Keith J Ruskin, Richard P Dutton, Anna Clebone Ruskin
{"title":"In control or along for the ride? Lessons for anesthesiologists from air traffic control.","authors":"Keith J Ruskin, Richard P Dutton, Anna Clebone Ruskin","doi":"10.1097/ACO.0000000000001289","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Anesthesia professionals work in an unpredictable, rapidly changing environment in which they are quickly diagnose and manage uncommon and life-threatening critical events. The perioperative environment has traditionally been viewed as a deterministic system in which outcomes can be predicted, but recent studies suggest that the operating room behaves more like a complex adaptive system, in which events can interact and connect with each other in unpredictable and unplanned ways.</p><p><strong>Recent findings: </strong>The increasing complexity of the healthcare environment suggests that the complete elimination of human error is not possible. Complex clinical situations predispose to errors that are the result of high workload, decision making under stress, and poor team coordination. The theory behind complex adaptive systems differs from medicine's traditional approach to safety and highlights the importance of an institutional safety culture that encourages flexibility, adaptability, reporting and learning from errors. Instead of focusing on standardization and strict adherence to procedures, clinicians can improve safety by recognizing that unpredictable changes routinely occur in the work environment and learning how resilience can prevent adverse events.</p><p><strong>Summary: </strong>A better understanding of automation, complexity, and resilience in a changing environment are essential steps toward the safe practice of anesthesia.</p>","PeriodicalId":50609,"journal":{"name":"Current Opinion in Anesthesiology","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Opinion in Anesthesiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/ACO.0000000000001289","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/6/28 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ANESTHESIOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Anesthesia professionals work in an unpredictable, rapidly changing environment in which they are quickly diagnose and manage uncommon and life-threatening critical events. The perioperative environment has traditionally been viewed as a deterministic system in which outcomes can be predicted, but recent studies suggest that the operating room behaves more like a complex adaptive system, in which events can interact and connect with each other in unpredictable and unplanned ways.
Recent findings: The increasing complexity of the healthcare environment suggests that the complete elimination of human error is not possible. Complex clinical situations predispose to errors that are the result of high workload, decision making under stress, and poor team coordination. The theory behind complex adaptive systems differs from medicine's traditional approach to safety and highlights the importance of an institutional safety culture that encourages flexibility, adaptability, reporting and learning from errors. Instead of focusing on standardization and strict adherence to procedures, clinicians can improve safety by recognizing that unpredictable changes routinely occur in the work environment and learning how resilience can prevent adverse events.
Summary: A better understanding of automation, complexity, and resilience in a changing environment are essential steps toward the safe practice of anesthesia.
期刊介绍:
Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Anesthesiology features hand-picked review articles from our team of expert editors. With fifteen disciplines published across the year – including cardiovascular anesthesiology, neuroanesthesia and pain medicine – every issue also contains annotated references detailing the merits of the most important papers.