Learning from Aviation to Improve Safety in the Operating Room ‐ a Systematic Literature Review

Abstract

Lessons learned from other high-risk industries could improve patient safety in the operating room (OR). This review describes similarities and differences between high-risk industries and describes current methods and solutions within a system approach to reduce errors in the OR. PubMed and Scopus databases were systematically searched for relevant articles written in the English language published between 2000 and 2011. In total, 25 articles were included, all within the medical domain focusing on the comparison between surgery and aviation. In order to improve safety in the OR, multiple interventions have to be implemented. Additionally, the healthcare organization has to become a 'learning organization' and the OR team has to become a team with shared responsibilities and flat hierarchies. Interpersonal and technical skills can be trained by means of simulation and can be supported by implementing team briefings, debriefings and cross-checks. However, further development and research is needed to prove if these solutions are useful, practical, and actually increase safety.

Quality Improvement in Hospitals: Identifying and Understanding Behaviors

“…For decades, thought leaders in healthcare improvement have suggested that U.S. hospitals would benefit from implementing improvement initiatives supported by process reengineering principles, with leadership committed to a culture of safety and teamwork [11][12][13][14][15][16][17][18][19]. Studies of high reliability organizations and organizations with mature quality and safety programs have confirmed such approaches and further emphasized the importance of developing and empowering frontline employees to detect and eliminate process failures [20][21][22][23][24][25][26].…”

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“…A systematic literature review offers a methodology that can be used by an interdisciplinary research team to design a transparent approach to selecting, analyzing, and synthesizing study to address its research question (Borrego, Foster, & Froyd, 2015). For instance, Wauben, Lange, and Goossens's (2012) research analyzed the similarities and differences of safety between the aviation industry and operation rooms in the hospital. Systematic literature review in other disciplines.…”

“… "Learning from Aviation to Improve Safety in the Operating Rooma Systematic Literature Review," described the similarities and differences between aviation and medicine industries and discussed methods and solutions with a systematic approach to reduce errors in operating rooms (Wauben, Lange, & Goossens, 2012).  Huster, Müller, Prohn, Nowak, & Herbig (2014) researched the medical risks faced by older pilots, and investigated whether the pilot risk of incapacitation for medical reasons increases with age.…”

Team Briefings in the Gynecological Operating Room

“…In recent years, team briefings have been proposed as potential mechanisms for standardizing team communication and functioning in the operating room. In aviation, briefings and safety checklists have long shown benefits to individuals and teams for establishing shared cognition and facilitating effective communication (Wauben et al, 2012;Russ et al, 2013). In healthcare, briefings in the operating room have been shown to reduce breakdowns in team communication (Lingard et al, 2005, Lingard et al, 2008Henrickson, et al, 2007, Papaspyros et al, 2010, improve perception of team performance (Makary et al, 2007;Papaspyros et al, 2010) and reduce the occurrence of nonroutine events (Henrickson et al, 2009;Einav et al,.…”