6 - Avoiding Patient Harm in Anesthesia: Human Performance and Patient Safety

Abstract

This chapter provides the reader with an overview of key human performance and safety issues concerning anesthesiology and demonstrates the relevance of those topics to the clinical performance of anesthesia professionals. Applying the knowledge of this chapter to patient care can help to avoid unnecessary harm to patients and also prevent\\ psychological harm to the anesthetist (as the “second victim”). Hence, this chapter is not only about patient safety, but also about the anesthesia professional’s safety and well-being as care provider. The authors provide a set of practical safety concepts and strategies to guide the reader in improving or refreshing case management related skills and to sensitize the reader to safety related core issues and competencies in anesthesia. Explicitly, readers will first learn about safety relevant aspects of a dynamic and complex work environment and the resulting consequences for clinicians. Several sections highlight the nature of anesthesia as a highly complex and dynamic working environment and the difficulties that arise for human performance and patient safety. Furthermore, characteristics and risks of different tasks performed by anesthesia professionals and countermeasures to mitigate their potential risks are discussed. Apart from that, the issues of human performance, human limitations and various relevant safety strategies that address them for both individuals and teams. Concluding, aspects of system safety concerning system thinking and the concept of High Reliability Organizations (HROs) are presented.