Endoskopie neu gedacht: Strategien aus der Luftfahrt und ihre Übertragung in die Medizin – Ein Überblick

Zusammenfassung

Einleitung

Die Anforderungen an die moderne Endoskopie sind in den letzten Jahrzehnten in verschiedenen Bereichen rasant gewachsen. Dazu zählen die Herausforderungen für das Endoskopieteam durch anspruchsvollere interventionelle Eingriffe, aber auch die sich schnell ändernden Rahmenbedingungen, die die heutige Arbeitsrealität mit sich bringt. Um dennoch weiterhin dem notwendigen Sicherheits- und Qualitätsanspruch gerecht zu werden, kann es helfen, sich durch einen Blick auf ähnlich komplexe Gebiete wie die zivile Luftfahrt Anregungen für effektive Konzepte in der Endoskopie zu suchen.

Haupttext

Crew Resource Management (CRM) und Threat and Error Management (TEM) sind wichtige Konzepte aus der zivilen Luftfahrt, welche die Luftfahrt zur momentan sichersten Transportart der Welt machen. Elemente wie Kommunikation, Teamarbeit, Situationsbewusstsein, Entscheidungsfindung und eine offene Fehlerkultur können ebenfalls in der Medizin Anwendung finden. Diese sind zum Teil mittels CRM-basierten Trainings und allgemeinen sowie spezifischen Checklisten schon mit Erfolg in akutmedizinische Bereiche übertragen worden. Um auch in der Endoskopie von den Erkenntnissen bestmöglich zu profitieren, bieten sich auf die individuellen Anforderungen der jeweiligen Endoskopieeinheit angepasste Workshops an, in denen in Zusammenarbeit mit professionellen CRM-Trainern Maßnahmen erarbeitet werden können. Beispiele hierfür wären eine einheitliche Kommunikationsrichtlinie für die endoskopischen Eingriffe, eine prä-interventionelle Sicherheitscheckliste oder ein TEM-basiertes dialogisches Team-Time-Out. Nach der Implementierung sind eine regelmäßige Evaluation und Weiterentwicklung der Maßnahmen entscheidend für den langfristigen Erfolg.

Schlussfolgerungen

Aus der zivilen Luftfahrt übertragene Elemente haben das Potenzial, Kommunikation, situationsbewusste Teamarbeit, strukturierte Entscheidungsfindung und eine offene Fehlerkultur in endoskopischen Teams zu fördern und somit zu sicheren und qualitativ hochwertigen Eingriffen beizutragen.

Abstract

Introduction

The demands on modern endoscopy have grown rapidly in various areas in recent decades. These include challenges for the endoscopy team due to more demanding interventional procedures, but also the rapidly changing conditions that today’s working reality entails. In order to continue to meet the necessary safety and quality standards, it can help to look at similarly complex areas such as civil aviation to find inspiration for effective concepts in endoscopy.

Main text

Crew Resource Management (CRM) and Threat and Error Management (TEM) are important concepts from civil aviation that currently make aviation the safest mode of transportation in the world. Elements such as communication, teamwork, situational awareness, decision-making and an open error culture can also be used in medicine. Some of these have already been successfully transferred to acute medical areas by using CRM-based training and general or specific checklists. In order to also benefit as much as possible from the findings in endoscopy, workshops tailored to the individual requirements of the respective endoscopy unit are available, in which measures can be developed in collaboration with professional CRM trainers. Examples of this would be a standardized communication guideline for endoscopic procedures, a pre-interventional safety checklist or a TEM-based dialogical team time-out. After implementation, regular evaluation and further development of the measures are essential for long-term success.

Conclusions

Elements transferred from civil aviation have the potential to promote communication, situation-aware teamwork, structured decision-making and an open error culture in endoscopic teams and thus contribute to safe and high-quality interventions.

Schlüsselwörter

Endoskopie - Darm - Magen

Keywords

Endoscopy - Intestine - Stomach

Publication History

Received: 23 December 2024

Accepted after revision: 25 February 2025

Article published online:
28 March 2025

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