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Search results for "General Hospitals"

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Journal Article > Study

Association of a surgical task during training with team skill acquisition among surgical residents: the missing piece in multidisciplinary team training.

Sparks JL, Crouch DL, Sobba K, et al. JAMA Surg. 2017 May 24; [Epub ahead of print].

Multiple studies have linked poor teamwork and communication to adverse events in the operating room. There is a growing recognition that surgeons must learn these nontechnical skills during training in addition to the traditional focus on technical ability. In this controlled study, surgical residents participated in an educational intervention (a simulated surgical emergency) that simultaneously targeted technical and nontechnical skill development. The study used two different types of simulation—high fidelity (a cadaver) and medium fidelity (an anatomically correct mannequin)—compared to a control group, which used a nonanatomic simulator. Investigators found that nontechnical skills improved in both intervention groups compared to the control group, measured using validated teamwork assessments. As the accompanying editorial notes, the study findings indicate that technical and nontechnical skills may be best taught together, as teamwork skills improved when residents also had to perform a simulated surgical task simultaneously.

Tools/Toolkit > Government Resource

Toolkit To Improve Safety in Ambulatory Surgery Centers.

Agency for Healthcare Research and Quality: Rockville, MD.

Ambulatory surgery centers provide care to growing numbers of patients. This toolkit draws from AHRQ's Comprehensive Unit-based Safety Program to help ambulatory surgical center teams develop communication and teamwork skills to reduce infections and other iatrogenic harms.

Journal Article > Study

We are going to name names and call you out! Improving the team in the academic operating room environment.

Bodor R, Nguyen BJ, Broder K. Ann Plast Surg. 2017;78(suppl 4):S222-S224.

This study of operating room teams found that nursing staff, attending surgeons, and anesthesiologists did not always know the name or postgraduate year rank of trainees participating in surgery with them. The authors describe this lack of familiarity with team members as a knowledge gap that has the potential to affect surgical safety.

Journal Article > Review

Monitoring teamwork: a narrative review.

Rutherford JS. Anaesthesia. 2017;72(suppl 1):84-94.

Anesthesiology was an early adopter of teamwork as a safety improvement strategy. This review explored models of assessing teamwork behaviors in anesthesiology. The authors found both implicit and explicit methods in place to monitor teamwork and determined that team training improves patient safety.

Book/Report

Safer delivery of surgical services: a programme of controlled before-and-after intervention studies with pre-planned pooled data analysis.

McCulloch P, Morgan L, Flynn L, et al. Health Services and Delivery Research. Southampton, UK: NIHR Journals Library; 2016.

This publication reports five British hospitals' experiences with teamwork interventions in surgical teams. Although teamwork training alone improved how teams functioned, it did not always enhance clinical performance. The investigators found that integrated training that combines technical and social improvements, such as Lean, resulted in more effective improvements.

Journal Article > Study

Integrated approach to reduce perinatal adverse events: standardized processes, interdisciplinary teamwork training, and performance feedback.

Riley W, Begun JW, Meredith L, et al. Health Serv Res. 2016;51(suppl 3):2431-2452.

Prior research has shown that reducing preventable perinatal harm leads to a decrease in malpractice claims. In this prospective study involving the perinatal units across 14 hospitals from 12 states and accounting for almost 350,000 deliveries, researchers found that successful implementation of 3 standard care processes resulted in a 14% decrease in harm in perinatal care from the baseline period.

Journal Article > Commentary

S-TEAMS: a truly multiprofessional course focusing on nontechnical skills to improve patient safety in the operating theater.

Stewart-Parker E, Galloway R, Vig S. J Surg Educ. 2017;74:137-144.

Before teamwork behaviors became a key component of medical error reduction, little research focused on nontechnical skill development in surgery. This commentary discusses a program designed to teach multidisciplinary teams nontechnical skills and enable participants to practice them in simulations. The authors found that teams continued to apply what they learned long after completing the training.

Journal Article > Study

Cluster randomized trial to evaluate the impact of team training on surgical outcomes.

Duclos A, Peix JL, Piriou V, et al; IDILIC Study Group. Br J Surg. 2016;103:1804-1814.

Teamwork training programs have been implemented in a large variety of health care settings, and growing evidence suggests a positive impact. However, the effect of teamwork training programs in the context of surgical safety checklists is less clear. In this randomized study, researchers examined whether adding a team training program to surgical safety checklist utilization affected major surgical complications. All 31 hospitals in the study had implemented a surgical safety checklist a median of 19 months prior to the study. Team training was introduced across operating room teams in 16 hospitals randomized to the intervention arm. Investigators found a significant reduction in major adverse events in both the intervention and control arms. These results suggest that team training may not provide additional benefit when combined with a checklist. A past PSNet interview discussed challenges associated with implementing surgical safety checklists.

Journal Article > Commentary

How communication among members of the health care team affects maternal morbidity and mortality.

Brennan RA, Keohane CA. J Obstet Gynecol Neonatal Nurs. 2016;45:878-884.

Communication failures in obstetric care can increase risk of harm for the mother and the infant. This commentary highlights how nurses can incorporate teamwork principles and structured communication to reduce risks of maternal injury.

Journal Article > Commentary

Patient safety in the emergency department.

Farmer BM. Emerg Med. 2016;48:396-404.

