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Cases & Commentaries
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John Day and John T. Paige, MD; May 2019
An elderly man with a complicated medical history slipped on a rug at home, fell, and injured his hip. Emergency department evaluation and imaging revealed no head injury and a left intertrochanteric hip fracture. Although he was admitted to the orthopedic surgery service with surgery to fix the fracture initially scheduled for the next day, the operation was delayed by 3 days due to several emergent trauma cases and lack of surgeon availability. He ultimately underwent surgery and was discharged a few days later but was readmitted several weeks later with chest pain and shortness of breath. He was found to have a pulmonary embolism; anticoagulation was initiated. The patient's rehabilitation was delayed, his recovery was prolonged, and he never returned to his baseline functional status.
Journal Article > Commentary
Runciman WB, Merry AF. Qual Saf Health Care. 2005;14:156-163.
This commentary discusses the many facets of crisis management in anesthesia care. The authors describe a previously published crisis management algorithm, explain why providers can fail to respond to crises appropriately, and highlight how precompiled responses and algorithms serve as useful aids. They advocate increased team-oriented training, regular review of devised algorithms, and consideration of similar algorithms in other clinical areas to optimize management of crisis situations. This commentary is accompanied by a manual of 24 specific sub-algorithms in anesthesia crisis management.
Journal Article > Review
Glymph DC, Olenick M, Barbera S, Brown EL, Prestianni L, Miller C. AANA J. 2015;83:183-188.
The concept of a small group briefings or huddles have been used as a communication tactic in health care settings. This literature review discusses huddle use in preoperative care, highlighting the need for more structure, education, and research to enhance its value as a communication strategy to improve patient safety.
Journal Article > Review
Rutherford JS. Anaesthesia. 2017;72(suppl 1):84-94.
Anesthesiology was an early adopter of teamwork as a safety improvement strategy. This review explored models of assessing teamwork behaviors in anesthesiology. The authors found both implicit and explicit methods in place to monitor teamwork and determined that team training improves patient safety.