| Project/Area Number |
18K04636
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 25020:Safety engineering-related
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| Research Institution | University of Miyazaki |
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Principal Investigator |
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2018: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
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| Keywords | Work-As-Imagined / Work-As-Done / Safety-I / Safety-II / レジリエンス・エンジニアリング / 呼吸器外科 / 個人 / チーム / 組織 / レジリエンス / レジリエンス・エンジニアリング理論 / レジリエントヘルスケア / 手術安全 / 外科 / 胸部外科手術 / WAI / WAD / 医療安全 / ノンテクニカルスキル |
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| Outline of Final Research Achievements |
Bleeding in thoracic surgery is dangerous and can be life-threatening or fatal to the patient.We observed daily surgical operations from the perspective of resilience engineering theory in individual surgeons, surgical teams, and hospital organizations. In order to practice surgery safely, we collected methods for responding to unexpected situations (disturbance: adhesions, bleeding, major bleeding that could lead to life-threatening) and adjustment methods, and analyzed the background factors.The surgical safety that has been practiced in the past is summarized as Safety-I, and the surgical safety that has adopted a new resilience approach is verbalized as Safety-II. We have constructed a new surgical safety support system (Safety I + Safety-II) that successfully combines these two so that it can be put into practice in actual surgery.
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| Academic Significance and Societal Importance of the Research Achievements |
肺癌手術の癒着への外科医個人、肺動脈出血へのチーム、生命を脅かす大出血への手術室組織において、外科医のWork-As-Imagined(WAI,頭の中で考える手術のなされ方）とWork-As-Done(WAD,実際の手術のなされ方),そのギャップを近づける方法法、パフォーマンスの調整の方法が明らかされた。
個人、チーム、組織のレベルで、レジリエント・ヘルスケア理論を外科手術に実装して、WAIとWADを近づけ、手術の変動にうまく対応し、手術安全を実践することができる。インシデントや予期せぬ事象を教訓とし、うまくいく経験を学習し、予見・監視・対応・学習の循環メカニズムの構築が重要である。
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