#11419. Failure to rescue following emergency surgery: A FRAM analysis of the management of the deteriorating patient

August 2026publication date
Proposal available till 17-05-2025
4 total number of authors per manuscript0 $

The title of the journal is available only for the authors who have already paid for
Journal’s subject area:
Physical Therapy, Sports Therapy and Rehabilitation;
Human Factors and Ergonomics;
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Abstract:
Failure to rescue (FTR) denotes mortality from post-operative complications after surgery with curative intent. Resilience Engineering might afford a useful perspective for studying how the management of deterioration usually succeeds and how resilience can be strengthened. We studied the response to the deteriorating patient following emergency abdominal surgery in a large surgical emergency unit, using the Functional Resonance Analysis Method (FRAM). FRAM focuses on the conflicts and trade-offs inherent in the process of response, and how staff adapt to them, rather than on identifying and eliminating error. 31 semi-structured interviews and two workshops were used to construct a model of the response system from which conclusions could be drawn about possible ways to strengthen system resilience. The model identified 23 functions, grouped into five clusters, and their respective variability. FRAM can be used for analysing surgical work systems in order to identify recommendations focused on strengthening organisational resilience.
Keywords:
Emergency surgery; Failure to rescue; FRAM; Patient safety; Resilience engineering

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