ERUS 2018: Importance of Non-technical Skills and Communication in the Management of Risk Scenarios: What Can We Learn From UK Lapco Group?

Marseille, France (UroToday.com) Sharmila Gupta, MD gave a captivating talk on the important non-technical skills and communications that are required in various risk scenarios in the operating theater. Dr. Gupta is a member of the Lapco group, which is the national training program for laparoscopic colorectal surgery. Lapco consists of 211 surgeons, with a 1/3 of them being colorectal surgeons in the UK. In Lapco there are 144 consultants undergoing training.

Dr. Gupta is greatly involved in training other colorectal surgeons, and her talk focused on important human factors and communication skills. She began with a discussion on the importance of the team brief before every procedure. This makes sure every team member knows his/her role, and this is the time to discuss each member’s role in different extreme scenarios. This helps improve the communication skills between team members and improves outcomes when extreme scenarios occur.

The next topic discussed was dual-task interference. Unfortunately, other outside triggers can tremendously affect our performance in the operating theater. Voices, sounds, noise, music, lights, and additional sensory triggers can greatly influence our primary task and need to be avoided.

When an extreme scenario occurs, Dr. Gupta recommended to use the acronym of “SIX STEPS”:
  1. Stop – stop what you are doing and assess the situation
  2. Identify – Identify what had happened, what is the extent and repercussions
  3. eXplain – Make sure other team members and specifically other surgeons in the room know what had occurred
  4. Structured Teaching – in few short sentences explain to your trainees (if relevant) what had occurred and what needs to be done
  5. Elicit understanding – Make sure the trainee understands what he/she needs to do
  6. Proceed if Safe – Perform the maneuver you wanted to do only if it is safe and approved by your superior staff in the operating theater
These six steps help us react to different extreme scenarios in a standardized manner with complete control at every step, and with the ability to communicate with all other team members in the operating theater. This will make sure everyone knows what is being done and what is expected of them in the next step.

Dr. Gupta concluded her important and talk, by stating the importance of communication throughout the case with all team members and ensuring that dual-task interference is always avoided.

Presented by: Sharmila Gupta, Colchester, UK

Written by: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre, Twitter:@GoldbergHanan at the EAU Robotic Urology Section (ERUS) Meeting - September 5 - 7, 2018 - Marseille, France