Human factors and the complex dynamics involved in team interaction represent a critical element of delivering safe patient care. While the knowledge base of medicine has a deep research history, there remains a gap between an individual clinician's understanding of the complexities of health and disease and the translation of this into comprehensive delivery of care. A significant component of this gap relates to non-technical skills and the challenges for a team of healthcare professionals when working together to achieve the same goal. This project will use the tools of simulation to explore the dynamic interactions within teams in the context of paediatric airway management, as well as the impact of the use of a cognitive aid on team performance.
The Department of Anesthesia at the Children’s Hospital at Westmead developed the Airway Decision and Planning Tool (ADAPT). The ADAPT system encourages group consideration of the actual difficulty relating to airway management for a patient, the requirements for the clinical situation, the best option to achieve the goal, the role of adjunctive manoeuvres such as supplemental oxygenation and the need to consider additional team members. Although informal feedback is positive, this initiative offers an opportunity to evaluate the impact of a cognitive aid on non-technical skills displayed by teams as well as strategies displayed by teams in scenarios where this aid is either present or not present.
The project has been developed by a collaboration between clinicians and researchers across The Children's Hospital at Westmead, the Sydney Clinical Skills and Simulation Centre (SCSSC) and the Centre for Health Innovation at The Alfred Hospital. Simulation sessions undertaken with participants as part of this study will be delivered at the SCSSC with or without the cognitive aid.
This research plan will deliver insights into the application of cognitive aids in all critical care contexts, not just the paediatric health care settings. It will also examine multiple facets of team-based performance with tremendous scope for universalisation. In addition to these benefits for the broader profession, the research team itself is seeking to develop a comprehensive program to further the development of simulation as an academic research stream. The combination of this varied team with a rigorous academic commitment to exploring new questions is a substantial step in this direction.
Dr Andrew Weatherall, Dr Philip Cheung, The Children’s Hospital at Westmead, NSW; Dr Adam Rehak, Sydney Clinical Skills and Simulation Centre Sydney, NSW; Associate Professor Stuart Marshall, Centre for Health Innovation, Alfred Health, Melbourne.
The project was awarded $A34,756 through the ANZCA research grants program for 2022.