Originally published by our sister publication Anesthesiology News

BOSTON—Being an anesthesiologist is a stressful and complex job. One must think quickly and juggle multiple tasks simultaneously. However, the human mind can only handle so many complex actions and decisions, making human errors a potential problem in clinical settings.

During a presentation at the 2024 Anesthesia Patient Safety Foundation Stoelting Conference, Joyce Wahr, MD, a professor emeritus in the Department of Anesthesiology at the University of Minnesota Medical School, in Minneapolis, called for enhanced technology in the OR to ease decision-making, reduce human errors and improve patient safety.

In the presentation, Dr. Wahr referenced Nobel Prize–winning psychologist Daniel Kahneman, MD, PhD, as the thought leader who inspired her work. Dr. Kahneman, who passed away in 2024, theorized that there are two thought systems in every individual that complement each other.

Known for his work on judgment and decision-making, Dr. Kahneman believed System 1 includes fast, subconscious and effortless thinking, while System 2 is slow, conscious thinking that takes effort and relies on principles.

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For example, System 1 errors often involve confirmation biases and emotions, while System 2 errors require effort and there is a limited reserve of it.

The main point of referencing these two systems is that there is competition for an individual’s limited reserve of effort, which includes physical activity, self-control in interactions with co-workers, fatigue and multitasking. Errors can occur when an individual is overwhelmed by these factors and the effort needed to make decisions. If technology or preapproved materials can reduce the burden, they should be used—even if not cost-effective.

Dr. Wahr explained that tools like barcode readers or prefilled, premixed solutions would have a far greater impact on improving patient safety than suggestions for better thinking or multitasking. She said there was recently a call to action for these items, but now she’d like to see that call fulfilled and entities begin to fund the anesthesia departments more.

Ultimately, Dr. Wahr said prompts for increased effort or more training have minimal impact on patient safety. In contrast, new technologies and strategies to limit human decisions will significantly improve patient conditions.

“We’ve said this again and again: Try harder is the weakest thing we can tell somebody,” Dr. Wahr said. “We need better actions; we know what those actions are.”

Dr. Wahr suggested various ways to improve conditions, including standardizing concentrations of high-alert drugs in ready-to-use forms, providing ready-to-use syringes and infusions, offering better technology training, and promoting a culture that encourages error reporting and discussion of lessons learned.

By Kenny Walter

Wahr reported no relevant financial disclosures.