Aviation-based teamwork skills work for surgeons: time for an 'aviation bundle'?

BACKGROUND: Aviation systems were developed to improve safety and have achieved remarkable results. Medicine has looked to replicate these systems; however, the gap in outcomes between the two industries remains vast. Bridging this chasm requires an in-depth analysis of the applicability of the aviation safety model in surgery. This study uses qualitative methods to explore how aviation-based practices may be adapted and applied more effectively in theatre. METHODS: Data were collected using multiprofessional focus groups in a single centre. The focus groups involved discussion around teamwork and aviation-based non-technical skills. With consent, audio recordings were anonymized and transcribed. Qualitative (thematic) analysis was used to identify themes. RESULTS: Five focus groups were conducted. Eight themes emerged, with a total of 18 sub-themes. Themes were: current practice, customization, applicability, team performance, human factors, analogy, incidents and integration of skills. Extent and limitations of the aviation surgery analogy also emerged. CONCLUSIONS: The new insights gained through this qualitative analysis highlight the need to tailor aviation-based practices to the operating theatre. To achieve this, we propose the 'aviation bundle' of non-technical skills. This blueprint aims to promote a culture of safety and efficiency in surgical practice and could be developed into a training programme for theatre staff.