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Guidelines on human factors in critical situations 2023
Benjamin Bijok1, François Jaulin2, Julien Picard3
1Pôle Anesthésie-Réanimation, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France; Pôle de l'Urgence, Bloc des Urgences/Déchocage, CHU de Lille, Lille, France.
Insights
This study provides 21 expert recommendations on integrating human factors into anesthesia and critical care. These guidelines enhance patient safety during critical events by focusing on communication, organization, environment, and training.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Human Factors Engineering
Background:
- Critical situations in anesthesia and critical care present unique challenges requiring optimized human performance.
- Integrating human factors principles is crucial for improving patient safety and outcomes in high-stakes medical environments.
Framework:
- The study utilized the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to ensure evidence-based recommendations.
- A multidisciplinary committee of experts from SFAR and GFHS societies developed the guidelines.
Implementation:
- Recommendations were formulated across four key domains: communication, organization, working environment, and training.
- The PICO (Patients, Intervention, Comparison, Outcome) format guided the formulation of research questions.
Implications:
- The 21 expert-generated recommendations offer a framework for incorporating human factors into the management of critical incidents.
- These guidelines aim to enhance safety and efficiency in anesthesia and critical care settings through improved human performance.
Objective:
To provide guidelines to define the place of human factors in the management of critical situations in anaesthesia and critical care.
Design:
A committee of nineteen experts from the SFAR and GFHS learned societies was set up. A policy of declaration of links of interest was applied and respected throughout the guideline-producing process. Likewise, the committee did not benefit from any funding from a company marketing a health product (drug or medical device). The committee followed the GRADE® method (Grading of Recommendations Assessment, Development and Evaluation) to assess the quality of the evidence on which the recommendations were based.
Methods:
We aimed to formulate recommendations according to the GRADE® methodology for four different fields: 1/ communication, 2/ organisation, 3/ working environment and 4/ training. Each question was formulated according to the PICO format (Patients, Intervention, Comparison, Outcome). The literature review and recommendations were formulated according to the GRADE® methodology.
Results:
The experts' synthesis work and application of the GRADE® method resulted in 21 recommendations. Since the GRADE® method could not be applied in its entirety to all the questions, the guidelines used the SFAR "Recommendations for Professional Practice" A means of secured communication (RPP) format and the recommendations were formulated as expert opinions.
Conclusion:
Based on strong agreement between experts, we were able to produce 21 recommendations to guide human factors in critical situations.
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