Towards a safer culture: implementing multidisciplinary simulation-based team training in New Zealand operating theatres - a framework analysis

Abstract

AimNetworkZ is a simulation-based multidisciplinary team-training programme designed to enhance patient safety by improving communication and teamwork in operating theatres (OTs). In partnership with the Accident Compensation Corporation, its implementation across New Zealand (NZ) began in 2017. Our aim was to explore the experiences of staff – including the challenges they faced – in implementing NetworkZ in NZ hospitals, so that we could improve the processes necessary for subsequent implementation.MethodWe interviewed staff from five hospitals involved in the initial implementation of NetworkZ, using the Organising for Quality model as the framework for analysis. This model describes embedding successful quality improvement as a process of overcoming six universal challenges: structure, infrastructure, politics, culture, motivation and learning.ResultsThirty-one people participated. Structural support within the hospital was considered essential to maintain staff enthusiasm, momentum and to embed the programme. The multidisciplinary, simulation-based approach to team training was deemed a fundamental infrastructure for learning, with participants especially valuing the realistic in situ simulations and educational support. Participants reported positive changes to the OT culture as a result of NetworkZ and this realisation motivated its implementation. In sites with good structural support, NetworkZ implementation proceeded quickly and participants reported rapid cultural change towards improved teamwork and communication in their OTs.ConclusionImplementation challenges exist and strategies to overcome these are informing future implementation of NetworkZ. Embedding the programme as business as usual across a nation requires significant and sustained support at all levels. However, the potential gains in patient safety and workplace culture from widespread multidisciplinary team training are substantial. Trial registration number ACTRN12617000017325.

The effect of interprofessional education on the work environment of health professionals: a scoping review

“…With respect to context, we will now address the countries where the interventions were carried out and the specific settings in which the IPE strategies were implemented. Regarding the countries, we found that all studies were conducted in countries belonging to the Global North, such as the United States (Carney et al, 2019;Dematteo & Reeves, 2011;Gros et al, 2021;Lee et al, 2021;Marrone, 2018;Nagelkerk et al, 2014;Rider et al, 2019;Roberts et al, 2014;Wong et al, 2016), Canada (Bajnok et al, 2012;Christofilos et al, 2015;Villemure et al, 2019), Australia (Braithwaite et al, 2013;Brewer & Flavell, 2020), New Zealand (Jowsey et al, 2019;Pullon & Fry, 2005), United Kingdom (Hinde et al, 2016;Slater et al, 2012), Germany (Tahtali et al, 2017), Sweden (Meurling et al, 2013) and Switzerland (Kolbe et al, 2013). The clinical settings were heterogeneous, with a predominance (Christofilos et al, 2015;Dematteo & Reeves, 2011;Gros et al, 2021;Kolbe et al, 2013;Marrone, 2018;Meurling et al, 2013;Roberts et al, 2014;Villemure et al, 2019;Wong et al, 2016).…”

“…Significant methodological variability was observed in the papers. Specifically, five documents were found to have a qualitative approach (Brewer & Flavell, 2020;Christofilos et al, 2015;Dematteo & Reeves, 2011;Jowsey et al, 2019;Rider et al, 2019), among which there were two exploratory phenomenological papers (Brewer & Flavell, 2020;Jowsey et al, 2019), two based on grounded theory (Christofilos et al, 2015;Rider et al, 2019) and one case study (Dematteo & Reeves, 2011). In addition, there were six mixed-methods studies (Bajnok et al, 2012;Carney et al, 2019;Kolbe et al, 2013;Lee et al, 2021;Nagelkerk et al, 2014;Slater et al, 2012) and ten quantitative studies (Braithwaite et al, 2013;Gros et al, 2021;Hinde et al, 2016;Marrone, 2018;Meurling et al, 2013;Roberts et al, 2014;Tahtali et al, 2017;Villemure et al, 2019;Wong et al, 2016).…”

The flip side of speaking up: a new model to facilitate positive responses to speaking up in the operating theatre

“…These 'ripple' effects reinforce the importance of interventions for senior staff about responding to concerns raised by team members. In multidisciplinary simulation-based team training, 30 where flattened hierarchies can be created during the debriefing discussions, senior clinical staff hear the views of others, and may be made more aware of their influence on the team and on subsequent patient care.…”

Análisis de perfil cognitivo, bienestar psicológico y habilidades sociales en personas que se dedican al teatro, en una muestra de teatristas de Panamá durante el año 2023

“…El teatro es una herramienta con la que cuentan distintos ámbitos para mejorar los procesos, la forma en la que podrían enfrentar las situaciones de su trabajo, mejorar la comunicación y el trabajo en equipo en ámbitos tan especializados como lo son los quirófanos de los hospitales, indicando que con esta práctica se mejora la cohesión del hospital, el entusiasmo e impulso del personal y la integración del equipo a los distintos programas (Jowsey et al, 2019;Robertson et al, 2015). Además, el uso del teatro para mejorar las competencias de los estudiantes de forma interdisciplinar para abordar distintos casos simulados, se indica como una adecuada estrategia para lograr impacto positivo en el aprendizaje de las competencias básicas interprofesionales (Wen et al, 2019).…”