Patientensicherheit in der Anästhesie

Neuhaus, Christopher; Röhrig, Rainer; Hofmann, G.; Klemm, Sarah; Neuhaus, Sophie; Hofer, Stefan; Thalheimer, M.; Weigand, Markus A.; Lichtenstern, Christoph

doi:10.1007/s00101-015-0115-6

Cited by 17 publications

(4 citation statements)

References 96 publications

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“…First, only if errors are reported openly can we learn from them. Therefore, all incidents need to be analyzed systematically and published in critical incident reporting systems [24,[42][43][44][45], in order to build up the culture of error. Only the courage of hospitals in Los Angeles [4,5] and Neuss (Germany) [38] to inform the public of their IT disaster caused by ransomware has encouraged a number of hospitals to go public on their past problems with malware as well as unsolved problems and risks.…”

Section: Discussionmentioning

confidence: 99%

“…We need to ask ourselves how the user can detect that systems are not running. [22][23][24][25], unpublished case reports of IT disasters, recommendations for emergency task forces, and the authors' individual experience in task forces. This is an approach to combine these concepts and cultures.…”

Section: Understanding Chains Of Events Leading From Hazard To Harmmentioning

confidence: 99%

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The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

Sax¹,

Lipprandt²,

Röhrig

2016

Yearb Med Inform

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SummaryIntroduction: As many medical workflows depend vastly on IT support, great demands are placed on the availability and accuracy of the applications involved. The cases of IT failure through ransomware at the beginning of 2016 are impressive examples of the dependence of clinical processes on IT. Although IT risk management attempts to reduce the risk of IT blackouts, the probability of partial/total data loss, or even worse, data falsification, is not zero. The objective of this paper is to present the state of the art with respect to strategies, processes, and governance to deal with the failure of IT systems. Methods: This article is conducted as a narrative review. Results: Worst case scenarios are needed, dealing with methods as to how to survive the downtime of clinical systems, for example through alternative workflows. These workflows have to be trained regularly. We categorize the most important types of IT system failure, assess the usefulness of classic counter measures, and state that most risk management approaches fall short on exactly this matter. Conclusion: To ensure that continuous, evidence-based improvements to the recommendations for IT emergency concepts are made, it is essential that IT blackouts and IT disasters are reported, analyzed, and critically discussed. This requires changing from a culture of shame and blame to one of error and safety in healthcare IT. This change is finding its way into other disciplines in medicine. In addition, systematically planned and analyzed simulations of IT disaster may assist in IT emergency concept development.

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Section: Discussionmentioning

confidence: 99%

Section: Understanding Chains Of Events Leading From Hazard To Harmmentioning

confidence: 99%

The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

Sax¹,

Lipprandt²,

Röhrig

2016

Yearb Med Inform

Self Cite

View full text Add to dashboard Cite

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“…Perioperativ tätiges ärztliches und pflegendes Personal ist mit einer Vielzahl von Theorien, Modellen und Methoden zur Optimierung der Patientensicherheit konfrontiert. Die Herausforderung besteht daher darin, all diese zu einem funktionierenden Risikomanagementkonzept zusammenzuführen, das die jeweiligen Stärken und Schwächen der einzelnen Elemente kennt und berücksichtigt [ 22 ]. Jedes Mitglied eines operativen Teams trägt somit zum Gelingen der Integrierung z.…”

Section: Ergebnisse Und Diskussionunclassified

Professionelle Teamarbeit und Kommunikation im Operationssaal – Eine narrative Übersicht

