Burnout, characterized by emotional exhaustion that results in depersonalization and decreased accomplishment at work, is correlated with poor patient safety culture. Multiple initiatives to measure and reduce healthcare worker burnout have emerged recently. This Department of Defense study used the AHRQ Hospital Survey on Patient Safety Culture to determine the scope of burnout in military hospitals, explore the relationship between burnout and teamwork, and explore effects of teamwork on burnout.

Morbidity and mortality conferences (MMC) serve as a way for health care teams to discuss adverse events and errors with the goal of improving patient safety. This article presents five recommendations to improve MMC: encourage culture change; allocate ample time for open communication to foster innovative thinking; take a global approach; learn from errors and near misses; and do not just talk the talk, but also walk the walk.

… for practicing primary care physicians is needed. … Burke HB, King HB. Responses of physicians to an objective safety and …

The Partnership for Patients is a government initiative to reduce health care–acquired conditions. This commentary describes a large-scale implementation of the Partnership for Patient methods across the Military Health System. The authors report the results of the program and recommend continuous leadership engagement to achieve success.

In teamwork training, multidisciplinary health care teams learn to respond effectively to acute situations. Prior studies of team training show improvements in safety culture, but its effect on patient outcomes has been mixed. This meta-analysis of 129 studies found that team training consistently led to enhanced participant satisfaction and skills. These improvements were present across different health care settings and team composition. Investigators also determined that team training positively affects length of stay and mortality, although they caution that few of the primary studies analyzed included these patient outcomes. The authors suggest that team training should be widely implemented and that further studies should evaluate its effect on length of stay, patient satisfaction, and mortality. A PSNet interview discussed how team training from other industries can be applied to health care.

This validation study found that the TeamSTEPPS questionnaire—which explores perceptions of teamwork within health care settings—reliably measures how staff perceive leadership, mutual support, situation monitoring, communication, and team structure. According to these findings, this instrument provides a valid way to assess teamwork for safety research and improvement efforts.

This commentary describes the development and implementation of a computerized tool that incorporated principles from TeamSTEPPs to record observations of team behaviors and support teamwork training.

This commentary discusses the importance of teamwork training evaluation in health care and recommends 12 best practices.

This review of teamwork training programs identifies several effective programs, but also notes problems that have been identified in prior research, including a lack of detailed evaluation of the programs’ effect on behavior change and long-term outcomes.

Teamwork training programs continue to emerge despite past reviews suggesting their mixed effectiveness in changing behavior. This study conducted a multilevel evaluation of the TeamSTEPPS training program within an operating room service line and used a comparison unit at a separate facility. Following a 4-hour didactic program, the trained group demonstrated increases in the quantity and quality of presurgical procedure briefings and the use of teamwork behaviors observed during cases. Similar to past efforts, increases were also noted in perceptions of safety culture and teamwork attitudes. This study adds to the literature by employing a multilevel evaluation strategy, using a comparison unit, and observing actual behavior change that was attributed to the training. Patient outcomes were not part of the measurement strategy.

This project report provides information on a multi-modal educational program designed to enhance teamwork and technical skills to safely address obstetric care emergencies.

This analysis reviews elements of effective team training initiatives and provides suggestions for implementing them.

This article provides an overview of debriefing as a learning tool in critical incident analysis and in clinical situations such as the operating room. Practical suggestions are provided to enable hospital leadership and team leaders to maximize the utility of debriefing sessions.

This commentary discusses a set of guidelines for implementing a three-pronged approach to teamwork: communication, coordination, and cooperation.

This article discusses how an organization should prepare to implement simulation programs to improve patient safety and describes techniques for engaging staff, targeting the intervention, and evaluating effectiveness of the program.

Crew resource management methods, initially developed in aviation, have been proposed as a means to reduce human errors in medicine through improved teamwork and communication. In this cluster-randomized trial, physicians and nurses on obstetrics wards underwent teamwork training based on the MedTeams model, which has been previously studied in the emergency department. The intervention did not result in improvement in patient (maternal or fetal) clinical outcomes or in the delivery of appropriate process measures. The authors ascribe this negative result to problems noted in other cluster-randomized trials of quality improvement interventions, such as inadequate time to implement the intervention, a relatively short follow-up period, and baseline variation between hospitals in the incidence of adverse events.

This article describes the development of the US Department of Defense's team training program for military health facilities, entitled TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). The program was based on two prior military crew resource management (CRM) programs and prior evidence in the field and was adapted to address issues encountered in military facilities, including the rapid turnover of personnel and the need to adapt to the cultures of specific military services. The program consists of teaching core skills in leadership, situation monitoring, team support, and communication through an interactive curriculum stressing application to everyday scenarios. The article extensively reviews the challenges of implementing the program and future plans for disseminating and evaluating the training.

… physician competence in these areas. … Baker DP; Salas E; King H; Battles J; Barach P. …