Safer Surgery part 16. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 124 Safer Surgery Figure The RATE software Thus the playback software allows the observer to watch all four video feeds simultaneously and to jump all the videos instantly to a different point based on any marked event that was marked by the observer watching the case using the RATE event-marking software see Figure . The RATE Event-Marking Software Figure shows a screen shot of the RATE event-marking software just after a case has started. The left half of the screen is for conversation tracking and the right half of the screen is for event tracking. In particular the upper portion of the left half of the screen allows observers to manually track conversations between members of the team by marking who is talking to whom using what type of communication . joking requesting coaching and about what topic . the patient the room the surgical tools other cases . The observer clicks four times in the four columns or can use type-ahead and the Tab key to mark a communication event. The summary is placed in the box to the right of these pick lists and is double-clicked by the observer when the communication event is finished. One can also single click on one of these conversations and click Answer Back below the Talk button and this will cause the From and To columns to automatically switch . Surgery Attending SA - Other - Discussing - Other Cases automatically gets selected in the four boxes as Other SA Reply Other Cases and then the observer Figure The RATE event-marking software 126 Safer Surgery hits the Talk button or edits one of these entries first if desired. The software user interface enables keeping up with conversations fairly well so long as the observer does not spend too much time typing in free-text comments possible using the text entry box on the bottom left of the screen . Based on these conversation traces RATE tracks communication counts of each individual and each pair of individuals by communication type and by categorized .
