Improving patient safety in the operating theatre and perioperative care: Obstacles, interventions, and priorities for accelerating progress

British Journal of Anaesthesia

Volumn 109, Issue SUPPL1, 2012, Pages

  Sevdalis, N ^a   Hull, L ^a   Birnbach, D J ^a,b  

^a IMPERIAL COLLEGE LONDON   (United Kingdom)

^b UNIVERSITY OF MIAMI MILLER SCHOOL OF MEDICINE   (United States)

Author keywords

communication; education; healthcare quality; healthcare team; leadership; patient safety

Indexed keywords

ARTICLE; EVIDENCE BASED MEDICINE; HEALTH CARE PERSONNEL; HEALTH CARE SYSTEM; HUMAN; OPERATING ROOM; OUTCOME ASSESSMENT; PATIENT SAFETY; PERIOPERATIVE PERIOD; PRIORITY JOURNAL; QUALITY CONTROL;

EID: 84871190548     PISSN: 00070912     EISSN: 14716771     Source Type: Journal    
DOI: 10.1093/bja/aes391     Document Type: Article

References (129)

1. Kohn LT, Corrigan JM, Donaldson MS. To Err Is Human. Washington, DC: National Academy Press, 1999
2. Chief Medical Officer. An Organisation with a Memory. London, UK: Department of Health, 2000
3. Brennan TA, Leape LL, Laird NM, et al. Incidence of adverse events and negligence in hospitalized patients: Results of the Harvard Medical Practice Study I. N Engl J Med 1991; 324: 370-6
4. Wilson RM, Runciman WB, Gibberd RW, Harrison BT, Newby L, Hamilton JD. The quality in Australian health care study. Med J Austr 1995; 163: 458-71
5. Vincent CA, Neale G, Woloshynowych M. Adverse events in British hospitals: Preliminary retrospective record review. Br Med J 2001; 322: 517-9 (Pubitemid 32230913)
6. Aiken LH, Clarke SP, Sloane DM, Sochalski J, Silber JH. Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. J Am Med Assoc 2002; 288: 1987-93 (Pubitemid 35204688)
7. Landrigan CP, Rothschild JM, Cronin JW, et al. Effect of reducing interns' work hours on serious medical errors in intensive care units. N Eng J Med 2004; 351: 1838-48 (Pubitemid 39426319)
8. Resar R, Pronovost P, Haraden C, Simmonds T, Rainey T, Nolan T. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Jt Comm J Qual Patient Saf 2005; 31: 243-8
9. Institute for Healthcare Improvement. What is a bundle 2011. Available from http://www.ihi.org/knowledge/Pages/ImprovementStories/WhatIsaBundle.aspx (accessed 20 August 2012)
10. Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009; 360: 491-9
11. de Vries EN, Prins HA, Crolla RMPH, et al. Effect of a comprehensive surgical safety system on patient outcomes. N Engl J Med 2010; 363: 1928-37
12. Gaba D. Anaesthesiology as a model for patient safety in health care. Br Med J 2002; 320: 785-8
13. Salas E, Wilson KA, Burke CS, Priest HA. Using simulation-based training to improve patient safety: What does it take Jt Comm J Qual Patient Saf 2005; 31: 363-71
14. Park CS. Simulation and quality improvement in anesthesiology. Anesthesiol Clin 2011; 29: 13-28
15. Argani CH, Eichelberger M, Deering S, Satin AJ. The case for simulation as part of a comprehensive patient safety program. Am J Obstet Gynecol 2012; 206: 451-5
16. Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training program and surgical mortality. J Am Med Assoc 2010; 304: 1693-700
17. Landrigan CP, Parry GJ, Bones CB, Hackbarth AD, Goldmann DA, Sharek PJ. Temporal trends in rates of patient harm resulting from medical care. N Engl J Med 2010; 363: 2124-34
18. Vincent C, Aylin P, Franklin B-D, et al. Is healthcare getting safer Br Med J 2008; 337: A2426
19. Tsang C, Palmer W, Bottle A, Majeed A, Aylin PL. A review of patient safety measures based on routinely collected hospital data. Am J Med Qual 2012; 27: 154-69
20. Mahajan R. Critical incident reporting and learning. Br J Anaesth 2010; 105: 69-75
21. Sari AB-A, Sheldon TA, Cracknell A, Turnbull A. Sensitivity of routine systems for reporting patient safety incidents in a NHS hospital: Retrospective patient case note review. Br Med J 2007; 334: 79-82
