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Search results for "Organizational Behaviorists"
- Organizational Behaviorists
- Teamwork Training
Journal Article > Study
Neily J, Mills PD, Young-Xu Y, et al. JAMA. 2010;304:1693-1700.
Classic studies have demonstrated that operating rooms are rife with communication and teamwork problems, and suboptimal teamwork has been linked to poor postoperative patient outcomes. In this rigorously designed study, surgical teams at 74 Veterans Affairs (VA) hospitals underwent teamwork training through the VA's Medical Team Training program. The training also included implementation of preoperative and postoperative checklists. The teamwork training was associated with a striking reduction in mortality compared to other VA hospitals that had not yet implemented the program, and a dose–response effect was also evident, with continuing training resulting in further reductions in mortality. An accompanying editorial lauds this study as an example of how to conduct a rigorous, evidence-based evaluation of a safety intervention, and stresses that addressing teamwork and safety culture are as essential to improving safety as technical and procedural interventions such as checklists.
Journal Article > Commentary
Smetzer J, Baker C, Byrne FD, Cohen MR. Jt Comm J Qual Patient Saf. 2010;36:152-163, 1AP-2AP.
This article discusses how a hospital responded to a fatal medication error that occurred when a nurse mistakenly administered epidural pain medication intravenously to a pregnant teenager. Findings from the root cause analysis of the error revealed underlying factors including fatigue (the nurse had worked a double shift the day before), failed safety systems (the hospital had recently implemented a bar coding system, but not all nurses were trained and workarounds were routine), and human factors engineering (bags containing antibiotics and pain medications were similar in appearance and could be accessed with the same type of catheter). A range of safety interventions were implemented as a result. However, the related editorials by leaders in the safety field (Drs. Sidney Dekker, Charles Denham, and Lucian Leape) take the hospital to task for focusing on narrow improvements rather than using complexity theory to solve underlying problems, and for creating a "second victim" by disciplining the nurse (who was fired and ultimately criminally prosecuted) rather than acknowledging the institution's responsibility and the caregiver's emotional distress. The article and commentaries provide a fascinating, in-depth look at the true impact of a never event.
Journal Article > Commentary
Weick KE. Adm Sci Q. 1993;38:628-652.
This article is a review and analysis of the Mann Gulch fire disaster, an event made famous in Norman Maclean's award–winning book, Young Men and Fire (1992). Using the story of a firefighter who improvised a response to a fire by setting a back-fire while the rest of his crew panicked and ultimately perished, Weick examines the disintegration of role structure and sensemaking within an organization. He discusses sources of resilience that make groups less vulnerable, including improvisation, virtual role systems, the attitude of wisdom, and norms of respectful interaction. The purpose is to understand why organizations unravel and how they become more resilient. The organizational literature is reviewed to demonstrate a need for reexamination of successful group structures. Weick's work influenced many others who have written about improving safety, particularly in teams that work in fast-moving and ambiguous clinical settings.