Lammert

Alb²,

Huber

et al. 2021

Anaesthesist

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Zusammenfassung Hintergrund Ein Operationsteam ist ein für Störungen anfälliges Konstrukt aus hierarchisch und oft geschlechtlich differenten Mitgliedern, die unterschiedlichen Berufsgruppen angehören. Zieldiversitäten der einzelnen Akteure unter ökonomisch steigendem Leistungsdruck bergen Konfliktpotenzial im Arbeitsalltag. Dies kann negative Auswirkungen auf die Patientensicherheit und die wirtschaftliche Effizienz des Klinikbetriebs haben. Ziel Ziel dieser Übersicht ist es, den Leser/die Leserin für die im operativen Klinikalltag bestehende Problematik zu sensibilisieren und ein Bewusstsein für die möglichen Lösungsansätze einer guten Kommunikationsstruktur und Teambildung sowie einer Moderation von außen durch ein Operationssaal(OP)-Management zu schaffen. Methoden Narratives Review anhand einer Literaturrecherche relevanter Originalarbeiten und Expertenempfehlungen der Datenbanken PubMed/MEDLINE; Schlüsselworte u. a. Teamarbeit, Kommunikation, OP, Teambildung. Ergebnisse und Schlussfolgerung Kommunikation und Teamarbeit im OP sind von immenser Bedeutung für die Patientensicherheit und die wirtschaftliche Entwicklung eines Klinikbetriebs. Verbesserungen in der Kommunikationsstruktur u. a. durch die konsequente Durchführung eines Team-Time-Out und eine „Moderation von außen“ (OP-Manager) bieten Lösungsansätze zur Vermeidung von Konfliktpotenzial im klinischen Alltag an.

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“…Unstrittig ist, dass durch fächerübergreifende Simulation-und CRM-Trainings ein positiver Effekt auf Kommunikation, Handlungssicherheit und Teamarbeit erzielt werden kann [22]. Auf der 4-Stufenskala zur Trainingsevaluation [23] wurden in unserer Arbeit die Ebenen "Reaktion des Teilnehmers" und "subjektiver Lernerfolg" positiv bewertet.…”

Section: Ergebnisseunclassified

Subjektiver Kompetenzgewinn zur Durchführung eines Notfallkaiserschnitts mittels interdisziplinärem Simulationstraining

Flentje

Schott

Woltemate

et al. 2017

Z Geburtshilfe Neonatol

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The emergency caesaran section is a gynecological emergency situation which is potentially life-threatening for mother and child. In the management of these time-critical situations human factors as well as the competence of the crisis resource management team have been shown to be important factors for success. The concept "simulation" has not been validated as a training tool for professional competence of multidisciplinary teams in the delivery suite. The aim of this study was, to assess the competence gain by subjective evaluation of the team members after taking part in an emergency caesarian section training which is integrable into the daily clinic setting. 36 members of a multidisciplinary team of a delivery suite took part in a 4-hourly "high-fidelity" simulation training "emergency caesarian section". Scenarios were created around the case setting of eclampsia with bradycardia of the child, uterus rupture, placenta abruption and cord prolapse. Each participant was involved in 2 scenarios as either a spectator or a team member. Using a questionnaire, the course performance and debriefing were evaluated and the subjective professional competence in Crisis Resource Management were recorded. In the collective of the trainee (over/equal 5 years), 25% had no experience in any cases of emergency caesarean in practice. On a scale of 1 to 6 (1=very good, 6=fail) the course was given an overall mark of 1.4 and a mark of 1.8 for its relevance to daily work. 6 months after the training, participants rated their competencies in prioritising necessary actions, following treatment plans, communicating among the team members as well as integrating new information as significantly improved. The 4-hour simulation training can be easily integrated into everyday clinical practice. The participants marked the course scenarios as realistic and relevant for their clinical practice. The number of years of prior work experience is not significanty related with the experience in rare emergency situations. The interdisciplinary team training is a way to improve individual performance as well as to establish and practise interdisciplinary emergency concepts.

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Patientensicherheit in der Anästhesie

Cited by 17 publications

References 96 publications

The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

The Rising Frequency of IT Blackouts Indicates the Increasing Relevance of IT Emergency Concepts to Ensure Patient Safety

Professionelle Teamarbeit und Kommunikation im Operationssaal – Eine narrative Übersicht

Subjektiver Kompetenzgewinn zur Durchführung eines Notfallkaiserschnitts mittels interdisziplinärem Simulationstraining

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