Human factors in contingency operations

Abstract

The UK Defence Medical Services are currently supporting contingency operations following a period of intensive activity in relatively mature trauma systems in Iraq and Afghanistan. Among the key lessons identified, human factors or non-technical skills played an important role in the improvement of patient care. This article describes the importance of human factors on Role 2 Afloat, one of the Royal Navy's maritime contingency capabilities, and illustrates how they are vital to ensuring that correct decisions are made for patient care in a timely manner. Teamwork and communication are particularly important to ensure that limited resources such as blood products and other consumables are best used and that patients are evacuated promptly, allowing the facility to accept further casualties and therefore maintain operational capability. These ideas may be transferred to any small specialist team given a particular role to perform.

The Royal Navy Operating Department Practitioner: Perioperative care on land and sea

“…DCR and DCS are an established part of military surgical doctrine with the goal of stabilising exsanguinating patients as part of a ‘1:2:4’ basis which equates to DCR within 1h, DCS within 2h and primary surgery within 4h. The ODP moves seamlessly between DCR teams in the emergency department and DCS teams in the operating theatre (OT), requiring use of their human factors, clinical and military capabilities to ensure best practice (Mercer et al 2016).…”

Military Anaesthesia in contingencies: what skill sets are required and how will we prepare our trainees?

“…As far as possible a trauma bay is recreated with deployed military equipment that would be available and a background contingency operation story is briefed. The scenario setup allows a manipulation of timelines to evacuation and so drive the scenario to promote discussions around limited resources, human factors47 and decision-making. Following each scenario there is an immediate video-assisted debrief focusing on technical and non-technical skills.…”

P62 Is the use of patient simulation a more effective method of teaching medical students to recognise the early signs of clinical deterioration, compared to using videos and photographs?

“…Context The return to contingency operations has presented the Defence Medical Services (DMS) with new challenges for training and maintenance of non-technical and technical trauma skills. 1 The Military Operational Surgical Training course (MOST), 2 delivered at the Royal College of Surgeons, London, has changed significantly to address these challenges. Designed for multidisciplinary deployable trauma teams, the MOST course includes lectures, workshops, practical skill stations, cadaveric surgical procedure sessions and simulation training.…”