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01-04-2009 | Commentary

Improving care by understanding the way we work: human factors and behavioural science in the context of intensive care

Authors: Nick Sevdalis, Stephen J Brett

Published in: Critical Care | Issue 2/2009

Abstract

Effectiveness and efficiency of care of the critically ill patient are subject to a number of systemic influences, including skills of individual physicians/nurses (technical and non-technical), team-working in the intensive care unit (ICU), and the ICU environment. We first discuss the paper of Fackler and colleagues as a contribution to the systems approach to clinical performance in the context of intensive care. We then highlight features of care delivery that are unique to intensive care and discuss the need for better understanding of human and non-human elements of the system of care of the critically ill patient as a driver for improvement of care delivery.

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Fackler J, Watts C, McHugh A, Miller T, Crandall B, Pronovost P: Critical care physician cognitive task analysis: an exploratory study. Crit Care 2009, 13: R33. 10.1186/cc7740PubMedCentralCrossRefPubMed

Vincent C, Moorthy K, Sarker SK, Chang A, Darzi AW: Systems approaches to surgical quality and safety: from concept to measurement. Ann Surg 2004, 239: 475-482. 10.1097/01.sla.0000118753.22830.41PubMedCentralCrossRefPubMed

Undre S, Arora S, Sevdalis N: Surgical performance, human error and patient safety in urological surgery. Br J Med Surg Urol 2009, 2: 2-10. 10.1016/j.bjmsu.2008.11.004CrossRef

Yule S, Flin R, Paterson-Brown S, Maran N: Non-technical skills for surgeons. A review of the literature. Surgery 2006, 139: 140-149. 10.1016/j.surg.2005.06.017CrossRefPubMed

Undre S, Sevdalis N, Healey AN, Darzi A, Vincent CA: Teamwork in the operating theatre: cohesion or confusion? J Eval Clin Pract 2006, 12: 182-189. 10.1111/j.1365-2753.2006.00614.xCrossRefPubMed

Healey AN, Undre S, Sevdalis N, Koutantji M, Vincent CA: The complexity of measuring interprofessional teamwork in the operating theatre. J Interprof Care 2006, 20: 485-495. 10.1080/13561820600937473CrossRefPubMed

Sevdalis N, Forrest D, Undre S, Darzi A, Vincent CA: Annoyances, disruptions and interruptions in surgery. The Disruptions in Surgery Index (DiSI). World J Surg 2008, 32: 1643-1650. 10.1007/s00268-008-9624-7CrossRefPubMed

Sevdalis N, Healey AN, Vincent CA: Distracting communications in the operating theatre. J Eval Clin Pract 2007, 13: 390-394. 10.1111/j.1365-2753.2006.00712.xCrossRefPubMed

Reader T, Flin R, Lauche K, Cuthbertson BH: Non-technical skills in the intensive care unit. Br J Anaesth 2006, 96: 551-559. 10.1093/bja/ael067CrossRefPubMed

10.

Jeffcott SA, Mackenzie CF: Measuring team performance in healthcare: review of research and implications for patient safety. J Crit Care 2008, 23: 188-196. 10.1016/j.jcrc.2007.12.005CrossRefPubMed

11.

Lingard L, Espin S, Evans C, Hawryluck L: The rules of the game: interprofessional collaboration on the intensive care unit team. Crit Care 2004, 8: R403-408. 10.1186/cc2958PubMedCentralCrossRefPubMed

12.

Reader T, Flin R, Mearns K, Cuthbertson BH: Interdisciplinary communication in the intensive care unit. Br J Anaesth 2007, 98: 347-352. 10.1093/bja/ael372CrossRefPubMed

13.

Reader T, Flin R, Cuthbertson BH: Communication skills and error in the intensive care unit. Curr Opin Crit Care 2007, 13: 732-736. 10.1097/MCC.0b013e3282f1bb0eCrossRefPubMed

14.

Thomas EJ, Sexton JB, Helmreich RL: Discrepant attitudes about teamwork among critical care nurses and physicians. Crit Care Med 2003, 31: 956-959. 10.1097/01.CCM.0000056183.89175.76CrossRefPubMed

15.

Alvarez G, Coiera E: Interdisciplinary communication: an uncharted source of medical error? J Crit Care 2006, 21: 236-242. 10.1016/j.jcrc.2006.02.004CrossRefPubMed

16.

Alameddine M, Dainty KN, Deber R, Sibbald WJ: The intensive care unit work environment: current challenges and recommendations for the future. J Crit Care 2008, in press.

17.

Alvarez G, Coiera E: Interruptive communication patterns in the intensive care unit ward round. Int J Med Inform 2005, 74: 791-796. 10.1016/j.ijmedinf.2005.03.017CrossRefPubMed

18.

Pronovost PJ, Berenholtz SM, Dorman T, Lipsett PA, Simmonds T, Haraden C: Improving communication in the ICU using daily goals. J Crit Care 2003, 18: 71-75. 10.1053/jcrc.2003.50008CrossRefPubMed

19.

Sundar E, Sundar S, Pawlowski J, Blum R, Feinstein D, Pratt S: Crew resource management and team training. Anesthesiol Clin 2007, 25: 283-300. 10.1016/j.anclin.2007.03.011CrossRefPubMed

Title: Improving care by understanding the way we work: human factors and behavioural science in the context of intensive care
Authors: Nick Sevdalis
Stephen J Brett
Publication date: 01-04-2009
Publisher: BioMed Central
Published in: Critical Care / Issue 2/2009
Electronic ISSN: 1364-8535
DOI: https://doi.org/10.1186/cc7787

At a glance: The STEP trials

Springer Medicine

Improving care by understanding the way we work: human factors and behavioural science in the context of intensive care

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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