Green B, Oeppen R S, Smith D W, Brennan P A
Department of Gastroenterology, Torbay Hospital, Torquay, UK.
Department of Diagnostic Radiology, University Hospital Southampton, UK.
Br J Oral Maxillofac Surg. 2017 Jun;55(5):449-453. doi: 10.1016/j.bjoms.2017.02.010. Epub 2017 Mar 23.
In healthcare, mistakes that are potentially harmful or fatal to patients are often the result of poor communication between members of a team. This is particularly important in high-risk areas such as operating theatres or during any intervention, and the ability to challenge colleagues who are in authority when something does not seem right or is clearly wrong, is crucial. Colleagues in oral and maxillofacial surgery recognised the importance of this as early as 2004, and it is now well known that failure or reluctance to challenge others who might be wrong can severely compromise a patient's safety. The Royal College of Surgeons of Edinburgh runs popular regular courses (Non-technical Skills for Surgeons, NOTSS) that teach how to ensure safety through good communication and teamwork. In this paper we introduce the concept of hierarchical challenge, and discuss models and approaches to address situations when problems arise within a team.
在医疗保健领域，对患者可能造成伤害或致命的错误往往是团队成员之间沟通不畅的结果。这在手术室等高危领域或任何干预过程中尤为重要，当某些事情看起来不对劲或明显错误时，向有权威的同事提出质疑的能力至关重要。口腔颌面外科的同事早在2004年就认识到了这一点的重要性，现在大家都清楚地知道，未能或不愿对可能犯错的其他人提出质疑会严重危及患者的安全。爱丁堡皇家外科医学院定期举办广受欢迎的课程（外科医生的非技术技能，NOTSS），教授如何通过良好的沟通和团队合作确保安全。在本文中，我们引入了分层质疑的概念，并讨论了在团队中出现问题时应对情况的模式和方法。
