AHRQ Patient Safety Network ► Residents' reluctance to challenge negative hierarchy in the operating room: a qualitative study.

AHRQ Patient Safety Network



Residents' reluctance to challenge negative hierarchy in the operating room: a qualitative study.

Bould MD, Sutherland S, Sydor DT, Naik V, Friedman Z. Can J Anaesth. 2015 Mar 20; [Epub ahead of print].

In this simulation study, most anesthesiology residents acceded to an attending physician's order to transfuse blood to a patient who had explicitly refused transfusions for religious reasons. Subsequent interviews with the residents revealed that strict hierarchies persist within medical training, despite evidencethat hierarchies impair communication and negatively affect safety. This study is reminiscent of one of theearliest studies of the impact of hierarchies on patient safety.

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