Navigation Links
Applying lessons from NASA helps manage threats and errors in pediatric cardiac surgery
Date:4/28/2014

Toronto, ON, Canada, April 28, 2014 All high-stakes industries that function at very high "6-sigma" safety levels have a pre-occupation with human error. The aviation industry epitomizes this concept; during the 1970s NASA and aviation researchers realized that humans are the least reliable resource in the cockpit. Subsequent research into >30,000 flights has confirmed that human error is inevitable, ubiquitous, and therefore needs to be understood and managed. Mismanaged error leads to cycles of further error and unintended states, with consequent loss of safety margins.

Using their experience with aviation errors, NASA/FAA researchers generated a "threat and error model." Now, researchers have applied this "threat and error model" to a pediatric cardiac surgery program. Edward J. Hickey, MD, a cardiac surgeon at The Labatt Family Heart Centre, The Hospital for Sick Children, Toronto, Canada, is presenting the results of his department's experience at the 94th AATS Annual Meeting in Toronto, ON, Canada, on April 28, 2014.

"We considered every patient's peri-operative journey to be a 'flight,' and we tracked it from patient arrival in the operating room until the point of discharge, with the aim of identifying 'threats,' 'errors,' unintended clinical states, and harmful outcomes," says Dr. Hickey. He reports on the results of "flight tracking" for the first 500 consecutive patients admitted for pediatric heart surgery (85% utilizing cardiopulmonary bypass).

Among the 524 "patient flights" that these 500 pediatric cardiac patients experienced, 763 threats were identified. More than 85% of threats were end-organ dysfunction, non-cardiac congenital lesions, and unusual or complex variants of a particular lesion type. "We saw that almost all threats were apparent before the flight had begun," comments Dr. Hickey.

The researchers found that only 50% of patient flights were error-free. Most errors, which were related
'/>"/>

Contact: Nicole Baritot
press@aats.org
978-299-4520
American Association for Thoracic Surgery
Source:Eurekalert  

Page: 1 2

Related medicine news :

