Is there an association between implementation of a medical team training program and surgical mortality?

Pawlik, Timothy M.; Urbach, David R.; Halverson, Amy L.; Baxter, Nancy N.; Brasel, Karen J.; Brown, C. J.; Chaudhury, Prosanto; Cutter, Calvin; Divino, Celia M.; Dixon, Elijah; Dubois, L.; Fitzgerald, G; Henteleff, Harry; Kirkpatrick, A. W.; Latosinsky, Steve; MacLean, Anthony R.; Mastracci, Tara M.; McLeod, Robin S.; Morris, Arden M.; Neumayer, Leigh; Temple, Larissa K.; McKenzie, Marg

doi:10.1503/cjs.001513

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…In a narrative synthesis of the literature, bundled team training intervention design has been suggested as an effective approach to support clinical practice and process improvement 19 . Specific to the perioperative setting, it has been suggested that team training may be effective to change behavior to promote practice changes to minimize preventable adverse events 20 . An additional consideration for successful team training is the ability for administrators to commit resources for development of interventions, philosophical support of suggested tools (i.e., verification checklist), routine dissemination of results, allocated time for team training, surgeon restrictions if noncompliant, and marketing of the training.…”

Section: Discussionmentioning

confidence: 99%

“…19 Specific to the perioperative setting, it has been suggested that team training may be effective to change behavior to promote practice changes to minimize preventable adverse events. 20 An additional consideration for successful team training is the ability for administrators to commit resources for development of interventions, philosophical support of suggested tools (i.e., verification checklist), routine dissemination of results, allocated time for team training, surgeon restrictions if noncompliant, and marketing of the training. Team training by webinar format was elected because of the various geographical locations.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

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Reducing Surgery Scheduling Errors in Multihospital System

Watson

Corbett²,

Oneal³

et al. 2017

J Patient Saf

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The purpose of this study was to assess whether bundled team training interventions for surgeons and office staff could effectively improve the accuracy of surgery scheduling, minimizing scheduling factors that may contribute to occurrence of wrong site surgery. Methods:This quasi-experimental observational study used an interrupted time series design to explore surgery scheduling errors (SSEs) and implemented bundled team training interventions intended to reduce SSEs at a Pacific Northwest Regional Surgery Scheduling Department. Each preintervention and postintervention segment consisted of 16 weekly data points. The bundled team training interventions included disclosure of preintervention scheduling errors, a scheduling verification checklist, an updated surgery scheduling policy and procedure, and toolkit to improve office scheduling of surgeries.Results: Improvements in SSEs were observed preintervention to postintervention, with decreased surgery SSE rate from 0.51% to 0.13% (P < 0.001). Reductions were observed in all SSE types. The segmented linear trend demonstrated an observed reduction of 42.70 SSE (P < 0.001).Conclusions: This is the first study conducted at a large healthcare system with a regional surgery scheduling department to demonstrate that statistically significant and clinically important reductions in SSEs can be achieved. The findings demonstrate that SSEs can be minimized and confirm that verification processes must begin in the surgeon's office once a decision has been reached to proceed with surgery. The study confirms the need for additional research targeted at understanding why SSEs occur at the time of scheduling.

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Section: Discussionmentioning

confidence: 99%

Section: Strengths and Limitationsmentioning

confidence: 99%

Reducing Surgery Scheduling Errors in Multihospital System

Watson

Corbett²,

Oneal³

et al. 2017

J Patient Saf

View full text Add to dashboard Cite

show abstract

“…The authors identified two important correlations: between the magnitude in mortality reduction and whether a hospital instituted a team training program (18% reduction vs. 7%) and between the magnitude in mortality reduction and the length of the training program. The observed correlation between team training program and improvement of patient outcomes does add to the belief that team training is valuable, but the analysis did not elucidate the mechanisms of patient outcome improvement from the team training intervention (Pawlik, Urbach, & Halverson, 2013). Additionally, focusing efforts into team training may carry the opportunity cost of other improvement strategies from a systems point of view.…”

Section: Strategies To Improve Teamworkmentioning

confidence: 99%

Teamwork and Collaboration

Xiao¹,

Parker²,

Manser³

2013

Reviews of Human Factors and Ergonomics

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Safety and quality of health care depend on collaborative efforts of multiprofessional and multidisciplinary teams of care providers. Team research in aviation and the military has produced a wealth of knowledge in terms of concepts and intervention strategies to improve team performance. Research on collaborative work in health care in the past 20 years has uncovered unique characteristics and requirements of teams in hospitals and other health care settings and has provided early assessment of the utility of the theoretical concepts, methodologies, and interventions developed outside health care. In this chapter, we review a set of concepts that have been used in characterizing teams in health care and in improving teamwork. These concepts include the organizational shell to capture the sociotechnical environment in which teams reside as well as nontechnical skills, team leadership, team mental models, and so on. We will review a number of leading interventions to enhance team performance, such as teamwork training (e.g., TeamSTEPPS) and structured communication (e.g., SBAR). Future directions are suggested on better understanding of the interdependencies between teams and their organizational shell, such as standardization of operating procedures and training, and to focus on the patient in terms of teamwork improvement.

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“…Currently, a large variation in content, duration, methods, and focus of team trainings is observed (Buljac-Samardzic & et al, 2010;Gross et al, 2019a). Existing studies are often aimed at the assessment and training of non-technical skills in specific specialty areas, such as operating rooms (ORs) (Pawlik, Urbach, Halverson, & Group, 2013;Wakeman & Langham, Jr., 2018), trauma teams (Lehner et al, 2017;Ziesmann, 2013), obstetrics (Mancuso et al, 2016;Riley et al, 2011), or emergency medicine (Haerkens, Kox, Noe, Van Der Hoeven, & Pickkers, 2018;Hicks, Bandiera, & Denny, 2008). However, the CRM principles that should be used in emergency situations are generic for all health care professionals and specialty areas (Gross et al, 2019a;Ostergaard, 2011).…”

mentioning

confidence: 99%