Team Behavior and Patient Outcome Changes After Human Factors Program in a Pediatric Airway Setting

Area of Science:

• Medical Education
• Patient Safety
• Surgical Procedures

Background:

• Pediatric airway endoscopy is a high-risk procedure.
• Communication failures and poor nontechnical skills contribute to adverse events.
• Human factors training is not standard in pediatric surgical practice.

Purpose of the Study:

• To evaluate a multimodal human factors training program.
• To assess improvements in operating room communication and team behavior.
• To measure changes in nontechnical skills during pediatric laryngotracheal endoscopy.

Main Methods:

• Prospective quality improvement study with pretesting and posttesting.
• Implementation of a multimodal human factors training program.
• Assessment of team behaviors using observational metrics and the NOTSS framework.

Main Results:

• Increased use of surgical checklists, preoperative discussions, and postoperative debriefings.
• Improved identification of procedural phases, reduced task interruptions, and more even noise distribution.
• Enhanced overall Non-Technical Skills for Surgeons (NOTSS) scores; no change in oxygen desaturation or atropine use.

Conclusions:

• A structured human factors training program improved communication, coordination, and nontechnical skills in pediatric airway endoscopy.
• The training led to a Kirkpatrick level 3 behavioral change.
• Observed improvements support integrating human factors education into pediatric surgical training.