Coping with Uncertainty. Resilient Decisions in Anaesthesia

Cuvelier, Lucie; Falzon, Pierre

doi:10.1201/9781317065265-3

Cited by 19 publications

(36 citation statements)

References 0 publications

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“…Airway obstruction in recovery after thyroid surgery (emergency) 10 Neck fusion surgery with unexpected difficult airway (elective), participant was called for help 11 Drug confusion (anxiety drug and muscle relaxant drug) before surgery (emergency) 12 Laparoscopy, unexpected difficult airway (elective) 13 Acute epiglottitis, transferred from emergency department (emergency) 14 Acute appendectomy, unexpected difficult airway (emergency), participant was called for help 15 Angioedema, transferred from emergency department (emergency) 16 Acute appendectomy (emergency) themes were discussed in most interviews (13)(14)(15)(16), whereas barriers were only mentioned in four to eight interviews. Figure 2 presents an overview of the subcategories for the three enabler themes 'equipment location and storage', 'experience and learning' and 'teamwork and communication'.…”

Section: Resultsmentioning

confidence: 99%

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Human factors enablers and barriers for successful airway management – an in‐depth interview study

et al. 2018

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Human factors are the individual, team, environmental and organisational aspects of the anaesthetic environment that affect performance and decision-making of anaesthesia teams. This study aimed to identify which human factors were enablers and/or barriers to anaesthesia teams during airway management challenges. Sixteen interviews were conducted with experienced anaesthetists and anaesthetic nurses using an in-depth interview technique (the Critical Decision Method) to identify human factors enablers and/or barriers during successful management of a significant airway challenge. Thematic analysis identified three overarching enablers: equipment location and storage; experience and learning; teamwork and communication. Five overarching barriers were also identified: time and resource limitations; teamwork and communication; equipment location and storage; experience and learning; insufficient back-up planning; and equipment preparation. This study showed that a variety of human factors issues affect the handling of airway challenges, ranging from individual and team to organisational and environmental aspects. Recommendations for the design of airway management decision support tools that relate to equipment standardisation, decision support complexity, inclusive mutual learning and teamwork are discussed.

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Section: Resultsmentioning

confidence: 99%

“…Anaesthesia team members typically show excellent adaptive capabilities in difficult situations [9,14]. However, although the presumed causes for human error have been studied frequently, there is a scarcity of research that looks into how anaesthesia teams have managed airway management challenges successfully.…”

Section: Introductionmentioning

confidence: 99%

Human factors enablers and barriers for successful airway management – an in‐depth interview study

et al. 2018

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“…Two studies were conducted in developing countries: Brazil [30] and South Africa [22]. For studies published in books, all were conducted in developed countries: the United Kingdom [36,39,45,46], New Zealand [41,47], Norway [34,40], France [32], Switzerland [33], Australia [37], Denmark [42],…”

Section: Study Characteristicsmentioning

confidence: 99%

“…Reconciling the gap between Work-as-imagined (WAI) and Work-as-done (WAD) to enhance safety by learning from everyday clinical work instead of focusing only on adverse events [27,29,30,32,36,39,46,47,38,41,43].…”

Section: Risk Of Biasmentioning

confidence: 99%

Resilient Health Care: a systematic review of conceptualisations, study methods and factors that develop resilience.

Iflaifel

Lim

Ryan

et al. 2019

Preprint

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Background Traditional approaches to safety management in health care have focused primarily on counting errors and understanding how things go wrong. Resilient Health Care (RHC) provides an alternative complementary perspective of learning from incidents and understanding how, most of the time, work is safe. The aim of this review was to identify how RHC was conceptualised, described and interpreted, to describe the methods used to study, and to identify factors that develop RHC. Methods Electronic searches of PubMed, Scopus and Cochrane databases were performed to identify relevant peer-reviewed studies, and a hand search for studies published in books that explained how RHC as a concept was interpreted, methods used to study, and factors to develop RHC. Studies were evaluated independently by two researchers. Data was synthesised using a deductive thematic approach. Results Twenty-seven studies were included; they shared similar descriptions of RHC which was the ability to adjust its functioning prior to, during, or following events and thereby sustain required operations under both expected and unexpected conditions. Qualitative methods such as observations and interviews were used to study RHC. Models for studying RHC currently exist and were in the early stages of implementation. Effective team relationships, trade-offs and healthcare ‘resilience’ training of health care professionals were factors used to develop RHC. Conclusions Although there was consistency in the conceptualisation of RHC, methods used to study and factors to develop RHC, further research should focus on operationalising RHC assessment methods and developing, testing and evaluating interventions for developing RHC.

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“…2. Coping with uncertainty: Resilient decisions in anesthesia (Cuvelier and Falzon, 2011) In the context of research on patient safety in pediatric anesthesia, an empirical research was conducted in a pediatric anesthesiology service in a French hospital, based on the critical-incident technique (a set of procedures used for collecting direct observations of human behavior that have critical significance and meet methodically defined criteria). The objective of this study is twofold: to identify the different types of disturbances that anesthesiologists have to manage in their work, and to highlight the resilience factors, i.e., the strategies developed through practice by anesthesiologists to allow the system to function despite these disturbances.…”

Section: Dealing With the Actual: Respondingmentioning

confidence: 99%