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0023 The scream project: Surrey crisis resource aimed management. a patient safety simulation project based on cognitive AIDS and human factor training
  1. Cally Dean1,
  2. Wendy King1,
  3. Robert Menzies2,
  4. Sam Soltanifar2,
  5. Suzi Lomax1
  1. 1Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
  2. 2Ashford and St Peters Hospital NHS Foundation Trust, Chertsey, UK


Background Management of a critical incident in theatre involves complex recognition and rapid decision making. Standard practice in the UK relies on memory alone to manage the situation. The concept of cognitive aids has been adopted by many high risk industries – such as aviation – as an aid to improve performance during critical events. Research supports improved team performance when cognitive aids are used in emergency medical situations.1

Methodology Following a funded visit to Stanford University’s Simulation Centre, we have designed the first UK Theatre Emergency Cognitive Aid Manual which we aim to introduce into the operating theatre culture through simulation. Each cognitive aid contains a series of management steps, plus additional information regarding drug doses, equipment etc.

The rolling crisis resource management (CRM) simulation programme will initially target consultant anaesthetists and ODPs. The ultimate objective is to train entire theatre teams together. In addition we are focusing on non-technical skills involved in critical incident management, and will deliver human factor training on educational half days.

To formally evaluate the project, we will undertake a comparative study of performance with and without cognitive aids, as well as via a subjective questionnaire.

Potential impact To our knowledge, this is the first venture of its kind in the UK. It is an exciting development for the two Trusts, with the programme commencing in September 2015. We aim to enhance non-technical as well as technical skills, encourage team-working, and develop the overall safety culture in theatres. Ultimately, we hope that simulation will improve the management of uncommon critical emergencies, thus optimising patient safety and outcome.

Conclusion By employing multidisciplinary simulation, we aim to embed the use of a cognitive aid manual into clinical practice. This CRM training model can be applied across the UK to enhance both patient care and patient safety.


  1. Arriaga AF, Bader AM, Wong JM, Lipsitz SR, Berry WR, et al. Simulation-based trial of surgical crisis checklists. N Engl J Med 2013;368:246–53

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