Crisis Management Leadership in the Operating Room
Author : Kenneth A. Lipshy, M.D. FACS
Description : Medical adverse events, patient safety concerns, disasters, and catastrophes are frequently attributed to human cognitive error or problematic system safety cultures.  While Crew Resource Management (CRM) and Medical Team Training (MTT) are steadily becoming the mainstay, the medical field lags significantly behind the aviation industry in terms of preparedness for a crisis.  Literature has proven that patient safety measures, including this training, improve overall patient care, yet Operating Room (O.R.) teams do not routinely engage in simulation training.  Crises in the O.R. are typically associated with cognitive error or system problems, but often are the results of unforeseen internal or external problems.  Crisis management leadership in the operating room must progress beyond the typical CRM and MTT exercises and accept that use of checklists work when the threat to the patient and team are fully recognized. Maladaptive behavior control and effective team leadership only occur when the principles utilized in this book are mastered.  After reading this book surgical leaders should be capable of: Recognizing how human error contributes to and perpetuates adverse events, Understanding how system deficiencies can allow a simple error to progress to a catastrophe or how the system can be prepared to mitigate a mistake, Understanding cognitive functions during normal and abnormal circumstances, and Effectively lead their team through the risk management and definitive action process. While the surgeons and other O.R. team members typically self-profess an exemplary response to any threatening event, second hand observer assessment usually reveals significant bias in the ability of team members to handle a crisis appropriately.  Dr. Kenneth Lipshy uses personal firsthand experience as well as instructions from military and first responders as to how any organization should respond to a crisis, to guide leaders toward a successful program in O.R. crisis management. About the Author: Kenneth A. Lipshy MD, FACS (Fellow American College of Surgeons) has been an active surgical leader in the Veterans Administration Health Care System. Prior to federal service he was in private practice for eight years. His private practice career was preceded by a three-year surgery oncology fellowship at Virginia Commonwealth University. His surgical education began during an internship at Ben Taub Hospital – Baylor College of Medicine Houston, TX and was followed by completion of his surgery residency at Marshall University Huntington WV. His interest in surgical error and its relationship to crises was sparked during his training while serving in over two dozen medical centers during his career. However, his true interest flourished while serving as assistant scoutmaster in a local troop where he recognized a correlation between wilderness misadventures and O.R. disasters. This, combined with close associations with local members of all branches of the armed services as well as first responders, opened the door to a wealth of information on these topics as they relate to fields that are constantly at risk of facing crises. Author's Website Endorsement:
The book, Crisis Management Leadership in the Operating Room, by Kenneth A. Lipshy, M.D., F.A.C.S., provides an excellent review of human cognitive errors, causes of errors, role of systems in preventing and mitigating errors, and education and training of surgical teams. National imperatives that necessitate focus on these domains are articulated well and examples from other high-reliability organizations are helpful in considering different strategies to improve safety in surgery. Topics of crisis management and effective leadership in the Operating Room environment are handled well. The key messages are succinctly articulated throughout the book. This book should be a valuable resource to surgical leaders, practicing surgeons, surgery residents, and members of surgical teams. It should help in underscoring and extending further national efforts currently underway to deliver surgical care of the highest quality and promote safety. It should also be valuable to surgical educators as they design and introduce new training programs to address gaps in this field to harness the myriad opportunities ahead. Ajit K. Sachdeva, M.D., F.R.C.S.C., F.A.C.S. Director, Division of Education American College of Surgeons

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