F

Focus: the declaration ‘focus’ is critical language used to highlight the occurrence of a key moment requiring the team’s attention. In response to a declaration of ‘focus’ staff in the vicinity should be trained to respond by paying attention, minimising noise levels, limiting conversation to important clinical communication and being prepared to act. Analagous to the declaration of ‘below ten-thousand’ for initiating the sterile cockpit concept in aviation, the term ‘focus’ is intended to concisely convey the urgent requirement for these actions in a non-confrontational way. It can be used prior to commencing airway management (e.g. immediately before commencing a briefing or airway checklist) or by any staff member, at any stage of patient care to heighten situation awareness, reduce distractions and facilitate clear communication, without necessarily escalating to the declaration of a crisis. It thus has applications beyond the context of airway management. The specific term ‘focus’ was introduced at Royal United Hospitals Bath to address the perceived reluctance of clinicians to use the aviation-based reference of ‘below ten-thousand’. The usefulness of such an intervention is dependent on prior education of all staff working in the environment (not just those involved in airway management) on its use and implications.

Foundation tools: resources intended to be referred to prior to undertaking a task that help to explain the task (and the underlying theory) to promote understanding or memory, before the event (in contrast to implementation tools). Such resources may include guidelines, protocols and procedures.

Frequency gambling: the unconscious tendency of practitioners to make management decisions based on previous experiences. While frequency gambling can be an efficient form of problem solving, it may also lead practitioners to fixate on aetiologies they have been conditioned to expect, resulting in patient harm.