In 2022, medical errors are among the top 10 causes of death according to the WHO.* These accidents are partly due to defects in communication, transmission of information or distractions and task interruptions.*
To increase the reliability of care activity and optimize patient safety, it is essential to implement reliability practices that take into account human factors, which are often inspired by other high-risk industries such as aviation, which has been teaching its teams the art of cooperation since the 1980s.
Cross-control, inspired by aviation
In a commercial airliner, there are always two pilots. One is in charge of the actual piloting; this is the pilot flying. The other checks, monitors, and controls the actions of the first while taking care of ancillary actions; this is the pilot monitoring. He has a key role since he must be on his guard at all times to best advise the pilot flying.
Both have tasks assigned to them in advance, to avoid risks and ensure flight safety. This is what we call cross-checking. It's a kind of mirror control, a double check that forms part of a risk management approach, as a prevention and recovery tool. Everything is supervised to avoid risks.
Cross-checking promotes teamwork. It is essential that pilots communicate with each other and listen to each other. Aviation is a real team effort where each individual has a role to play.
It is therefore essential to be able to identify the areas of vulnerability where cross-checking must be mandatory and systematic.
Adaptingcross-checking to healthcare activity
As with aviation, it is necessary to identify moments of vulnerability in healthcare. In the context of surgical activity, since 2010, the WHO has proposed the implementation of a surgical checklist where the different phases correspond to the areas of vulnerability and where cross-checking is necessary, if not fundamental:
- Phase 1: Before anesthetic induction, the time-out prior to anesthesia.
- Phase 2: Before the surgical intervention, the time-out prior to incision.
- Phase 3: After the surgical intervention, the time-out before leaving the operating room.
The surgical checklist is only meaningful if it is carried out as a team, with cross-checking by the various healthcare professionals involved around the patient. It is a tool that promotes cross-checking and structures teamwork by providing a situation update in the form of briefings and debriefings.
The checklist provides a shared mental framework with clear objectives at each stage of the patient's care pathway.
It encourages all stakeholders to discuss the intervention, thereby promoting teamwork and communication.
Simulation for training healthcare professionals
Simulation is integrated into new pedagogies relevant for training healthcare professionals. It has been used for a long time in other fields such as aeronautics* and can be seen as a tool to test one's work environment.
SafeTeam Academy and STAN Institute are training organizations that use simulation-based learning and, based on this pedagogical expertise in simulation, innovate to offer new ways of learning.
STAN Institute uses in-situ simulation to train learners. Drawing on its experience in the aeronautics sector, the STAN Institute team, experts in human factors, safety and feedback, have transposed their knowledge to the medical world.
The founders of SafeTeam Academy have created perceived simulation: as in the cinema, learners are immersed in an immersive video film during which practices and routines will be questioned. SafeTeam Academy uses simulation as a tool for making healthcare practices more reliable by calling on a historical industry in France: cinema. Realism and perceived authenticity are among the vectors of learning. The tool offered by SafeTeam Academy is also part of a futuristic vision of simulation: developing mobile debriefing teams.
In both cases, these experiential educational tools help to analyze practices and acquire new skills within the structures, thus promoting the learning of healthcare professionals.
The e-learning training courses offered by SafeTeam Academy have been designed to be complemented by live simulation.
In this sense, simulation centers such as STAN Institute and simulation trainers are real agents of change and work perfectly together to offer a hybrid experience (blended learning) that is the most powerful to date.
If you too would like to play a part in improving the reliability of care in your facilities, please contact us: contact@safeteam.academy ; info@stan-institute.com
* WHO | 10 facts on patient safety. WHO. http://www.who.int/features/factfiles/patient_safety/en/ (accessed 27 Jan 2019).
* Joint Commission Center for Transforming Healthcare releases targeted solutions tool for hand-off communications. Jt Comm Perspect Jt Comm Accreditation Healthc Organ 2012;32:1, 3.
* How to better train and evaluate students in medicine and health sciences?, Thierry Pelaccia, Preface by Jacques Tardif