22. Hutchinson A, Young TA, Cooper KL, et al. Trends in healthcare incident reporting and relationship to safety and quality data in acute hospitals: Results from the National Reporting and Learning System. Qual Saf Health Care 2009; 18: 5-10
23. Walker I, Reshmwalla S, Wilson IH. Surgical safety checklists: Do they improve outcomes? Br J Anaesth 2012; 109: 47-54
24. Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006; 355: 2725-32 (Pubitemid 46021509)
25. Bosk CL, Dixon-Woods M, Goeschel CA, Pronovost P. The art of medicine - reality check for checklists. Lancet 2009; 374: 444-5
26. Vats A, Vincent CA, Nagpal K, Davies RW, Darzi A, Moorthy K. Practical challenges of introducing WHO surgical checklist: UK pilot experience. Br Med J 2010; 340: B5433
27. Smith AF, Mishra K. Interaction between anaesthetists, their patients, and the anaesthesia team. Br J Anaesth 2010; 105: 60-8
28. Manser T. Teamwork and patient safety in dynamic domains of healthcare: A review of the literature. Acta Anaesthesiol Scand 2009; 53: 143-51
29. Salas E, Rosen MA, King H. Managing teams managing crises: Principles of teamwork to improve patient safety in the emergency room and beyond. Theor Issues Ergon Sci 2007; 8: 381-94
30. Reason J. Understanding adverse events: Human factors. Qual Health Care 1995; 4: 80-9
31. Bion JF, Abrusci T, Hibbert P. Human factors in the management of the critically ill patient. Br J Anaesth 2010; 105: 26-33
32. Wilson KA, Burke CS, Priest HA, Salas E. Promoting health care safety through training high reliability teams. Qual Saf Health Care 2005; 14: 303-9 (Pubitemid 41133187)
33. Yule S, Paterson-Brown S. Surgeon's non-technical skills. Surg Clin North Am 2012; 92: 37-50
34. Flin R, Patey R, Glavin R, Maran N. Anaesthetists' non-technical skills. Br J Anaesth 2010; 105: 38-44
35. Rutherford JS, Flin R, Mitchell L. Non-technical skills of anaesthetic assistants in the perioperative period: A literature review. Br J Anaesth 2012; 109: 27-31
36. Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Development of a behavioural marker system for scrub practitioners' non-technical skills (SPLINTS system). J Eval Clin Pract 2012, in press, doi: 10.1111/j.1365-2753. 2012.01825.x 37 Reader TW, Flin R, Lauche K, Cuthbertson BH. Non-technical skills in the intensive care unit. Br J Anaesth 2006; 96: 551-9
37. Reader TW, Flin R, Mearns K, Cuthbertson BH. Interdisciplinary communication in the intensive care unit. Br J Anaesth 2007; 98: 347-52 (Pubitemid 47072673)
38. Reader TW, Flin R, Mearns K, Cuthbertson BH. Team situation awareness and the anticipation of patient progress during ICU rounds. BMJ Qual Saf 2011; 20: 1035-42
39. Burtscher MJ, Manser T, Kolbe M, et al. Adaptation in anaesthesia team coordination in response to a simulated critical event and its relationship to clinical performance. Br J Anaesth 2011; 106: 801-6
40. Sevdalis N, Healey AN, Vincent CA. Distracting communications in the operating theatre. J Eval Clin Pract 2007; 13: 390-4 (Pubitemid 46789640)
41. Sevdalis N, Forrest D, Undre S, Darzi A, Vincent CA. Annoyances, disruptions, and interruptions in surgery: The Disruptions in Surgery Index (DiSI). World J Surg 2008; 32: 1643-50
42. Healey AN, Sevdalis N, Vincent CA. Measuring intraoperative interference from distraction and interruption observed in the operating theatre. Ergonomics 2006; 49: 589-604 (Pubitemid 43832380)
43. Savoldelli GL, Thieblemont J, Clergue F, Waeber J-L, Forster A, Garnerin P. Incidence and impact of distracting events during induction of general anaesthesia for urgent surgical cases. Eur J Anaesthesiol 2010; 27: 683-9
44. Cambell G, Arfanis K, Smith AF. Distraction and interruption in anaesthetic practice. Br J Anaesth 2012; 109: 707-15
45. Vincent C, Moorthy K, Sarker SK, Chang A, Darzi A. Systems approaches to surgical quality and safety: From concept to measurement. Ann Surg 2004; 239: 475-82 (Pubitemid 38372763)
