| Managing nonroutine events in anesthesia: the role of adaptive coordination. | |
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MedLine Citation:
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PMID: 20942256 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: This field study aimed at examining the role of anesthesia teams' adaptive coordination in managing changing situational demands, such as in nonroutine events (NREs). BACKGROUND: Medical teams' ability to adapt their teamwork (e.g., their coordination activities) to changing situational demands is crucial to team performance and, thus, to patient safety. Whereas the majority of previous studies on the matter have focused on critical but rare events, it has recently been pointed out that the effective management of NREs is a key challenge to medical teams. Hence this study investigated the relationship between coordination activities, NRE occurrence, and team performance. METHOD: We videotaped 22 anesthesia teams during standard anesthesia induction and recorded data from the vital signs monitor and the ventilator. Coordination was coded by a trained observer using a structured observation system. NREs were recorded by an experienced staff anesthesiologist using all three video streams. Checklist-based team performance assessment was also performed by an experienced staff anesthesiologist. RESULTS: We found that anesthesia teams adapt their coordination activities to changing situational demands. In particular, the increased occurrence of NREs caused an increase in the time the teams spent on task management. A stronger increase in the teams' task management (i.e., more adaptive coordination) was related to their performance. CONCLUSION: Our results emphasize the importance of adaptive coordination in managing NREs effectively. APPLICATION: This study provides valuable information for developing novel team training programs in health care that focus on adaptation to changing task requirements, for example, when faced with NREs. |
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Authors:
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Michael J Burtscher; Johannes Wacker; Gudela Grote; Tanja Manser |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Human factors Volume: 52 ISSN: 0018-7208 ISO Abbreviation: Hum Factors Publication Date: 2010 Apr |
Date Detail:
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Created Date: 2010-10-14 Completed Date: 2010-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0374660 Medline TA: Hum Factors Country: United States |
Other Details:
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Languages: eng Pagination: 282-94 Citation Subset: IM; S |
Affiliation:
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Center for Organizational and Occupational Sciences, ETH Zurich, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adaptation, Psychological* Anesthesiology / methods, organization & administration* Group Processes* Humans Patient Care Team / organization & administration* Safety Management / methods, organization & administration* Task Performance and Analysis Videotape Recording |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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