Canadian journal of anaesthesia = Journal canadien d'anesthésie
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The purpose of this article is to review the role of technical and nontechnical skills in routine and crisis situations. We discuss the role of different simulation modalities in addressing these skills and competencies to enhance patient safety. ⋯ Healthcare simulation is a valuable tool to improve patient safety. Simulation-based education can focus on the necessary technical and nontechnical skills to enhance patient safety. Simulation-based research can serve as a means to identify gaps in current practice, test different solutions, and show improved practice patterns by studying performance in a setting that does not compromise patient safety.
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Checklists are increasingly being used by surgical teams in the perioperative period to improve clinical care and increase patient safety. In this article, we review some of the mechanisms by which checklists work and evaluate evidence supporting their use. ⋯ Checklists can aid clinicians involved in complex processes and multidisciplinary team interactions to improve the quality and safety of care by prompting dialogue and exchange of information.
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This article presents a summary of recent advances, including tools and interventions, that are designed to improve drug safety for patients in critical care settings, particularly those undergoing anesthesia and surgery. ⋯ There is a need to improve drug delivery systems in complex critical care environments, particularly the operating room. Anesthesiologists must continue to play a leading role in promoting drug safety in these environments.
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The purpose of this narrative review is to discuss the impact of clinical practice guidelines on the outcomes of care and patient safety. ⋯ Under certain conditions, guidelines can add value to care and improve outcomes; they need to be evidence-based, methodologically sound, and appropriately applied to patients and clinical scenarios. Simply summarizing evidence in a guideline is an inadequate process. To achieve the benefit of guidelines, implementation strategies need to be robust.
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The adoption of new technologies in medicine is frequently met with both enthusiasm and resistance. The universal adoption of health information technology (IT) and anesthesia information management systems (AIMS) remains low despite the potential benefits. Electronic medical records, and hence AIMS, are at the intersection of patient safety. This article highlights advantages and barriers to adoption and implementation of IT in general and AIMS in particular, with a focus on clinical decision support systems (CDSS) and computerized physician order entry (CPOE) as hallmarks that may lead to improvement in patient safety and quality in the perioperative setting. ⋯ Health IT and AIMS are at the intersection of patient safety and technology. Anesthesiologists are perfectly positioned to be the physician leaders of adoption, design, implementation, and integration, not only for AIMS but also for health-system IT solutions in general.