Why non-technical skills matter in surgery. New paradigms for surgical leaders

Cobianchi, Lorenzo; Mas, Francesca Dal; Verde, Juan M.; Garcia-Vazquez, Alain; Martellucci, Jacopo; Swanström, Lee L.; Ansaloni, Luca

doi:10.1007/s44250-022-00002-w

Cited by 7 publications

(5 citation statements)

References 53 publications

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“…Participants from the four workshops emphasised the crucial importance of well‐trained, skilled and competent professionals, and agreed on the need for research on how to train health care providers (HCPs) about nontechnical skills alongside AVB skills. Soft or nontechnical skills include cognitive (e.g., situational awareness) and social skills (e.g., communication and teamwork) 37 . Additionally, participants in all workshops stressed the importance of research about how to sustain knowledge and skills at the point of care, and how to train HCPs to view and manage labour and childbirth as physiological processes that need to be supported, rather than pathological processes that require interventions.…”

Section: Resultsmentioning

confidence: 99%

“…Soft or nontechnical skills include cognitive (e.g., situational awareness) and social skills (e.g., communication and teamwork). 37 Additionally, participants in all workshops stressed the importance of research about how to sustain knowledge and skills at the point of care, and how to train HCPs to view and manage labour and childbirth as physiological processes that need to be supported, rather than pathological processes that require interventions. Participants in two of the workshops also commented on the need for research about the feasibility and effectiveness of remote e‐training for AVB, particularly in Africa.…”

Section: Resultsmentioning

confidence: 99%

Section: Research Questions Related To Training and Clinical Aspectsmentioning

confidence: 99%

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Engaging women to set the research agenda for assisted vaginal birth

Torloni,

Campos,

Coullaut

et al. 2024

Health Expectations

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IntroductionPublic and patient involvement can provide crucial insights to optimise research by enhancing relevance and appropriateness of studies. The World Health Organization (WHO) engaged in an inclusive process to ensure that both technical experts and women had a voice in defining the research gaps and needs to increase or reintroduce the use of assisted vaginal birth (AVB) in settings where this intervention is needed but unavailable or underused.MethodsWe describe the methods and outcomes of online workshops led by WHO to obtain women representatives' perspectives about AVB research gaps and needs.ResultsAfter technical experts created a list of research questions based on various evidence syntheses, WHO organised four online workshops with 31 women's representatives from 27 mostly low‐ and middle‐income (LMIC) countries. Women rated the importance and priority of the research questions proposed by the technical experts, improving and broadening some of them, added new questions, and voiced their main concerns and views about AVB. Women helped to put the research questions into context in their communities, highlighted neglected factors/dimensions that influence practices and affect women's experience during labour and childbirth, underscored less salient consequences of AVB, and highlighted the main concerns of women about research on AVB. The consolidated vision of technical experts and women's representatives resulted in a technical brief published by WHO. The technical brief is expected to stimulate global research and action closely aligned with women's priorities.ConclusionsWe describe a successful experience of engaging women, mostly from LMICs, in the identification of research gaps and needs to reintroduce AVB use. This process contributed to better aligning research questions with women's views, concerns, and priorities. Given the scarcity of reports about engaging women from LMICs to optimise research, this successful experience can serve as an inspiration for future work.Patient or Public ContributionWomen representatives were involved at every stage of the workshops described in full in this manuscript.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Engaging women to set the research agenda for assisted vaginal birth

Torloni,

Campos,

Coullaut

et al. 2024

Health Expectations

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“…Fourth, these injuries can impair the function and quality of life of patients due to pain, stiffness, deformity, disability, or psychological distress 16 . Additionally, contextual factors specific to the study setting, such as limited resources, delayed presentation, delayed debridement, delayed fixation, limited options for soft-tissue coverage, lack of trained staff, lack of laboratory facilities, and lack of rehabilitation services, may also impact the outcomes of these injuries [40][41][42][43][44][45][46][47] .…”

Section: Discussionmentioning

confidence: 99%

Functional and Radiographic Outcomes of Open Proximal Femoral Fractures Caused by Gunshot Wounds in Yemen