46. Undre S, Arora S, Sevdalis N. Surgical performance, human error and patient safety in urological surgery. Br J Med Surg Urol 2009; 2: 2-10
47. Sevdalis N, Brett S. Improving care by understanding the way we work: Human factors and behavioural science in the context of intensive care. Crit Care 2009; 13: 139
48. Calland JF, Guerlain S, Adams RB, Tribble CG, Foley E, Chekan EG. A systems approach to surgical safety. Surg Endosc 2002; 16: 1005-14 (Pubitemid 34592011)
49. Van Beuzekom M, Boer F, Akerboom S, Hudson P. Patient safety: Latent risk factors. Br J Anaesth 2010; 105: 52-9
50. Simpson KR, James DC, Knox GE. Nurse-physician communication during labor and birth: Implications for patient safety. J Obstet Gynecol Neonatal Nurs 2006; 35: 547-56 (Pubitemid 44874952)
51. Salas E, Guthrie JW, Wilson-Donnelly KA, et al. Modeling team performance: The basic ingredients and research needs. In: rouse WB, ed. Organizational Simulation. New York: john Wiley & Sons, Ltd, 2005; 185-21
52. Blum RH, Raemer DB, Carroll JS, Dufresne RL, Cooper JB. A method for measuring the effectiveness of simulation-based team training for improving communication skills. Anesth Analg 2005; 100: 1375-80 (Pubitemid 40577389)
53. Baker DP, Day R, Salas E. Teamwork as an essential component of high-reliability organizations. Health Serv Res 2006; 41: 1576-98 (Pubitemid 44114583)
54. Healey AN, Undre S, Sevdalis N, Koutantji M, Vincent CA. The complexity of measuring interprofessional teamwork in the operating theatre. J Interprof Care 2006; 20: 485-95 (Pubitemid 44473425)
55. Reader TW, Flin R, Mearns K, Cuthbertson BH. Developing a team performance framework for the intensive care unit. Crit Care Med 2009; 37: 1787-93
56. Salas E, Rosen MA, Burke CS, Nicholson D, Howse WR. Markers for enhancing team cognition in complex environments: The power of team performance diagnosis. Aviat Space Environ Med 2007; 78: B77-85 (Pubitemid 46717212)
57. Thomas EJ, Sherwood GD, Mulhollem JL, Sexton JB, Helmreich RL. Working together in the neonatal intensive care unit: Provider perspectives. J Perinatol 2004; 24: 552-9 (Pubitemid 39232385)
58. Hackman JR, ed. Groups That Work (and Those That Don't) - Creating Conditions for Effective Teamwork. San Francisco: jossey-Bass, 199
59. West MA. Effective Teamwork - Practical Lessons from Organizational Research, 3rd Edn. Chichester: BPS Blackwell, 2012
60. Staender SE, Mahajan RP. Anesthesia and patient safety: Have we reached our limits? Curr Opin Anaesthesiol 2011; 24: 349-53
61. Nordquist J, Sundberg K, Johansson L, Sandelin K, Nordenstro?m J. Case-based learning in surgery: Lessons learned. World J Surg 2012; 36: 945-55
62. Institute of Medicine. Crossing the Quality Chasm - A New Health System for the 21st Century. Washington, DC: National Academy Press, 2001
63. Helmreich RL, Merritt AC, Wilhelm JA. The evolution of Crew Resource Management training in commercial aviation. Int J Aviat Psychol 1999; 9: 19-32
64. van Avermaete JAG, Kruijsen E. The evaluation of non-technical skills of multi-pilot aircrew in relation to the JAR-FCL requirements. Project report: cR-98443. Amsterdam, 1998
65. O'Connor P, Ho?rmann HJ, Flin R, Lodge M, Goeters KM. Developing a method for evaluating Crew Resource Management skills: A European perspective. Int J Aviat Psychol 2002; 12: 263-85 (Pubitemid 37110341)
66. Flin R, Martin L, Goeters KM, et al. Development of the NOTECHS (non-technical skills) system for assessing pilots' CRM skills. Hum Factors Aerospace Safe 2003; 3: 97-119
67. Baker DP, Dismukes RK. A gold standards approach to training instructors to evaluate crew performance. NASA/TM-2003-212809 report, 2003. Available from http://human-factors.arc .nasa.gov/flightcognition/Publications/GoldStandardsTM. PDF (accessed 20 August 2012)
68. Howard SK, Gaba DM, Fish KJ, Yang G, Sarnquist FH. Anesthesia crisis resource management training: Teaching anaesthesiologists to handle critical incidents. Aviat Space Environ Med 1992; 63: 763-70
