Use of Emergency Manuals During Actual Critical Events in China: A Multi-Institutional Study

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BackgroundEmergency manuals (EMs) are guides that provide a sequence of procedures and are used in response to critical events in the operating room. Literature has described the clinical advantage of such cognitive aids but implementation remains a problem because habits can be difficult to change. Studies have shown that successful use of EMs can be achieved by simulation training. This form of active learning engages the participants and provides the advantage of hands-on experience. Therefore, a simulation competition, namely Simulation Wars, was established in China to promote simulation training and increase training participation. This study aims to assess whether participation in such a simulation competition increases the participants’ implementation of EMs in the operating room in real situations of crisis.MethodsAnesthesia providers who participated in the 2017 Zhongshan Emergency Manuals simulation training competition and multi-institutional survey studies were eligible to participate in this study. A year after the inaugural competition, surveys were distributed to the participating providers to assess their use of EMs in the operating room post competition.ResultsOne hundred six anesthesia providers across two different hospitals qualified for the study. The response rates among anesthesia providers were similar for both surveys, with 45/51 (88.2%) pre-competition and 48/55 (87.2%) post-competition. Analysis shows that EM usage during critical events increased significantly following a simulation training competition (p<0.05).ConclusionThe study indicates that EM use in the operating room significantly increased after participating in the simulation training competition.

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Simulation Competition Enhances Emergency Manual Uses During Actual Critical Events

Huang

Parus

et al. 2018

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“…One year after multi-institutional implementation a study was performed which shows strong correlation of EM usage to simulation training with roughly 69% of surveyed participant respondents having participated in multidisciplinary simulation training with 70%. These participants reported EM use during at least one critical event in the previous six months with the average number of events being two, proving a largely successful implementation plan and execution as a whole [23]. Additional planning and successful EM implementation through simulation training was completed in 2017 in the form of "Simulation Wars", a competition of sorts including teams, a point system with judges, and awards.…”

Section: Implementation Worldwidementioning

confidence: 98%

Operating Room Emergency Manuals Improve Patient Safety: A Systemic Review

Simmons¹,

Huang²

2019

The aim of this review is to highlight the latest movements surrounding Emergency Manual (EM) implementation nationally and abroad within perioperative medicine with a focus on studies linking EM to patient safety. This is a comprehensive literature review which includes a brief introduction to the definition and history of EM as well as an overview of a successful implementation strategy, international influence and correlations to patient safety. The recent changes in healthcare and healthcare reimbursement have directed the focus throughout healthcare to quality improvement and patient safety. The potential of EMs' application to improve patient outcomes has influential implications both on patient outcomes as well as reimbursements. This study includes relevant citations with the large majority published in the last five years. EM implementation in healthcare has grown within the US and internationally over the last decade. Prominent organizations have created EMs containing principles of evidence-based medicine and widely accepted protocols that have been endorsed by major entities in the medical field. Successful implementation strategies primarily focus on different forms of simulation training and have been found to increase adherence to protocols through EM use. An increasing amount of educational institutions and healthcare facilities worldwide are perpetuating such implementation and a growing number of successful cases are being published.

“…The implementation of EM was promoted through online forums, conferences, simulation-based training, and competitions. This significantly increased the awareness of Chinese anesthesiologists about crisis in the OR and the willingness to use EM [5,6].…”

Section: Introductionmentioning

confidence: 99%

Use of an Emergency Manual During an Intraoperative Pulmonary Arterial Rupture, Hypoxemia, and Bradycardia

Huang

Guo

et al. 2020

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The use of an emergency manual can improve team performance on critical steps during crisis events. Measures of improved performance have so far been captured through survey and simulation data; however, real-life case studies showing successful use of the manuals are fewer in number. The case of a patient with an unexpected rupture of the pulmonary artery, hypoxemia, and bradycardia during a video-assisted thoracic surgery lobectomy is described here. Relevant sections of Stanford University Operating Room Emergency Manuals were activated immediately and used during the rescue. The team of surgeons, anesthesiologists, and nurses managed the crisis in an orderly, smooth, and efficient manner, and the patient recovered without any complication. The use of the emergency manual reinforced by regular simulation-based training benefited the team and ultimately, the patient's safety.