安全を創る

• Published in: Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine) Vol. 38; no. 3; pp. 505 - 508
• Main Author: 小濱 圭祐
• Format: Journal Article
• Language: Japanese
• Published: 日本腹部救急医学会 31.03.2018; Japanese Society for Abdominal Emergency Medicine
• Subjects: ノンテクニカルスキル; 事故調査; 再発防止; 医療安全
• ISSN: 1340-2242; 1882-4781
• DOI: 10.11231/jaem.38.505

The safety climate in the aviation field is advanced and universal, with a systematic education system for safety methods well established. On the contrary, there is no standardized method of investigation, documentation, and dissemination for safety in the field of medicine, which depends on every single person or organization under the present circumstances. To maintain optimal performance in medicine requires focusing on non-technical skills involved in decision-making, team building and maintenance, workload management, situational awareness management, and communication, which are considered crucial in the aviation field. Although evidence is scarce, we consider non-technical skills a promising tool for a culture change in the field of medicine as well. We need to learn from our past accidents and incidents. Sharing the cause of an accident is the first step toward preventing a similar incident from occurring again. The Japan Medical Safety Research Organization was established recently to act as an accident prevention system in the field of medicine. The same mechanism in the aviation sector is known as the Japan Transport Safety Board (JTSB), and it has already long been in place. Aviation and medicine have many features in common. Safety is paramount in both fields. The field of medicine can consider the option of a quick way to enhance the safety climate of the profession by learning from its counterpart in aviation. 航空分野と医療分野は職場環境としての共通点が多い。とくに，安全で効率的な業務の遂行は共通の目標である。航空分野の安全風土は先進的かつ普遍的であり，系統的な安全教育が確立されている。一方の医療分野においての安全は古典的かつ特殊なものとして，今なおその基準となる指標や標準化された指針たるものは存在せず，個人や組織の考えに依存している。航空分野では一般的に認識されているチームワークや確実な安全に対する意識などに代表されるノンテクニカルスキルを，医療従事者も診療技術の1つとして認識し，重篤な転帰に至る前にエラーをコントロールする術をもち合わせる必要がある。そのうえで，不幸にも発生した事故に対して，同様の事故を繰り返さない，類似する事故を防ぐための仕組みを作ることができれば安全意識はより確実なものとなる。事故原因の徹底した分析解明とその結果の効果的な共有は事故再発防止に大変有用なものである。