Hutaif,

Al-Moaish,

Al-fadliy

2024

JBJS Open Access

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Background: Open proximal femoral fractures caused by gunshot wounds are rare but devastating injuries that pose considerable challenges for prognosis and management. The aim of this study was to evaluate the functional and radiographic outcomes of patients with open proximal femoral fractures caused by gunshot wounds treated at 3 Level-I trauma centers in Yemen and to identify the factors that influence them. Methods: We prospectively enrolled 174 patients with open proximal femoral fractures caused by gunshot wounds. The fractures were classified according to the Gustilo-Anderson and OTA/AO systems. The primary outcome measures were fracture union, infection, and functional outcomes. The secondary outcome measures were the Harris hip score (HHS) and the Short Form-36 (SF-36) health survey score. We performed multivariable logistic regression modeling to identify the predictors of complications and poor functional outcomes. Results: The overall rate of fracture union was 87%. The complication rates were 18% for infection, 13% for nonunion, 23% for reoperation, 12% for delayed union, 4% for osteonecrosis, 6% for heterotopic ossification, and 2% for amputation. The mean HHS at the final follow-up was 78.4, and the mean SF-36 score was 67.3. Conclusions: Open proximal femoral fractures caused by gunshot wounds are associated with high rates of complications and poor functional outcomes in Yemen. Early debridement, appropriate fixation, infection control, and adequate soft-tissue coverage are essential for achieving satisfactory results. The type of wound, the type of fracture, and the type of definitive fixation are significant predictors of the outcomes. Future studies should compare different fixation methods and evaluate the long-term outcomes and complications of these injuries. Level of Evidence: Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.

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“…This has deserved increasing focus in recent years and there is compelling evidence to support the incorporation of NTS training into undergraduate and postgraduate settings, particularly in trauma. In fact, NTS has transcended trauma care and is spreading to other non-trauma surgical settings ( 33–35 ).…”

Section: Trauma Team Training Focusing On Non-technical Skillsmentioning

confidence: 99%

Non-technical skills and teamwork in trauma: from the emergency department to the operating room

Alexandrino,

Martinho,

Ferreira

et al. 2023

Front. Med.

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Management of a trauma patient is a challenging process. Swift and accurate clinical assessment is required and time-sensitive decisions and life-saving procedures must be performed in an unstable patient. This requires a coordinated response by both the emergency room (ER) and operating room (OR) teams. However, a team of experts does not necessarily make an expert team. Root cause analysis of adverse events in surgery has shown that failures in coordination, planning, task management and particularly communication are the main causes for medical errors. While most research is focused on the ER trauma team, the trauma OR team also deserves attention. In fact, OR team dynamics may resemble more the ER team than the elective OR team. ER and OR trauma teams assemble on short notice, and their members, who are from different specialties and backgrounds, may not train regularly together or even know each other beforehand. And yet, they have to perform high-risk procedures and make high stake decisions, in a time-sensitive manner. The airline industry has long recognized the role of team training and non-technical skills (NTS) in reducing hazards. The implementation of the so called crew resource management or crisis resource management (CRM) has significantly made airline travel safer and the transposition to the medical context, with specific training in non-technical skills, has also brought great benefits. In fact, it is clear that adoption of non-technical skills (NTS) in healthcare has led to an increase in patient safety. In this narrative review we recapitulate some of the key non-technical skills and their relevance in trauma, with a focus on both the emergency department (ER) and the operating room (OR) teams, as well as on the transition of care from one to the other. Also, we explore the use of debriefing the team, as well as the roles of NTS training in both undergraduate and postgraduate settings. We review some of the existing trauma training courses and their roles in developing NTS. Finally, we briefly address the challenges posed by the development of trauma hybrid operating rooms.

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Why non-technical skills matter in surgery. New paradigms for surgical leaders

Cited by 7 publications

References 53 publications

Engaging women to set the research agenda for assisted vaginal birth

Engaging women to set the research agenda for assisted vaginal birth

Functional and Radiographic Outcomes of Open Proximal Femoral Fractures Caused by Gunshot Wounds in Yemen

Non-technical skills and teamwork in trauma: from the emergency department to the operating room

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