TADAA - Enabling Continuous Improvement for Anaesthetists

TADAA Towards Automated Detection of Anaesthetic Activity Bryan Houliston Aura Laboratory

TADAA Outline ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TADAA Enabling continuous improvement for anaesthetists Bryan Houliston Aura Laboratory

Agenda Introduction 1 Task analysis and TADAA 2 Key abilities for anaesthetists 3 Enabling improvement 4 Conclusion 5

Introduction ,[object Object],[object Object],[object Object],[object Object]

Traditional Focus on Patient Monitoring patient Understanding anaesthetic state Closed loop systems (Simanski, 2008) Sensors & alarms (Jones, 2001) Knowledge bases

Adverse Events (Davis, 2003) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],‘ System’ factors 49% ,[object Object],[object Object],Lack of consultation 36% ,[object Object],[object Object],Lack of education 27%

Emerging Focus on Anaesthetist Monitoring anaesthetist Understanding anaesthetic activity Simulator training (Dalley, 2004) Incident reports (Smith, 2006) Checklists (Hart, 2005)

Task Analysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TADAA Towards Automated Detection of Anaesthetic Activity Viewer module Repository module Recorder module

How Will TADAA Help ? ,[object Object],[object Object],[object Object]

Patients Want… (Davis, 2003) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Better ‘systems’ ,[object Object],[object Object],Better consultation ,[object Object],[object Object],Better education

Surgeons Want … (Vitez, 1998) Calmly manage a crisis Quick emergence Familiar with procedure Quick induction Correct intubation Timely starts Correct monitor placement Short turnaround Communicate with OR staff Good patient relationship Knowledge & skills Less waiting around Communication

Other Colleagues Want… ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Anaesthetists’ ‘Core’ Work… (Larsson, 2003) Co-ordinator Technique (Knowledge & skills) Patient (Communication) OR team (Consultation) Planning & monitoring (Recording)

Three Most Important Abilities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

TADAA Automates Recording Drugs drawn up but not given Fixing, locating equipment With preceding activity Drug administration, Intubation, etc ,[object Object],Events currently recorded manually Events not currently recorded Automated incident reports Reduces ‘tedious’ work More time for art, service, samaritan-ness More timely, accurate, consistent, complete data Reduce onus to ‘dob in’

TADAA Supports Communication Progress of procedure Workload assessment Progress against plan Workload assessment Progress of procedure Progress of turn around ,[object Object],Patients’ families, Surgeons OR team Co- ordiniators Automate progress updates Reduce interruptive timing Monitor developing emergencies Schedule relief

TADAA Builds Knowledge Synthesise ‘the norm’ for procedure Identify tacit knowledge, unconscious behaviours Review unfamiliar procedure, patient condition ,[object Object],Exemplar procedures Analyse by procedure type Analyse by anaesthetist Familiarity with procedure Recognise deviations from ‘the norm’ Awareness of own strengths, weaknesses Tacit knowledge of experts

Conclusion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object]

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Thanks to: Dave Parry and Alan Merry Staff at Advanced Clinical Skills Centre HamIT Tracient Bryan Houliston Aura Laboratory

TADAA - Enabling Continuous Improvement for Anaesthetists

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TADAA - Enabling Continuous Improvement for Anaesthetists