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PubMed · 14728228

Coordination challenges in operating-room management: an in-depth field study.

Cheryl L Plasters·F Jacob Seagull·Yan Xiao
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Abstract

Dynamic settings possess complex information needs all requiring attention in order to be managed effectively. The following study describes the multi-faceted information exchanges essential for an operating room suite to be managed within the context of efficient, cost effective, safe practice. Through the combined use of observation, the Critical Incident Technique, and interviews, this study analyzed information issues that impact coordination. Results demonstrate how distributed team planning is inherent to the efficacy of the system, and discuss implications for information tools to support coordination within in a complex setting.

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AnesthesiologyAppointments and SchedulesCommunicationEfficiency, OrganizationalGeneral SurgeryHumansInterprofessional RelationsInterviews as TopicNursing, SupervisoryObservationOperating Room Information SystemsOperating RoomsTask Performance and AnalysisWorkforceJournal ArticleResearch Support, U.S. Gov't, Non-P.H.S.Research Support, U.S. Gov't, P.H.S.

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Cheryl L Plasters, F Jacob Seagull, Yan Xiao. 2003. Coordination challenges in operating-room management: an in-depth field study.. https://pubmed.ncbi.nlm.nih.gov/14728228/

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PubMed2007

Perception of training needs and opportunities in advanced airway skills: a survey of British and Irish trainees.

BACKGROUND AND OBJECTIVE: We surveyed delegates at the Group of Anaesthetists in Training (UK) meeting to investigate evidence of a training-gap (number of fibreoptic intubations believed to bestow competence vs. number actually performed). METHODS: Questionnaires were distributed to and collected from delegates in person. Questions covered six areas, including experience of fibreoptic intubation and cricothyrotomy, fibreoptic intubation as a specialist skill and ethical issues. RESULTS: We received 221 replies (76%). All trainees believed competence to be achievable with 10 intubations (interquartile range (IQR) 10-20); the median number performed was 2 (IQR 0-4). This was statistically significant for the groups' senior house officers, 1st and 2nd year registrars and 3rd and 4th year registrars; P < 0.0001. Many final year trainees (12/20, 60%) also failed to achieve their competency target. Few trainees had seen or performed any cricothyrotomies (medians 0, IQRs 0-1 and 0-0). Most (195/208, 94%) believed that fibreoptic intubation was a core skill and 199/212 (94%) believed that all should be competent by completion of training. Ten percent (n = 208) felt it unethical to perform an awake training intubation with full consent and 10% believed it acceptable without explanation. Most (82.7%) would fibreoptically intubate an asleep patient (requiring intubation) without consent. CONCLUSION: Trainees reported a gap between their perception of competence and achievement in awake fibreoptic intubation. Simple and complex simulations and structured training programmes may help. Anaesthetists must address the ethics of clinical training in advanced airway management.

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