A national survey of the impact of NAP4 on airway management practice in United Kingdom hospitals: closing the safety gap in anaesthesia, intensive care.

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A national survey of the impact of NAP4 on airway management practice in United Kingdom hospitals: closing the safety gap in anaesthesia, intensive care and the emergency department T.M. Cook, N. Woodall, C. Frerk British Journal of Anaesthesia Volume 117, Issue 2, Pages 182-190 (August 2016) DOI: 10.1093/bja/aew177 Copyright © 2016 The Author(s) Terms and Conditions

Fig 1 An illustration of closing the safety gap: the ‘safety gap’ is the difference between practice and 100% compliance with a recommendation. Blue columns represent practice before NAP4 and green columns after NAP4. The difference between the two columns indicates the degree of change. The pink arrow indicates the safety gap before NAP4 and the orange arrow the safety gap after NAP4. The relative lengths of the two arrows indicates the degree to which the safety gap has been closed. British Journal of Anaesthesia 2016 117, 182-190DOI: (10.1093/bja/aew177) Copyright © 2016 The Author(s) Terms and Conditions

Fig 2 The extent of personal and departmental changes in practice in response to NAP4. Blue columns- personal changes in practice, green columns – departmental changes in practice. British Journal of Anaesthesia 2016 117, 182-190DOI: (10.1093/bja/aew177) Copyright © 2016 The Author(s) Terms and Conditions

Fig 3 NAP4's impact on closing the ‘safety gap’ in Anaesthetic practice. The x axis relates to recommendations made in NAP4. The y axis indicates the extent to which the gap between actual and ideal practice has been reduced, as a result of changes in practice because of implementation of NAP4 recommendations. The recommendations are listed in descending order of impact. The green line indicates the median of all the impacts in the graph. British Journal of Anaesthesia 2016 117, 182-190DOI: (10.1093/bja/aew177) Copyright © 2016 The Author(s) Terms and Conditions

Fig 4 NAP4's impact on the safety gap in Anaesthetic practice. The x axis relates to recommendations made in NAP4. The y axis indicates the percentage of departments complying with the recommendation. The blue bar indicates compliance before NAP4, the green bar the change as a consequence of NAP4 and the pink bar is the remaining gap between practice after NAP4 and ideal practice. The recommendations are listed in descending order of the impact of NAP4 in bridging the gap between actual and ideal practice. British Journal of Anaesthesia 2016 117, 182-190DOI: (10.1093/bja/aew177) Copyright © 2016 The Author(s) Terms and Conditions

Fig 5 NAP4's impact on the safety gap in Intensive Care practice. The x axis relates to recommendations made in NAP4. The y axis indicates the extent to which the gap between actual and ideal practice has been as a result of changes in practice because of implementation of NAP4 recommendations. The recommendations are listed in descending order of impact. The green line indicates the median of all the impacts in the graph. British Journal of Anaesthesia 2016 117, 182-190DOI: (10.1093/bja/aew177) Copyright © 2016 The Author(s) Terms and Conditions

Fig 6 NAP4's impact on the safety gap in Emergency Department practice. The x axis relates to recommendations made in NAP4. The y axis indicates the extent to which the gap between actual and ideal practice has been as a result of changes in practice because of implementation of NAP4 recommendations. The recommendations are listed in descending order of impact. The green line indicates the median of all the impacts in the graph. British Journal of Anaesthesia 2016 117, 182-190DOI: (10.1093/bja/aew177) Copyright © 2016 The Author(s) Terms and Conditions