‘Help! I need somebody’: getting timely assistance in clinical practice

Smith, M. A.; Byrne, Anthony

doi:10.1111/anae.13497

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…They need to feel safe to be safe , but we would argue that anaesthetists also need to feel safe to act safely; working within a system where individuals are punished for ‘mistakes’ does not create a good working atmosphere. They also need to feel able to ask for help and to raise concerns without being criticised. As professionals, we need to learn to balance comfort with constant vigilance and ‘intelligent wariness’ without becoming overwatchful .…”

Section: Creating Safety and Promoting Resiliencementioning

confidence: 99%

People, systems and safety: resilience and excellence in healthcare practice

Smith

Plunkett

2018

Anaesthesia

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Summary This article outlines recent developments in safety science. It describes the progression of three ‘ages’ of safety, namely the ‘age of technology’, the ‘age of human factors’ and the ‘age of safety management’. Safety science outside healthcare is moving from an approach focused on the analysis and management of error (‘Safety‐1’) to one which also aims to understand the inherent properties of safety systems that usually prevent accidents from occurring (‘Safety‐2’). A key factor in the understanding of safety within organisations relates to the distinction between ‘work as imagined’ and ‘work as done’. ‘Work as imagined’ assumes that if the correct standard procedures are followed, safety will follow as a matter of course. However, staff at the ‘sharp end’ of organisations know that to create safety in their work, variability is not only desirable but essential. This positive adaptability within systems that allows good outcomes in the presence of both favourable and adverse conditions is termed resilience. We argue that clinical and organisational work can be made safer, not only by addressing negative outcomes, but also by fostering excellence and promoting resilience. We outline conceptual and investigative approaches for achieving this that include ‘appreciative inquiry’, ‘positive deviance’ and excellence reporting.

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Section: Creating Safety and Promoting Resiliencementioning

confidence: 99%

People, systems and safety: resilience and excellence in healthcare practice

Smith

Plunkett

2018

Anaesthesia

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“…One study that investigated the 'delivered', as opposed to the 'specified', curriculum in a New Zealand medical school found that there was sometimes a mismatch between students' expectations of learning skills and the reality of the placement. 19 Our style of practice also lends itself to students learning about teamwork, communication, 20 and other elements of practice that contribute to patient safety. Finally, 'preparing for practice' is a recognised element of the later years at many medical schools, and we could easily take the lead on these activities.…”

mentioning

confidence: 99%

Anaesthesia and the undergraduate medical curriculum

Smith

Sadler

Carey

2018

British Journal of Anaesthesia

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pathways for neurobehavioural testing or management of patients with perioperative NCD. Ultimately, adoption of the recommendations by Evered and colleagues 7 will depend on the greater community of investigators that study cognitive disorders after anaesthesia and surgery, and the policy of journals that publish their work. Other groups have attempted to standardize the diagnosis of POCD to allow comparisons of results between studies. 13 Despite the latter efforts, the criteria for detecting and defining POCD have remained variable and inconsistent over the ensuing quarter of a century since their opinions were published. Evered and colleagues 7 provide a thorough and thoughtful approach to address how to define cognitive changes after anaesthesia and surgery. Nonetheless, with the exception of delirium, neurocognitive decline after anaesthesia and surgery currently remains a research observation.

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“…So I examined the incidence of opening quotations in 150 consecutive Anaesthesia editorials up to September 2017. I discovered musings from Voltaire [1] and Tolstoy [2], William Osler [3], Atul Gawande [4], and even Michael Jordan [5], The Beatles [6] and Spiderman's uncle [1]! Henry Ford put in a particularly strong showing, supplying three quotations to three editorials over the time period [7][8][9].…”

Section: An Unusual Failure Of Sevoflurane Quikfil Pen Bottlesmentioning

confidence: 99%

Don't quote me on this, but…

Scott

2017

Anaesthesia

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‘Help! I need somebody’: getting timely assistance in clinical practice

Cited by 5 publications

References 25 publications

People, systems and safety: resilience and excellence in healthcare practice

People, systems and safety: resilience and excellence in healthcare practice

Anaesthesia and the undergraduate medical curriculum

Don't quote me on this, but…

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