Standardization of surgical procedures for identifying best practices and training
Autor: | Pamela Andreatta, Steve Kasten, Rebecca M. Minter, Thomas J. Armstrong, Denny Yu, Adam C. Frischknecht |
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Rok vydání: | 2012 |
Předmět: |
medicine.medical_specialty
Standardization Difficulty communicating business.industry Best practice Communication Rehabilitation Anastomosis Surgical Public Health Environmental and Occupational Health Video Recording Surgical procedures Surgical training Microvessels Practice Guidelines as Topic Task Performance and Analysis medicine Task analysis Humans Medical physics Training needs business Vascular Surgical Procedures Simulation Small field of view |
Zdroj: | Work (Reading, Mass.). 41 |
ISSN: | 1875-9270 |
Popis: | A taxonomy was developed a) to describe surgical procedures with sufficient detail to review differences among surgeons, b) to examine the relationship between individual technique and outcomes, c) to enable surgeons to standardize technique around best practices and d) to identify clinical-evidence-based key points of teaching and assessment for surgical training. Sixty-seven microvascular anastomoses were recorded through video cameras mounted in the dissecting microscope. A hierarchical task analysis was used to decompose the observed procedures into successive levels of detail. The results were then presented to individual and small groups of microvascular surgeons to help define steps and step attributes necessary to describe a procedure so that other surgeons can perform the procedure exactly the same way. Coincidently, it was found that because the surgeons' attention is confined to a very small field of view in which they can see only the veins and arteries and the ends of their instruments, they often have difficulty communicating with others in the operating room. Analyses of selected cases using the proposed taxonomy shows how subtle details are revealed that may affect outcomes, and indicate specific training needs. By comparing different methods and outcomes, it should be possible to identify best practices for given conditions. |
Databáze: | OpenAIRE |
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