Human Factors:

The Sealed Section!


So this is where it gets tricky.


How do you use the extra people in the room to best effect?


This is where having a dedicated leader already settled upon pays dividends.


"OK, guys, I am in charge. Let's do a check on the situation:


"Airway guys...RUOK?

Aamon. Work with them and get them anything they want.


Line guys....RUOK?

Anita. Work with them and get them anything they want.


Critical Bleeding Protocol activated?

R. Help with the blood checking and keep it coming.


Chest compression team: we need three people: one doing, one calling time, and one resting.

And one person on the defib.

Anyone not assigned a task, step back outside the room."



And as the Airway team brings their situation under control and can start to concentrate on anaesthesia;


And the Lines team get the central line in and start to de-escalate their role;


And as surgery gets under way and they start to gain surgical control;


And as the critical bleeding protocol escalates into full swing;


There comes a time when people, having successfully navigated their tasks, become redundant.


This is probably one of the most underutilised times in the case:


It is where the team has the opportunity for restoration.


That is, as L finds, that having run that blood gas, she is no longer needed in her assigned role, the opportunity now exists to go for a cup of tea.


To the uninitiated, this suggestion may seem facetious, but in fact, it is a strategic factor in maintaining the team as a high performance team.


There is still a lot of work to be done:

A lot of decisions to be made,

A lot of attention to be paid to detail,

And the battle is not yet won.


In order to be high performance in these matters and more, it is vital that rest is built into the case management strategy.


Otherwise, even the best clinicians get to the point where their brain switches into 'limp mode':


"In order to perform at your best, you have to be at your best"


Therefore, a cycle of restoration begins, and the core team of A&A, L&L & B is not disbanded until everyone has had a chance to sit down and recharge their batteries.


When you think about it. it's common sense.

But then again,

Sometimes. common sense is not that common.

In the end, the sim is successfully completed.

And the most important element is at hand:


The debrief.




If it weren't for the improvement value of reflective practice

including EVERYONE who got involved,

we wouldn't be having this discussion.


Great effort!

Great team!

Thanks to everyone!

Now let's deconstruct the event and seach for opportunities.

V. proud!


Wow. That was so much fun!

Let's do it again sometime!


Below Ten Thousand

An international collaboration

Empowering clinicians in safety culture