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Safer Surgery part 48

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Behaviour in the Operating Theatre: A Clinical Perspective. As a senior anaesthetist and surgeon, we recognize that we have a great deal of influence on the atmosphere created in the operating theatre and that our behaviour influences those around us. These were not environments in which one questioned decision- making or challenged leadership if one wished to set foot in...

Safer Surgery part 1

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Rhona Flin and Lucy Mitchell. Analysing Behaviour in the Operating Theatre. Rhona Flin and Lucy Mitchell 2009. British Library Cataloguing in Publication Data Safer surgery : analysing behaviour in the operating theatre.. Teams in the workplace.. Safer surgery : analysing behaviour in the operating theatre / [edited] by Rhona Flin and Lucy Mitchell.. PART i TOOLS FOR MeASuRing BehAviOuR in...

Safer Surgery part 2

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Table 2.1 Summary of NOTSS v1.1 evaluation results 16. Table 3.1 PBA domains 30. Table 3.2 Example elements for total hip replacement PBA, taken. Table 3.3 Global assessment taken from T&O curriculum 33 Table 3.4 Validation worksheet example taken from T&O curriculum 41 Table 4.1 Index procedures within the surgical specialties 50 Table 5.1 Non-technical skill categories examined in the...

Safer Surgery part 4

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Life in the Backrooms of Medicine. Proceedings of the IVth European Congress of Psychology. Tools for Measuring Behaviour in the Operating Theatre. Development and Evaluation of the NOTSS Behaviour Rating System for Intraoperative. In 2002, a number of surgeons in Scotland were intrigued by the development of the ANTS (Anaesthetists’ Non-Technical Skills) system and the use of behaviour rating checklists...

Safer Surgery part 5

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process produced a list of 150 unsorted non-technical skills such as ‘coordinates the team’, and ‘confirms understanding with assistant’ as raw input data for system development in phase 2.. Phase 2: Development of the nOTSS System. The goal of Phase 2 was to develop a system that could be used by surgeons to rate other surgeons’ behaviours in vivo in...

Safer Surgery part 6

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Flin, R., Yule, S., Paterson-Brown, S., Maran, N., Rowley, D.R. (ed.) (2005) The CanMEDS 2005 Physician Competency Framework.. (1996) Human factors in the operating room:. (1994) Team performance in the operating room.. Hoffmann, R., Crandall, B., and Shadbolt, N. The American Journal of Surgery . Klampfer, B., Flin, R., Helmreich, R.L., Hausler, R., Sexton, B., Fletcher, G., et al.. Development...

Safer Surgery part 7

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In order to guarantee a sufficiently wide range of assessment, each surgical specialty has selected a number of index procedures. These procedures are selected on the basis of their broad accessibility to trainees, observability and in most cases an aspect of the procedure which contributes something unique to the assessment range. By the end of training all the index procedures...

Safer Surgery part 8

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system itself is located on a secure site at: <www.elogbook.org>. which is counter to the core values of the system. Considerable interest from overseas in the orthopaedic curriculum and in particular with the PBA tools has led to a number of proposed international pilot projects.. International compatibility of surgical training systems is a key issue in relation to making it...

Safer Surgery part 9

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Our study views feasibility as a key assessment characteristic and it is formally considered within the study’s design. Following each case, the supervising consultant completes a PBA or OSATS before giving feedback to the trainee. We observe this process and record the time taken to complete the assessment form and the duration of feedback. The follow-up questionnaires which we distribute...

Safer Surgery part 10

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This has enabled us to maximize recruitment of cases, not only through an appreciation of the practical listing of surgical cases, but by engaging with the working practices and culture of each surgical team.. Consider the specific nature of context for implementing studies in the surgical workplace.. Spend time working with surgical teams to maximize the success of the research.....

Safer Surgery part 11

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At the time of writing, analyses of the data were ongoing but examples are now given of some coded segments in the identified non-technical skill categories. If I hand over a suture which is short, maybe because the surgeon has already used it, I would say to him ‘that’s a short length’ to make him aware of it otherwise he...

Safer Surgery part 12

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OTAS © aims to be such a comprehensive and robust measure of teamwork in surgery. We report, in detail, the conceptual background, initial development and empirical application, revision and further testing of the OTAS. Components of Teamwork. Systematic study of teamworking started in the 1950s and 1960s, with an emphasis on military teams. Subsequently, empirical study of teamwork extended to...

Safer Surgery part 13

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Exemplar behaviours and demonstrative scenarios for each sub-team/stage of a procedure are fully described in the OTAS user manual (Undre and Healey 2006, freely available for research use at: <http://www.csru.org.uk>).. Further Empirical Testing: Urological Cases (Undre et al. feasibility of the revised OTAS © tool;. usefulness of the revisions;. reliability in the behavioural scoring.. As in the previous study, care...

Safer Surgery part 14

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Major failures may expose more threats, create more errors and can lead directly to an adverse outcome (Catchpole et al. Though we did not directly measure surgical outcomes or observe any death, in more than 40 cases the Great Ormond Street team observed over 500 minor problems and 8 major problems that represented considerable lapses in the quality of care...

Safer Surgery part 15

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Thanks also to the rest of the Great Ormond Street project team, and especially Professor Marc de Leval and Mr Tony Giddings.. The Evaluation of Non-technical Skills of Multi-pilot Aircrew in Relation to the JAR-FCL Requirements. (2005) Identifying and Reducing Errors in the Operating Theatre (Rep. Catchpole, K., Giddings, A.E., Wilkinson, M., Dale, T., Hirst, G., and de Leval, M.R....

Safer Surgery part 16

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Figure 8.2 shows a screen shot of the RATE event-marking software just after a case has started. The left half of the screen is for conversation tracking and the right half of the screen is for event tracking. In particular, the upper portion of the left half of the screen allows observers to manually track conversations between members of the...

Safer Surgery part 17

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Thomas et al. The reasoning regarding leader and follower attitudes does not apply to the issue of leader behaviour and follower behaviour. In contrast to attitudes, if several members of a team simultaneously apply some of the identified ‘leadership‘. In agreement with Thomas et al. Accordingly, in agreement with Murray and Foster (2000) and Ostergaard et al. Behaviour markers for...

Safer Surgery part 18

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It is important to keep in mind the impact of patient outcome variables, clinical performance and team members’ subjective experiences of the process of teamworking. It stems from mastery of oneself, being fully aware and in tune with the rest of the team, despite leadership or followership and irrespective of the current context. According to empirical evidence, one reason could...

Safer Surgery part 19

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One of the underlying principles of error management is the recognition of the inevitability of human error and the adoption of a blame-free environment.. Most of the time commercial pilots fly as ad hoc teams and often work with unfamiliar team members, with different skills and knowledge and different tasks and responsibilities. One of the barriers for teamwork is partly...

Safer Surgery part 20

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the most reported ones are described below, subdivided into the categories used in the questionnaire.. Improving communication between all team members, improving information on patient characteristics, surgical day schedule, necessary equipment, and surgical approach (32 per cent of the remarks ‘communication &. The results of the pilot provide important information for implementing TOPplus on a wider scale and ensure that...