When things go wrong
WHY NON-TECHNICAL SKILLS MATTER
Jan Robinson
For professionals, a discussion on the term
competence tends to settle on an individual’s
knowledge and skill, the technical nature of
the scope of a profession’s practice. And this
makes sense – it is the focus of education, of
licensure, and of continuing competence. In
reality, however, once essential competence is
established, the things that go wrong in care
delivery are more related to human behaviour
and the systems supporting the care, than
technical ability.
The literature related to patient safety in human
medicine purports that approximately 80%
of error is attributed to human factors. This
statistic is actually borne out in the complaints
received by most regulators, where poor
communication, lack of supervision, inattention
to standards of practice, etc. are more
prominent than actual poor medicine.
To achieve safe, quality veterinary care the
focus of course needs to be on the areas of
highest risk to animals. Over the last two years,
the College has paid increasing attention to
the concept of risk in veterinary medicine and
what conversations with the profession might
increase attentiveness to managing potential
error. Human error cannot be eliminated
in practice. In fact, there will unfortunately
sometimes be unintentional poor patient
outcomes as a result. The question is, are we
collectively paying attention to identified areas
of risk and working together to minimize them
as best we can.
So – to pay attention to risks in practise we
must include the concept of non-technical
skills. While perhaps not a preferred term to
the “ears” of a professional, non-technical
skills are defined in the literature by Flin et al.
2003 as “the cognitive, social and personal
resource skills that complement technical
skills, and contribute to safe and efficient
task performance.” Non-technical skills are
important to any profession and are described
as the following seven skills sets:
• Situational awareness (attention to the work
environment)
• Decision making
• Communication
• Teamwork
• Leadership
• Managing stress, and
• Coping with fatigue
Practitioners who exemplify best practice
are attentive to this skill set, knowingly
or unknowingly, and achieve consistent
performance in these areas resulting in
reduced risk of harm to patients. The mounting
science on this topic is duplicated in other
Summer 2016
Vol. 32 No. 2
ISSN 0821-6320
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professions for example for pilots and their
crew; the gas, oil, and mining industries; and
surgical teams in human health care.
Non-technical skills are fundamentally relevant
to the practice of veterinary medicine. The
Quality Assurance programs of the College
and the profession need to embrace this
concept and lead this discussion. Good
patient health outcomes, individual or herd,
depend on it.
To read more about the importance of nontechnical skills in practice:
Flin, Rhona H, Paul O’Connor, and Margaret
Crichton. Safety at the Sharp End: A Guide
to Non-Technical Skills. Aldershot, England:
Ashgate, 2008.
CONTENTS
Professionalism - Respect . . . . . . . . . . . . . . . 2
Decal now available . . . . . . . . . . . . . . . . . . . 4
Learning in Practice . . . . . . . . . . . . . . . . . . . 6
Licensure in Emergencies . . . . . . . . . . . . . . 2
Quality Practice Team . . . . . . . . . . . . . . . . . . 4
Peer Advisory Conversation . . . . . . . . . . . . . 7
Strengthening the veterinary profession through quality practice and public accountability.
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