Task Management in Anesthesiology

Team-Based Task Allocation and Preparation

The American Society of Anesthesiologists recommends pre-assigning specific tasks to each team member during the surgical pause or team briefing before every case, to prevent delays and confusion during emergencies 1
Each team member should receive a designated task, such as removing the tracheal tube or turning off airway gases, and understand they must perform their pre-assigned task immediately without waiting for others to act 1
Team members should assist others with incomplete tasks once they have completed their own, to ensure all tasks are completed efficiently 1
Displaying easily visible protocols for prevention and management of emergencies in every operating room can ensure immediate access to structured guidance during time-critical situations 1, 2

The Anaesthesia society recommends implementing automated electronic anaesthetic record systems integrated with the hospital's electronic health record, to reduce documentation burden and improve accuracy 3
Automated systems can free cognitive resources by eliminating manual charting during critical periods, and ensure comprehensive information capture from all monitoring devices 3
Integration of automated systems can reduce task fragmentation, which doubles medication errors when providers must simultaneously accomplish multiple tasks 4

The Anaesthesia society recommends adjusting workload to match available staff and carefully monitoring adequacy of resources, to effectively cope with potential crisis situations 4
Supervising two operating rooms can pose a risk of being unable to intervene, ranging from 87% for short cases to 40% for long cases, and this risk increases further when supervising three rooms 4
Setting workload ratios that ensure an anaesthetist can effectively manage complications at any moment is crucial, and accounting for high-risk periods when allocating tasks is also important 4

The Anaesthesia society recommends developing organizational policies targeting fatigue risk at all levels, including limitation of on-duty periods, mandatory rest periods, and respect for existing work hour legislation 4
Informing teammates of one's fatigue state can foster group vigilance without judgment, and utilizing risk securitization tools during fatigued states can help mitigate risks 4
Factoring caregiver fatigue into the risk-benefit balance during decision-making for invasive procedures is essential, to ensure patient safety 4

The Anaesthesia society recommends ensuring continuous presence of an appropriately trained anaesthetist with the patient at all times during anaesthesia or sedation, at least until WHO sign-out completion and handover to trained staff 3, 5
This continuous presence is the cornerstone of patient safety, and trainees must be appropriately supervised at all times, sometimes requiring direct consultant supervision 3

The Anaesthesia society recommends setting patient-specific alarm limits before use and enabling audible alarms during anaesthesia, to provide early warning of deteriorating conditions 3
Monitoring can reduce risks by detecting error consequences and providing early warning of patient deterioration, and human factors and ergonomics are key to safe healthcare delivery 3

The American Society of Anesthesiologists recommends not waiting for another team member to act before performing your pre-assigned task during emergencies, to prevent delays and ensure efficient task completion 1
Avoiding supervision of more than two operating rooms simultaneously is crucial, given the high probability of being unable to respond to complications 4
Ignoring fatigue signals can lead to deteriorating perception of fatigue, creating an illusion of performance, and preventing task fragmentation and interruptions during medication prescribing and other high-risk activities is essential 4

The American Society of Anesthesiologists recommends positioning the patient at the level of the anesthetist's umbilicus (T10 dermatome or waist) to facilitate mask holding and drug administration without bending, with evidence from Anaesthesia 6
Configuring anesthetic machines appropriately (left-handed machines to the left, right-handed to the right) is crucial to avoid requiring the anesthetist to lean forward repeatedly or turn their head to view monitors, as suggested by Anaesthesia 6
Bringing injection ports close to the anesthetist by gently flexing the patient's arm or using infusion extensions with three-way taps is recommended, according to Anaesthesia 6
Human factors and ergonomics are key to safe healthcare delivery, including proper positioning of monitors at eye level and in front of the anesthetist, as stated in Anaesthesia 6