2020 Fiscal Year Final Research Report
Practical research of resilience engineering theory of surgica safety-assisted system and the development of teaching materials
| 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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| 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 |
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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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| Free Research Field |
医療安全 患者安全 呼吸器外科 質改善
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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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