69. Gaba DM, Fish KJ, Howard SK. Crisis Management in Anesthesiology. New York: churchill-Livingstone, 1994
70. Morey JC, Simon R, Jay GD, et al. Error reduction and performance improvement in the emergency department through formal teamwork training: Evaluation results of the MedTeams project. Health Serv Res 2002; 37: 1553-81 (Pubitemid 36070254)
71. Risser DT, Rice MM, Salisbury ML, Simon R, Jay GD, Berns SD. The potential for improved teamwork to reduce medical errors in the emergency department. The MedTeams Research Consortium. Ann Emerg Med 1999; 34: 373-83 (Pubitemid 29416031)
72. Sherwood G, Thomas E, Bennett DS, Lewis P. A teamwork model to promote patient safety in critical care. Crit Care Nurs Clin North Am 2002; 14: 333-40
73. Grogan EL, Stiles RA, France DJ, et al. The impact of aviationbased teamwork training on the attitudes of health-care professionals. J Am Coll Surg 2004; 199: 843-8 (Pubitemid 39536254)
74. Undre S, Koutantji M, Sevdalis N, et al. Multi-disciplinary crisis simulations: The way forward for training surgical teams. World J Surg 2007; 31: 1843-53 (Pubitemid 47283191)
75. Paige JT, Kozmenko V, Yang T, et al. High-fidelity, simulationbased, interdisciplinary operating room team training at the point of care. Surgery 2009; 145: 138-46
76. Powers KA, Rehrig ST, Irias N, et al. Simulated laparoscopic operating room crisis: An approach to enhance the surgical team performance. Surg Endosc 2008; 22: 885-900
77. Kirkpatrick DL, Kirkpatrick JD. Evaluating Training Programs: The Four Levels, 3rd Edn. San Francisco: Berrett-Koehler Publishers, 2006
78. Salas E, Wilson KA, Burke CS. Does crew resource management training work? An update, an extension, and some critical needs. Hum Factors 2006; 48: 392-412 (Pubitemid 44061496)
79. O'Connor P, Cambell J, Newon J, et al. Crew resource management training effectiveness: A meta-analysis and some critical needs. Int J Aviat Psychol 2008; 18: 353-68
80. Buljac-Samardzic M, Dekker-van Doorn CM, van Wijngaarden JDH, van Wijk KP. Interventions to improve team effectiveness: A systematic review. Health Policy 2010; 94: 183-95
81. McCulloch P, Rathbone J, Catchpole K. Interventions to improve teamwork and communications among healthcare staff. Br J Surg 2011; 98: 469-79
82. Haller G, Garnerin P, Morales M-A, et al. Effect of crew resource management training in a multidisciplinary obstetrical setting. Int J Qual Health Care 2008; 20: 254-63 (Pubitemid 352024908)
83. Paige JT, Kozmenko V, Yang T, et al. Attitudinal changes resulting from repetitive training of operating room personnel using of high-fidelity simulation at the point of care. Am Surg 2009; 75: 584-90
84. Arora S, Sevdalis N, Ahmed M, Wong H, Moorthy K, Vincent C. Safety skills training for surgeons: A half-day intervention improves knowledge, attitudes and awareness of patient safety. Surgery 2012; 152: 26-31
85. Shekhter I, Rosen L, Sanko J, Everett-Thomas R, Fitzpatrick M, Birnbach D. A patient safety course for preclinical medical students. Clin Teach 2012, in press 87 Neily J, Mills PD, Young-Xu Y, et al. Association between implementation of a medical team training program and surgical mortality. J Am Med Assoc 2010; 304: 1693-700
86. Arora S, Lamb B, Undre S, Kneebone R, Darzi A, Sevdalis N. Framework for incorporating simulation into urology training. BJU Int 2011; 107: 806-10
87. Khan MS, Ahmed K, Gavazzi A, et al. Development and implementation of centralized simulation training: Evaluation of feasibility, acceptability and construct validity. BJU Int 2012, in press, doi:10.1111/j.1464-410X.2012.11204.x 90 Weaver SJ, Rosen MA, Salas E, Baum KD, Kind HB. Integrating the science of team training: Guidelines for continuing education. J Contin Educ Health Prof 2010; 30: 208-20
88. Ziv A, Wolpe PR, Small SD, Glick S. Simulation-based medical education: An ethical imperative. Acad Med 2003; 78: 783-8 (Pubitemid 36993078)
