Cluster randomized trial to evaluate the impact of team training on surgical outcomes.

Background: The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation.

Methods: A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013.

[ORION®: a simple and effective method for systemic analysis of clinical events and precursors occurring in hospital practice].

Purpose: Morbimortality review is now recommended by the French Health Authority (Haute Autorité de santé [HAS]) in all hospital settings. It could be completed by Comités de retour d'expérience (CREX), making systemic analysis of event precursors which may potentially result in medical damage. As commonly captured by their current practice, medical teams may not favour systemic analysis of events occurring in their setting.

[From Crex mutualisation to clinical audit].

In mid-2004, following a Mission nationale d'expertise et d'audits hospitaliers (MeaH) proposal, three voluntary cancer centres started setting up a safety procedure in radiotherapy. Their work made it possible to single out the need to continue elaborating a repository, aiming at a "minimal written reference", to take into account the human factor as one of the four families of factors contributing to a systemic deviation and to build collectively, in radiotherapy departments, the experience feedback committee (comité de retour d'expérience [Crex]). Formalizing a comité de retour d'expérience is unavoidable in any safety-management system (SMM or MGS).

[Crex and Orion analysis in radiation oncology: towards a mutualisation of corrective actions].

After working on treatment organization in radiotherapy (bonnes pratiques organisationnelles en radiothérapie--action pilote MeaH 2003), the development of a security policy has become crucial. With the help of Air France consulting and the MeaH, three cancer centers in Angers, Lille et Villejuif worked together on the implantation of experience feed back committees (Crex) dedicated to the registration, analysis and correction of precursor events. This action has now been implemented in all the FNCLCC centers.

[Towards global security in radiation oncology. Using event notification feed-back].

Large modifications are on going in our medical practice in oncology (cancer incidence, ageing, rules, authorizations, billings...