Jennie Price – Theatre Operations Manager Ian Erridge – Theatre Practice Development Lead

Project Overview

• What is SCReaM?

• Why has it been implemented?

• How was it implemented?

Why? • 234 million operations / yr worldwide

• 3 million intraoperative adverse events / yr

• RSCH & ASPH around 53,500 operations / yr

– Estimated 775 adverse events a year

• Key treatment steps omitted under stress

• Largest source of variation in surgical mortality

• Significant improvement in management

of theatre crises using cognitive aids

Arriaga et al. NEJM 2013

SCReaM Emergency Action Prompt Cards

• Located in all AR and Theatres

• Comprises 33 emergency action prompt cards

• 3 colour coded divided sections: Cardiac Arrest (Red) Critical Events (Blue) Symptom Based Management (Green) • The “ROC”: The team brief WHO checklist in AR and OR

Human Factors and Putting Prompt Cards into Practice Training

• 1 day Human Factors course led by aviation pilots for Real-life MDTs

• 1 Day Simulated emergencies To integrate and evaluate prompt cards Not about individual performance Not a test Opportunity to practice in a safe environment

Summary

• Improve team performance in managing theatre crises:

– introducing emergency prompt cards

– Human factor training

– High fidelity simulation

• First UK version