1. Applying math to biology: Software identifies disease-causing mutations in undiagnosed illnesses
2. Zane Benefits Publishes New Information on Applying for Individual Health Insurance in 2014
3. Jvion Examines How Applying Smarter Technology Delivers Smarter Clinical Documentation
4. Dahryn Trivedi on Applying Practicality to Patience
5. New Video Tutorial on Applying Garland Roof Self-Adhering System
6. Kettlebell Exercises Expert Lorna Kleidman Recommends Applying Kettlebells to Maximize Aerobic Training
7. Regulating legal marijuana could be guided by lessons from alcohol and tobacco, study says
8. Jvion Releases Five Biggest Lessons in ICD10 Documentation Success
9. Preschoolers Can Learn Lasting Heart-Healthy Lessons from Sesame Street
10. Edifecs Expert to Discuss Lessons Learned from First 30 Days of Health Insurance Exchanges
11. Most People Missed the Vital Lessons to Make A Marriage Last, Marriage Expert Says
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Applying lessons from NASA helps manage threats and errors in pediatric cardiac surgery
(Date:9/17/2014)... Thomas A. Sellers, Ph.D., M.P.H., Jong Park, Ph.D. and Hui-Yi ... that influence the risk for developing prostate cancer, according to ... , Prostate cancer is the most common non-skin cancer in ... with the disease in his lifetime. Family history is the ... brother or father with prostate cancer is twice as likely ...
(Date:9/17/2014)... People with facial paralysis are perceived as being ... universal language of facial expression, a new study from ... The findings highlight the important role the face plays ... prejudice against those with facial paralysis because of their ... in the College of Liberal Arts at Oregon State ...
(Date:9/17/2014)... Tools4ever, the market leader ... and Boston Software Systems, leader in healthcare ... Under the agreement, Tools4ever will use ... within its identity and password management solutions. ... automation platforms that streamline complex processes and ...
(Date:9/17/2014)... September 17, 2014. Kessler Foundation is the recipient ... the International Progressive Multiple Sclerosis (MS) Alliance. ... Traumatic Brain Injury Research, is principal investigator of ... of cognitive rehabilitation in individuals with progressive multiple ... grants awarded by the Alliance to investigators in ...
(Date:9/17/2014)... Gerontological Society of America (GSA) invites all journalists ... the country,s largest interdisciplinary conference in the field ... Washington, DC. Media representatives may register free of charge. ... the five-day gathering at the Walter E. Washington Convention ... 2014 is "Making Connections: From Cells to Societies" and ...
Breaking Medicine News(10 mins):Health News:Lack of facial expression leads to perceptions of unhappiness, new OSU research shows 2Health News:Lack of facial expression leads to perceptions of unhappiness, new OSU research shows 3Health News:Tools4ever Partners with Boston Software Systems to Automate Identity and Password Management 2Health News:Tools4ever Partners with Boston Software Systems to Automate Identity and Password Management 3Health News:Tools4ever Partners with Boston Software Systems to Automate Identity and Password Management 4Health News:Kessler Foundation receives first-round grant from International Progressive Multiple Sclerosis Alliance 2Health News:Join GSA in Washington, DC, for the Nation's Premier Aging Conference 2
... ... Innovation and Growth , ... (PRWEB) June 21, 2010 -- DKI Direct ( http://www.dkidirect.com ), a leading Patient ... Chief Marketing Officer. Lewis will lead and build the marketing efforts for both existing ...
... viral for bacterial infections, review found , MONDAY, ... one who can,t always tell if your child has ... for antibiotics: Pediatricians say this is the most common ... Other common missed or mistaken diagnoses include those involving ...
... and cost-effective when targeted to high-risk patients, according ... the official journal of the American Gastroenterological Association ... be excessively costly or even harmful. "Surveillance ... that has the potential to decrease the burden ...
... something is due to our genes and how much is ... academic journal Addiction shows that the case is ... drugs, for two related reasons. First, a young woman ... to choose friends who smoke, drink, or use drugs, thereby ...
... in the journal Addiction reveals that drunkenness increases ... a strong inclination to suppress anger. The two ... reduces the risk of drawing erroneous conclusions about cause and ... of evidence suggesting that drinking may in fact inflict physical ...
... ... because of a small number of adverse event reports received by the FDA from users ... and its safety if used as directed. , ... (PRWEB) June 21, 2010 -- EphedrineHydrochloride.com is pleased to announce ...
Cached Medicine News:Health News:DKI Direct Appoints Greg Lewis as Chief Marketing Officer 2Health News:More Than Half of Pediatricians Make Diagnostic Errors: Survey 2Health News:More Than Half of Pediatricians Make Diagnostic Errors: Survey 3Health News:Surveillance colonoscopy should be targeted to high-risk patients 2Health News:New research shows peer drug use may increase an individual's genetic tendency to use drugs 2Health News:Ephedrine Hydrochloride.com Launches Review Site Examining Ephedrine HCL & Ephedra Based Diet Pills 2
(Date:9/17/2014)... and SAN JOSE, Calif. , Sept. 17, ... named as a laureate of The Tech Awards 2014, ... to benefit humanity and spark global change. The Tech Awards, ... presented by Applied Materials, Inc., selected Gradian as one of ... Photo - http://photos.prnewswire.com/prnh/20140917/146680 Gradian equips ...
(Date:9/17/2014)... India , September 17, 2014 ... antagonist, GRC 17536, has shown positive data in a ... painful diabetic neuropathy , Glenmark ... Receptor Potential Ankyrin 1 (TRPA1) antagonist, GRC 17536 has ... placebo controlled, multi-centre, proof of concept study conducted on ...
(Date:9/17/2014)... YORK , Sept. 17, 2014  Millions of people ... cervical disc disease. Recently the FDA approved ... cervical disc, an innovative implant device developed by Spinal Kinetics, ... resulting in neck and or arm pain. Hospital for Special ... is the only hospital in New York City ...
Breaking Medicine Technology:Gradian Health Systems Named A 2014 Laureate of The Tech Awards 2Gradian Health Systems Named A 2014 Laureate of The Tech Awards 3Glenmark's TRPA1 Antagonist 'GRC 17536' Shows Positive Data in a Proof of Concept Study 2Glenmark's TRPA1 Antagonist 'GRC 17536' Shows Positive Data in a Proof of Concept Study 3Cervical Disc Clinical Trial for People with Neck and Arm Pain Set to Begin at Hospital for Special Surgery 2
... SweetSpot Diabetes Care, Inc. announced today it has ... Drug Administration (FDA) for the SweetSpot Diabetes Data Management ... understand and use blood glucose meter data to diagnose ... many patients and health care providers to develop this ...
... , Inc. (OTC: HEWA), a leading VIPPS-accredited, ... pre-order program to enable consumers immediate access to Atorvastatin ( ... the medication at up to 50 percent less than ... "We will be one of the earliest and most ...
Cached Medicine Technology:SweetSpot Diabetes Care Receives FDA 510(k) Clearance for SweetSpot Diabetes Data Management Service 2HealthWarehouse.com Offers Lowest Price Generic Lipitor on the Market 2HealthWarehouse.com Offers Lowest Price Generic Lipitor on the Market 3
... immunoassay(EIA) test system for the detecton ... Sm, RNP, SSA, SSB, Scl-70 and ... from this assay can be used ... of autoimmune disease. This product is ...
... Multiparameter Kit is designed for ... of the most common autoantibodies. ... quality control system. The built-in ... in each strip gives the ...
... were designed with the proper sensitivity and ... diagnosis of autoimmune disease. Sera from over ... normal individuals were tested during the development ... Concepts compared the results to reference methods ...
... The assay uses highly pure, functional human C1q ... complexes (CIC). In the first stage, CIC in ... controls and standards are dispensed into the C1q ... removed in a washing step and a ready ...
Medicine Products: