RESUMEN
PURPOSE: Medical errors are the third leading cause of death in the United States after malignant tumors and cardiovascular disease. Handling of errors becomes more and more eclectic due to the implementation of incident reporting systems and the use of checklists. Since 2015, any German hospital would have a critical incident reporting system (CIRS). The aim of this study is to discover the nationwide utilization and attitude toward CIRS of orthopedic and trauma surgeons. METHODS: Between April 10, 2015 and May 22, 2015, a web-based questionnaire, which was designed by an expert team consisting of orthopedic and trauma surgeons, aeronautic human factors specialists, and psychologists (Lufthansa Aviation Training), was sent to all members of the German Society for Orthopedic and Trauma Surgery. The survey consisted of three questions regarding CIRS and its use in German hospitals. RESULTS: A total of 669 orthopedic and trauma surgeons working in German hospitals completed the questionnaire. All participants rated CIRS as useful, although 71.3% of participants did not report a critical incident in the last 12 months. In that time period, only 13.4% of participating residents reported at least one incident, but 44.7% of chief physicians reported one incident within the same period. CONCLUSION: The present study demonstrates that even though CIRS as a tool is positively appreciated by orthopedic and trauma surgeons working in German hospitals, many do not know about its existence at their own hospital. This can be a reason for the low number of critical incidents reported.
Asunto(s)
Errores Médicos/estadística & datos numéricos , Gestión de Riesgos/métodos , Cirujanos/estadística & datos numéricos , Centros Traumatológicos/estadística & datos numéricos , Heridas y Lesiones/cirugía , Adulto , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Seguridad del PacienteRESUMEN
INTRODUCTION: The development of a new safety culture in orthopaedics and trauma surgery needs to be based on the knowledge of the status quo. The objective of this research was therefore to perform a survey of orthopaedic and trauma surgeons to achieve a subjective assessment of the frequency and causes of "insecurities" or errors in daily practice. METHODS: Based on current literature, an online questionnaire was created by a team of experts (26 questions total) and was sent via e-mail to all active members of a medical society (DGOU) in April 2015. This was followed by two reminder e-mails. The survey was completed in May 2015. The results were transmitted electronically, anonymously and voluntarily into a database and evaluated by univariate analyses. RESULTS: 799 active members took part in the survey. 65% of the interviewed people stated that they noticed mistakes in their own clinical work environment at least once a week. The main reasons for these mistakes were "time pressure", "lack of communication", "lack of staff" and "stress". Technical mistakes or lack of knowledge were not of primary importance. CONCLUSIONS: The survey indicated that errors in orthopaedics and trauma surgery are observed regularly. "Human factors" were regarded as a major cause. In order to develop a new safety culture in orthopaedics and trauma surgery, new approaches must focus on the human factor.
Asunto(s)
Procedimientos Ortopédicos/normas , Complicaciones Posoperatorias/epidemiología , Administración de la Seguridad/normas , Traumatología/normas , Heridas y Lesiones/cirugía , Estudios Transversales , Alemania , Humanos , Procedimientos Ortopédicos/tendencias , Complicaciones Posoperatorias/prevención & control , Administración de la Seguridad/organización & administración , Administración de la Seguridad/tendencias , Traumatología/organización & administración , Traumatología/tendenciasRESUMEN
For pilots and doctors, as well as a variety of other professions the knowledge of human performance limitations is essential, especially in critical situations. Crew resource management was developed in the 1980s in the aviation industry in order to ensure systematic training and support in such instances. Just recently, the value is recognized not only in other high reliability organizations but also in medicine.