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Purpose of review: Anesthesiologists work in a complex environment that is intolerant of errors. Cognitive errors, or errors in thought processes, are mistakes that a clinician makes despite 'knowing better'. Several new studies provide a better understanding of how to manage risk while making better decisions.

Recent findings: Heuristics, or mental shortcuts, allow physicians to make decisions quickly and efficiently but may be responsible for errors in diagnosis and treatment. Using simple 'decision-making checklists' can help healthcare providers to make the correct decisions by monitoring their own thought processes. Anesthesiologists can adopt risk assessment tools that were originally developed for use by pilots to determine the hazards associated with a particular clinical management strategy.

Summary: Effective decision-making and risk management reduce the risk of adverse events in the operating room. This article proposes several new decision-making and risk assessment tools for use in the operating room.

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