89. Aggarwal R, Grantcharov T, Moorthy K, Hance J, Darzi A. A competency-based virtual reality training curriculum for the acquisition of laparoscopic psychomotor skill. Am J Surg 2006; 191: 128-33 (Pubitemid 43042537)
90. Aggarwal R, Grantcharov TP, Eriksen JR, et al. An evidence-based virtual reality training program for novice laparoscopic surgeons. Ann Surg 2006; 244: 310-4 (Pubitemid 44305548)
91. Calatayud D, Arora S, Aggarwal R, et al. Warm-up in a virtual reality environment improves performance in the operating room. Ann Surg 2010; 251: 1181-5
92. Arora S, Aggarwal R, Sirimanna P, et al. Mental practice enhances surgical technical skills: A randomised controlled study. Ann Surg 2011; 253: 265-70
93. Korndorffer JR Jr, Bellows CF, Tekian A, Harris IB, Downing SM. Effective home laparoscopic simulation training: A preliminary evaluation of an improved training paradigm. Am J Surg 2012; 203: 1-7
94. Zausig YA, Grube C, Boeker-Blum T, et al. Inefficacy of simulatorbased training on anesthesiologists' non-technical skills. Acta Anaesthesiol Scand 2009; 53: 61-9
95. Hull L, Arora S, Aggarwal R, Darzi A, Vincent CA, Sevdalis N. The impact of non-technical skills on technical performance in surgery: A systematic review. J Am Coll Surg 2012; 214: 214-30
96. Hull L, Arora S, Symons NR, et al. Training faculty in nontechnical skills assessment: National guidelines on program requirements. Ann Surg 2012, in press 100 Furnham A. The Psychology of Behaviour at Work: The Individual in the Organization. Hove: Psychology Press, 2005
97. Jen MH, Bottle A, Majeed A, Bell D, Aylin P. Early in-hospital mortality following trainee doctors' first day at work. PLoS One 2009; 4: E7103
98. Young JQ, Ranji SR, Wachter RM, Lee CM, Niehaus B, Auerbach AD. 'July effect': Impact of the academic year-end changeover on patient outcomes: A systematic review. Ann Intern Med 2011; 155: 309-15
99. Arora S, Sevdalis N, Nestel D, Woloshynowych M, Darzi A, Kneebone RL. The impact of stress on surgical performance: A systematic review of the literature. Surgery 2010; 147: 318-30
100. Crossingham G, Gale T, Roberts M, Carr A, Langton J, Anderson I. Content validity of a clinical problem solving test for use in recruitment to the acute specialties. Clin Med 2011; 11: 23-5
101. Bann S, Darzi A. Selection of individuals for training in surgery. Am J Surg 2005; 190: 98-102 (Pubitemid 40828613)
102. Paice AG, Aggarwal R, Darzi A. Safety in surgery: Is selection the missing link? World J Surg 2010; 34: 1993-2000
103. Gale TC, Roberts MJ, Sice PJ, et al. Predictive validity of a selection centre testing non-technical skills for recruitment to training in anaesthesia. Br J Anaesth 2010; 105: 603-9
104. Crossingham GV, Sice PJ, Roberts MJ, Lam WH, Gale TC. Development of workplace-based assessments of non-technical skills in anaesthesia. Anaesthesia 2012; 67: 158-64
105. Smith AF, Glavin R, Greaves JD. Defining excellence in anaesthesia: The role of personal qualities and practice environment. Br J Anaesth 2011; 106: 38-43
106. Mellin-Olsen J, Staender S, Whitaker DK, Smith AF. The Helsinki Declaration on patient safety in anaesthesiology. Eur J Anaesthesiol 2010; 27: 592-7
107. Whitaker DK, Brattebø G, Smith AF, Staender SE. The Helsinki Declaration on patient safety in anaesthesiology: Putting words into practice. Best Pract Res Clin Anaesthesiol 2011; 25: 277-90
108. Undre S, Sevdalis N, Healey AN, Vincent CA. The Observational Teamwork Assessment for Surgery (OTAS): Refinement and application in urological surgery. World J Surg 2007; 31: 1373-81 (Pubitemid 46945358)
109. Sevdalis N, Lyons M, Healey AN, Undre S, Darzi A, Vincent CA. Observational teamwork assessment for surgery: Construct validation with expert vs. novice raters. Ann Surg 2009; 249: 1047-51
