Team work & task performance analysis of anesthesia induction procedures

Members of anesthesia induction teams in the University Hospital Zurich Interdisciplinary Emergency Station are concerned about the lack of optimal team function. Recommended solutions emerging from previous team work investigations to help identify problem areas have not been implemented. The overall objectives of the current study were to document concurrent activities of anesthesiology induction teams during the preoperative patient induction process to reveal a better understanding of team work supporting task performance during anesthesia induction, and to provide recommendations as to how teamwork and task performance could be modified to improve efficiency. To identify processes with the greatest time variance, a time-task analysis of seventeen anesthesia induction procedures (average duration 0:31:00) was recorded concurrently using FIT-System. Processes with the greatest variance were identified as those that could be altered to improve procedural efficiency. Seven interviews with anesthesiologists and anesthesiology nurses were conducted to interpret findings, and to obtain insight to intrinsic teamwork characteristics. The study found that team ownership changes readily, there is little work standardization or regulation, team and equipment preparations are insufficient, and task complexity is excessively concentrated. If general anesthesia induction efficiency for elective surgery schedules is to improve, attention to three areas, and to synergy between them, are required. First, the organization of teamwork and general work practices requires optimization. Second, shifting certain patient preparation events to take place prior to arrival in the induction room should be considered. Third, an improved state of readiness of equipment and anesthesia teams required for the induction procedure is necessary.