Development of a rapid response plan for intraoperative emergencies: the Circulate, Scrub, and Technical Assistance Team

Am J Surg. 2017 Jan;213(1):181-186. doi: 10.1016/j.amjsurg.2016.01.047. Epub 2016 Jun 29.

Abstract

Background: Unplanned intraoperative events are inevitable and cause stress and inefficiency among staff. We believe that developing a technical rapid response team with explicitly defined, narrow roles would reduce the amount of chaos during such emergencies. This article provides a detailed description of the development and implementation of such a program.

Methods: In-situ simulation of an intraoperative emergency was used for a formal assessment of the current practice. Debriefing sessions identified areas of improvement and solicited solutions. A multidisciplinary working group then developed and implemented the technical rapid response team based on the needs assessment. The program was designed to create a Circulating, Scrubbing, and Technical Assistance Team that helps with equipment, supplies, anesthesia, and communication.

Results: We anticipate the program will foster a culture of safety, and promote positive relationships and attitudes of the entire multidisciplinary team.

Conclusions: In the future, research regarding patient outcomes and staff satisfaction and safety attitudes may help provide objective evidence of the benefits of the program.

Keywords: Crew resource management; Crisis response; Emergency; In-situ simulation; Intraoperative contingency planning; Laparoscopy; Team training.

MeSH terms

  • Emergencies*
  • Humans
  • Interdisciplinary Communication
  • Intraoperative Complications*
  • Patient Care Team / organization & administration*
  • Program Development
  • Simulation Training