Journal of Obstetric, Gynecologic & Neonatal Nursing
Clinical IssuesCommunication and Teamwork in Patient Care: How Much Can We Learn From Aviation?
Section snippets
The problem: What is known about the presence and effects of assertiveness in teams?
Theories of organizational safety have been applied to health care environments (Gaba, 2000). Normal accident theory (NAT) focuses on the complexity and “tight coupling” of system components as sources of accidents. From a NAT perspective, accidents are inevitable because the root causes of accidents can be traced to latent properties of the organizational system which, when triggered, result in a cascade of events which is not always caught by the system's technical or procedural defenses; and
Review of the literature
A literature search was conducted of PubMed, CINAHL, Social Science Abstracts, and the Social Sciences Citation Index. The search was limited to English language and human studies using the terms “patient safety,”“medical error,”“interprofessional relations,”“physician‐nurse relationships,”“communication,”“safety,”“obstetrics,”“assertion,” and “adverse events,”“teamwork climate,”“teamwork and medicine,”“medical error and team communication,”“human factors,” and “situation awareness.” Titles and
Human factors in aviation safety
Much of the interest in communication in health care has been generated through application of concepts from the aviation industry safety model of crew resource management (CRM) to the health care setting. The CRM movement grew out of recognition that human (rather than weather or equipment) factors were responsible for the majority of accidents and incidents in aviation (Helmreich, 2000). Aviation psychology researchers demonstrated that pilots’ attitudes affected performance and were amenable
State of the science & directions for research
When viewed together, high reliability, normal accident, and human factors theories indicate that errors will continue to occur in the provision of medical care, and a single‐minded focus on “system” level functions for preventing error may actually increase the potential for harm to occur (Knox, 2003, Rochlin, 1999, Weick, 2002), suggesting the need to improve medical teamwork and communication as a key strategy for preventing patient harm.
There is good evidence from the aviation industry that
References (46)
- et al.
The human factor in cardiac surgery: Errors and near misses in a high technology medical domain
Annals of Thoracic Surgery
(2001) - et al.
A “near‐miss” model for describing the nurse's role in recovery of medical errors
Journal of Professional Nursing
(2004) Conflict, communication, and collaboration: Improving interactions between nurses and physicians
Journal of Perianesthesia Nursing
(2003)- et al.
How do expert labor nurses view their role?
Journal of Obstetric, Gynecologic, and Neonatal Nursing
(2003) - et al.
The interplay of knowledge and decision making between nurses and doctors in critical care
International Journal of Nursing Studies
(2001) - et al.
Safety in the operating theatre—Part 1: Interpersonal relationships and team performance
Current Anaesthesia Critical Care
(1995) - et al.
Adverse perinatal outcomes: Recognizing, understanding, and preventing common types of accidents
Lifelines
(2003) - et al.
Analyzing communication sequences for team training needs assessment
Human Factors
(1998) The clinical landscape of critical care: Nurses’ decision‐making
Journal of Advanced Nursing
(2003)- et al.
Time as a catalyst for tension in nurse‐surgeon communication
Association of Operating Room Nurses Journal
(2001)
Structural and organizational issues in patient safety: A comparison of health care to other high‐hazard industries
California Management Review
Difference in safety climate between hospital personnel and naval aviators
Human Factors
An investigation into the assertive behaviour of trained nurses in general hospital settings
Journal of Advanced Nursing
The complexity of team training: What we have learned from aviation and its applications to medicine
Quality and Safety in Health Care
On error management: Lessons from aviation
British Medical Journal
Why crew resource management? Empirical and theoretical bases of human factors training in aviation
Cockpit resource management: Exploring the attitude‐performance linkage
Aviation, Space, and Environmental Medicine
The evolution of crew resource management training in commercial aviation
International Journal of Aviation Psychology
Collaboration: A concept analysis
Journal of Advanced Nursing
To err is human
Crossing the quality chasm: A new health system for the 21st century
Keeping patients safe: Transforming the work environment of nurses
Who is flying this plane anyway? What mishaps tell us about crew member role assignment and air crew situation awareness
Human Factors
Cited by (45)
A qualitative study of speaking out about patient safety concerns in intensive care units
2017, Social Science and MedicineTeam training for safer birth
2015, Best Practice and Research: Clinical Obstetrics and GynaecologyCitation Excerpt :However, the same methods have failed to result in improvements in teamwork on labour wards [2]. In order to achieve better outcomes for mothers and babies, it is essential that team-training interventions are simple and relevant to the maternity care setting [78,79]. Therefore, research has focussed on the development of training tools that are specific and applicable to obstetric emergencies, typically involving ‘skills and drills’ training.
Planning a Collaborative Conference to Provide Interdisciplinary Education With a Focus on Patient Safety in Obstetrics
2014, Nursing for Women's Health"Attention on the flight deck": What ambulatory care providers can learn from pilots about complex coordinated actions
2013, Patient Education and CounselingCitation Excerpt :There is a rich literature that explores adopting aviation constructs to make medical practice safer and more effective. For example, in a review of the application of aviation industry techniques to improve patient safety for inpatient obstetric care [6], the authors noted that, whereas pilot attitudes regarding interpersonal interaction on the flight deck predicted effective performance and were amenable to behavior-based training to improve team performance, their adoption in healthcare, including Crew Resource Management Training [7–10], are unlikely to have an impact on safety without including the experiences of nurses and other health care professionals who provide care [6]. Others have concluded that team training and adoption of standardized processes and behaviors that are effective in improving operational performance in aviation and can potentially have a similar benefit in healthcare [11,12].
Reducing risk in maternity by optimising teamwork and leadership: An evidence-based approach to save mothers and babies
2013, Best Practice and Research: Clinical Obstetrics and Gynaecology