Pal Atanu, Lal Roshan, Frizelle Frank
Department of Surgery, James Paget University Hospital, Great Yarmouth, UK.
Department of Surgery, Christchurch Hospital, Christchurch, New Zealand.
ANZ J Surg. 2018 Dec;88(12):1231-1235. doi: 10.1111/ans.14892. Epub 2018 Oct 10.
Aviation systems were developed to improve safety and have achieved remarkable results. Medicine has looked to replicate these systems; however, the gap in outcomes between the two industries remains vast. Bridging this chasm requires an in-depth analysis of the applicability of the aviation safety model in surgery. This study uses qualitative methods to explore how aviation-based practices may be adapted and applied more effectively in theatre.
Data were collected using multiprofessional focus groups in a single centre. The focus groups involved discussion around teamwork and aviation-based non-technical skills. With consent, audio recordings were anonymized and transcribed. Qualitative (thematic) analysis was used to identify themes.
Five focus groups were conducted. Eight themes emerged, with a total of 18 sub-themes. Themes were: current practice, customization, applicability, team performance, human factors, analogy, incidents and integration of skills. Extent and limitations of the aviation surgery analogy also emerged.
The new insights gained through this qualitative analysis highlight the need to tailor aviation-based practices to the operating theatre. To achieve this, we propose the 'aviation bundle' of non-technical skills. This blueprint aims to promote a culture of safety and efficiency in surgical practice and could be developed into a training programme for theatre staff.
航空系统旨在提高安全性并取得了显著成果。医学领域一直希望复制这些系统；然而，这两个行业在成果方面的差距仍然巨大。弥合这一差距需要深入分析航空安全模型在手术中的适用性。本研究采用定性方法来探索基于航空的实践如何在手术室中更有效地进行调整和应用。
在单一中心通过多专业焦点小组收集数据。焦点小组围绕团队合作和基于航空的非技术技能展开讨论。经同意，对音频记录进行匿名处理并转录。采用定性（主题）分析来确定主题。
进行了五个焦点小组讨论。出现了八个主题，共有18个子主题。主题包括：当前实践、定制、适用性、团队绩效、人为因素、类比、事件和技能整合。航空手术类比的范围和局限性也显现出来。
通过这种定性分析获得的新见解凸显了需要根据手术室情况调整基于航空的实践。为实现这一目标，我们提出了非技术技能的“航空包”。这一蓝图旨在促进手术实践中的安全和效率文化，并可发展成为手术室工作人员的培训计划。