110. Hull L, Arora S, Kassab E, Kneebone RL, Sevdalis N. Observational teamwork assessment for surgery (OTAS): Content validation and tool refinement. J Am Coll Surg 2011; 212: 234-43
111. Russ S, Hull L, Rout S, Vincent C, Darzi A, Sevdalis N. Observational teamwork assessment for surgery: Feasibility of clinical and nonclinical assessor calibration with short-term training. Ann Surg 2012; 255: 804-9
112. Sevdalis N, Davis RE, Koutantji M, Undre S, Darzi A, Vincent CA. Reliability of a revised NOTECHS scale for use in surgical teams. Am J Surg 2008; 196: 184-90 (Pubitemid 351970519)
113. Black SA, Nestel D, Kneebone RL, Wolfe JHN. Assessment of surgical competence at carotid endarterectomy under local anaesthesia in a simulated operating theatre. Br J Surg 2010; 97: 511-6
114. Mishra A, Catchpole K, McCulloch P. The Oxford NOTECHS system: Reliability and validity of a tool for measuring teamwork behaviour in the operating theatre. Qual Saf Health Care 2009; 18: 104-8
115. McCulloch P, Mishra A, Handa A, Dale T, Hirst G, Catchpole K. The effects of aviation style non-technical skills training on technical performance and outcome in the operating theatre. Qual Saf Health Care 2009; 18: 109-15
116. Steinemann S, Berg B, Skinner A, et al. In situ, multidisciplinary, simulation-based teamwork training improves early trauma care. J Surg Educ 2011; 68: 472-7
117. Steinemann S, Berg B, DiTullio A, et al. Assessing teamwork in the trauma bay: Introduction of a modified 'NOTECHS' scale for trauma. Am J Surg 2012; 203: 69-75
118. Yule S, Flin R, Maran N, Rowley DR, Youngson GG, Paterson-Brown S. Surgeons' non-technical skills in the operating room: Reliability testing of the NOTSS behaviour rating system. World J Surg 2008; 32: 548-56
119. Yule S, Flin R, Rowley D, et al. Debriefing surgical trainees on non-technical skills (NOTSS). Cogn Technol Work 2008; 10: 265-74
120. Yule S, Flin R, Paterson-Brown S, Maran N, Rowley D. Development of a rating system for surgeons' non-technical skills. Med Educ 2006; 40: 1098-104 (Pubitemid 44600570)
121. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Rating non-technical skills: Developing a behavioural marker system for use in anaesthesia. Cogn Technol Work 2004; 6: 165-71 (Pubitemid 39203628)
122. Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists' Non-Technical Skills (ANTS): Evaluation of a behavioural marker system. Br J Anaesth 2003; 90: 580-8 (Pubitemid 36592330)
123. Fletcher G, McGeorge P, Flin R, Glavin RJ, Maran N. The role of non-technical skills in anaesthesia: A review of current literature. Br J Anaesth 2002; 88: 418-29 (Pubitemid 34213591)
124. Mitchell L, Flin R, Yule S, Mitchell J, Coutts K, Youngson G. Evaluation of the Scrub Practitioners' List of Intraoperative Non-Technical Skills (SPLINTS) system. Int J Nurs Stud 2012; 49: 201-11
125. Kim J, Neilipovitz D, Cardinal P, Chiu M, Clinch J. A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I study. Crit Care Med 2006; 34: 2167-74 (Pubitemid 44305621)
126. Malec JF, Torsher LC, Dunn WF, et al. The Mayo High Performance Teamwork scale: Reliability and validity for evaluating key crew resource management skills. Simul Healthc 2007; 2: 4-10 (Pubitemid 47181448)
127. McKay A,Walker S, Brett SJ, Vincent C, Sevdalis N. Team performance in resuscitation teams: Comparison and critique of two recently developed scoring tools. Resuscitation. Advance Access published on 3 May 2012, DOI: Dx.doi.org/10.1016/ j.resuscitation.2012.04.015
128. Walker S, Brett S, McKay A, Lambden S, Vincent C, Sevdalis N. Observational skill-based clinical assessment tool for resuscitation (OSCAR): Development and validation. Resuscitation 2011; 82: 835-44
129. Klampfer B, Flin R, Helmreich RL, et al. Enhancing Performance in High Risk Environments: recommendations for the Use of Behavioural Markers. Report by the Gottlieb Daimler and Karl Benz Foundation Kolleg Group Interaction in High Risk Environments (GIHRE) group, 2001