Acta Chir Belg
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The rigorous implementation of safety policies have made air travel one of the safest modes of transport. Health institutions and hospital managing bodies increasingly adopt cues from aviation safety protocols and policies in an attempt to reduce medical errors and patient harm. Among hospital staff, surgeons are most likely to be confronted with these aviation-derived safety concepts. ⋯ This article aims to familiarize surgeons with the concepts and methodology of safety policies in modern aviation safety, many of which have been applied in the setting of surgery, or have potential to do so. We review the use of checklists, crew resource management, the sterile cockpit, blame free reporting and human fatigue. We discuss how these concepts can be translated to the operating room and illustrate their relevance through a comparative description of historical air accidents and surgical incidents from our own clinical experience. We also indicate relevant differences and similarities between flight crews and surgical teams and their respective infrastructures, as these may impede or facilitate the adoption of aviation safety policies. Finally, we offer some recommendations to effectively implement aviation safety policies in the operating room.
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Surgical safety checklists aim to improve patient safety by prompting the attention of the surgical team towards critical steps during the operation. The checklist's items are aimed to improve compliance with proven interventions, and to facilitate multidisciplinary communication and teamwork. Based on the current literature, corroborated by systematic reviews and meta-analysis, surgical safety checklists have a positive impact on communication and reduce postoperative complications including mortality. ⋯ Several determinants leading to behaviour were checklists are checked but not properly executed have been highlighted. As surgical safety checklists are in essence complex sociological interventions, they must be implemented accordingly. Key factors for the implementation of these checklists have been suggested in the literature, although, the most profound way of implementation remains unclear.