Perceptions, Definitions, and Preparedness Regarding Low-Performing and Impaired Colleagues in Cardiothoracic and Vascular Anesthesia: An International Survey.
Evangelia Samara, Mona Momeni, Agathi Karakosta, Anna Smyrli, Konstantina Kolonia, Petros Tzimas, Jiapeng Huang, Vojislava Neskovic, Manuel Granell Gil, Gianluca Paternoster, Abdelazeem Eldawlatly, Mikhail Kirov, Evgeny Grigoryev, Hushan Ao, Davy Cheng, Fawzia Aboulfetouh, Eric Benedet Lineburger, Jakob Wittenstein, Mert Senturk, Zerrin Sungur, Abdulaziz Ahmad, Xiaojie Liu, Carolina Baeta Neves Duarte Ferreira, Fabio Guarracino, Ueda Kenichi, Laszlo L Szegedi, Mina Tharwat Fouad Beshara, Marc Vives, Priya Ramachandran Menon, Mohamed R El Tahan
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引用次数: 0
Abstract
Objective: To define low-performing colleagues in cardiothoracic and vascular anesthesia (LPC-CTVA), evaluate institutional preparedness to identify and manage such individuals, and identify predictors of recognition, reporting, and response behaviors.
Design: International cross-sectional survey.
Setting: Web-based data collection from June to September 2024.
Participants: Of 878 responses, 537 (61.2%) were complete and analyzed, representing 57 countries.
Interventions: None.
Measurements and main results: A 43-item questionnaire was developed by a multidisciplinary team and distributed via professional societies, social media, and email. It assessed definitions of LPC-CTVA, institutional protocols, and preparedness to address underperformance. Consensus was defined as ≥70% agreement. Thirteen of the 18 statements met consensus. Common indicators included non-compliance with infection control (80.0%), outdated knowledge (80.3%), repeated procedural failures (80.0%), and persistent negligence (79.1%). Institutional support was limited: among 464 respondents, 22.2% reported active supervision for underperformance, 15.3% reported the presence of identification mechanisms, and 11.7% indicated the existence of formal management processes. Although 39.9% of 434 had encountered a low-performing colleague, only 23.1% of 447 had reported one. Preparedness to manage impaired colleagues was reported by 46.2% of 418 respondents, and preparedness to manage underperforming colleagues by 44.1% of 416 respondents. Key barriers included the belief that others would act (33.7% of 265), perceived ineffectiveness (28.3%), and fear of retaliation (21.9%). Preparedness was more prevalent among older, more experienced clinicians, those in leadership roles, and those with prior experience in reporting.
Conclusions: A consensus-based definition of LPC-CTVA has been established. However, institutional readiness and clinician confidence remain limited. Experience and structured systems enhance response capability.
期刊介绍：
The Journal of Cardiothoracic and Vascular Anesthesia is primarily aimed at anesthesiologists who deal with patients undergoing cardiac, thoracic or vascular surgical procedures. JCVA features a multidisciplinary approach, with contributions from cardiac, vascular and thoracic surgeons, cardiologists, and other related specialists. Emphasis is placed on rapid publication of clinically relevant material.
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