Emergency departments are high-risk environments due to the urgency of care needs and complexity of communication. This commentary explores challenges associated with medication administration, handoffs, discharge processes, and electronic health records in emergency medicine and recommends strategies to reduce risks.

Tools/Toolkit > Multi-use Website

TeamSTEPPS: Strategies and Tools to Enhance Performance and Patient Safety.

  • Classic

Washington, DC: Department of Defense. Rockville, MD: Agency for Healthcare Research and Quality; 2016.

Effective teamwork plays an essential role in providing safe patient care. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program was developed in collaboration by the United States Department of Defense and AHRQ in order to support effective communication and teamwork in health care. This updated version of the widely implemented program provides new tools to measure its impact, supports increased emphasis on the role of effective communication in team training, and includes a new course management guide. Teamwork training programs have been shown to improve knowledge and attitudes, but have received mixed reviews on their effectiveness in changing behaviors. An AHRQ WebM&M commentary discussed how improved teamwork and shared decision-making might have prevented the unnecessary placement of a peripherally inserted central catheter that led to significant complications.

Journal Article > Study

Crew resource management training in the intensive care unit. A multisite controlled before-after study.

Kemper PF, de Bruijne M, van Dyck C, So RL, Tangkau P, Wagner C. BMJ Qual Saf. 2016;25:577-587.

This study found that classroom-based crew resource management training for intensive care unit staff was well received and improved self-reported situational awareness tactics, safety culture, and job satisfaction. However, there were no measurable changes in professional communication or patient outcomes compared to control groups.

Journal Article > Study

Situation, background, assessment, and recommendation–guided huddles improve communication and teamwork in the emergency department.

Martin HA, Ciurzynski SM. J Emerg Nurs. 2015;41:484-488.

In an effort to improve communication in an urban emergency department, nurse practitioners and registered nurses underwent a teamwork training intervention emphasizing joint patient evaluations by both the nurse practitioner and registered nurse simultaneously followed by a huddle using the SBAR communication method. The intervention was successfully used in more than 80% of patient encounters and improved teamwork and provider satisfaction.

Journal Article > Study

Beyond the team: understanding interprofessional work in two North American ICUs.

Alexanian JA, Kitto S, Rak KJ, Reeves S. Crit Care Med. 2015;43:1880-1886.

The intensive care unit is often cited as a model of interprofessional teamwork. This ethnographic study found that while interprofessional communication is common between intensive care unit team members, most of these interactions are more properly characterized as collaboration or coordination rather than true teamwork.

Journal Article > Study

Crew resource management in the intensive care unit: a prospective 3-year cohort study.

Haerkens MH, Kox M, Lemson J, Houterman S, van der Hoeven JG, Pickkers P. Acta Anaesthesiol Scand. 2015;59:1319-1329.

Following crew resource management training for intensive care unit staff and implementation of a checklist, this pre-post study found that complications (such as cardiac arrests) and mortality decreased. Training and checklists were introduced simultaneously, so the improvements may be due to one or both interventions, and each of these have demonstrated mixed success in prior studies.

Journal Article > Review

Healthcare Utilizing Deliberate Discussion Linking Events (HUDDLE): a systematic review.

Glymph DC, Olenick M, Barbera S, Brown EL, Prestianni L, Miller C. AANA J. 2015;83:183-188.

The concept of a small group briefings or huddles have been used as a communication tactic in health care settings. This literature review discusses huddle use in preoperative care, highlighting the need for more structure, education, and research to enhance its value as a communication strategy to improve patient safety.

Journal Article > Review

Team training for safer birth.

Cornthwaite K, Alvarez M, Siassakos D. Best Pract Res Clin Obstet Gynaecol. 2015;29:1044-1057.

Obstetric care is considered a high-risk environment. Highlighting the importance of coordinated teamwork during obstetric emergencies, this review discusses strategies to augment clinical outcomes in this setting, including team training, communication improvement, and situational awareness.

Journal Article > Study

Crisis management on surgical wards: a simulation-based approach to enhancing technical, teamwork, and patient interaction skills.

Arora S, Hull L, Fitzpatrick M, Sevdalis N, Birnbach DJ. Ann Surg. 2015;261:888-893

This simulation study examined how residents respond to postoperative deterioration in the surgical ward. Residents improved in validated assessments of clinical performance, teamwork, and communication with patients compared to before the simulation. This work underscores the importance of simulation in patient safety education across multiple clinical settings.

Journal Article > Study

A combined teamwork training and work standardisation intervention in operating theatres: controlled interrupted time series study.

Morgan L, Pickering SP, Hadi M, et al. BMJ Qual Saf. 2015;24:111-119.

An intervention that combined teamwork training with efforts to standardize certain operative procedures resulted in increased adherence to the World Health Organization safe surgery checklist and improved communication within the operating room. No effect was found on clinical outcomes, but the study was likely too small to detect such an impact.

Journal Article > Study

Implementation of crew resource management: a qualitative study in 3 intensive care units.

Kemper PF, van Dyck C, Wagner C, de Bruijne M. J Patient Saf. 2014 Nov 20; [Epub ahead of print].

Teamwork training has become a critical tool for promoting health care safety. This study describes the preparation, implementation, and impact of a crew resource management training program at three Dutch intensive care units. Following the training sessions, the participants launched several local quality improvement projects.

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