Crisis Preparedness: A Systems-Based Framework for Avoiding Harm in Surgery.

Area of Science:

• Healthcare Management
• Patient Safety
• Surgical Operations

Background:

• High-performing healthcare organizations require robust failure management systems for crisis preparedness.
• The surgical community currently lacks an integrated approach to crisis readiness.
• Effective crisis preparedness involves both responding to critical events and preventing harm.

Purpose of the Study:

• To create a practical framework for crisis preparedness in surgery.
• To identify and adapt crisis preparedness interventions from high-reliability industries for clinical use.

Main Methods:

• A multimethod qualitative study design.
• Observational fieldwork in commercial aviation.
• Semi-structured interviews with airline pilots and mixed focus groups with safety experts.
• Thematic analysis using the framework method and expert consensus for clinical adaptation.

Main Results:

• A crisis preparedness framework comprising 6 behavioral interventions was derived.
• Interventions include enhancing situational awareness, team briefings, standard operating procedures, emergency drills, positive work environments, and performance debriefings.
• Twenty-two experts from aviation and healthcare contributed to the study.

Conclusions:

• Surgical crisis preparedness necessitates integrated systems, not isolated safety measures.
• The study provides a novel framework and practical tools to enhance surgical crisis readiness.
• Implementation of this framework can improve patient safety and organizational resilience.