Anesthesia information management system (AIMS) technology is designed to facilitate high-quality anesthetic recordkeeping. We examined the hypothesis that no difference exists between AIMS and handwritten anesthetic records in regard to the completeness of important information contained as text data. We also investigated the effect of observational research on the completeness of anesthesiologists' recordkeeping. Methods As part of a larger randomized controlled trial, participants were randomized to produce 400 anesthetic records, either handwritten (n = 200) or using an AIMS (n = 200). Records were assessed against a 32-item checklist modified from a clinical guideline. Intravenous agent and bolus recordings were quantified, and data were compared between handwritten and AIMS records. Records produced with intensive research observation during the initial phase of the study (n = 200) were compared with records produced with reduced intensity observation during the final phase of the study (n = 200). Results The AIMS records were more complete than the handwritten records (mean difference 7.1%; 95% confidence interval [CI] 5.6 to 8.6%; P \ 0.0001), with higher completion rates for six individual items on the checklist (P \ 0.0001). Drug annotation data were equal between arms. The records completed early in the study, during a period of more intense observation, were more thorough than subsequent records (87.3% vs 81.6%, respectively; mean difference 5.7%; 95% CI 4.2 to 7.3%; P \ 0.0001). Conclusions The AIMS records were more complete than the handwritten records for 32 predefined items. The potential of observational research to influence professional behaviour in an anesthetic context was confirmed. This trial was registered at the Australian New Zealand Clinical Trials Registry No 12608000068369.

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“…Automation of anesthesia documentation increased as computing technology expanded, with claims of enhanced time management [5], improved data collection for quality improvement [6], and superior capture of billing elements [7]. These claims were met with concerns of potential malpractice liability [8], significant financial investment [9], increased complexity of tasks [10] and decreased vigilance related to a decrease in attentiveness to the patient and monitors [11]. Studies analyzing vigilance and workload indicated no significant differences between the two methods [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Anesthesia recordkeeping: accuracy of recall with computerized and manual entry recordkeeping

Davis

Green

Colquhoun

et al. 2012

J Clin Monit Comput

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Anesthesia information management systems (AIMS) are rapidly gaining widespread acceptance. Aggressively promoted as an improvement to manual-entry recordkeeping systems (MERS) in the areas of accuracy, quality improvement, billing and vigilance, these systems record all patient vital signs and parameters, providing a legible hard copy and permanent electronic record. Concern exists that the practitioner may be less vigilant unless this data is recorded manually. This study's purpose was to determine if vigilance, as measured by the ability to recall important data, is influenced by the method of recordkeeping. This study analyzed differences in the accuracy of Certified Registered Nurse Anesthetists' (CRNAs) recall of specific patient variables during the course of an actual anesthetic case. CRNAs using AIMS were compared to CRNAs using MERS. Accuracy of recalled values of 10 patient variables was measured: highest and lowest values for heart rate, systolic blood pressure, inspiratory pressure, and end-tidal carbon dioxide levels, lowest oxygen saturation and total fluid volume. Four tertiary care facilities participated in this research; two of which used MERS, two utilized AIMS. A total of 214 subjects participated in this study; 106 in the computerized recordkeeping group, and 108 in the manual entry recordkeeping group. Demographic covariates were analyzed to ensure homogeneity between groups and facilities. No significant statistical differences were identified between the accuracy of recall among the groups. There was no difference in the accuracy of practitioners' recall of patient variables when using computerized or manual entry recordkeeping systems, suggesting little impact on vigilance.

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Analysis of Tasks and Human Factors in Anesthesia for Coronary-Artery Bypass

Cited by 40 publications

References 0 publications

Comparison of anaesthetists' activity patterns in the operating room and during simulation

Comparison of anaesthetists' activity patterns in the operating room and during simulation

A randomized comparison between records made with an anesthesia information management system and by hand, and evaluation of the Hawthorne effect

Anesthesia recordkeeping: accuracy of recall with computerized and manual entry recordkeeping

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