Mohamed Alsabri1, Zoubir Boudi2, Dominique Lauque, Roger Daglius Dias3, Julia S Whelan4, Linda Östlundh5, Guillaume Alinier, Churchill Onyeji1, Philippe Michel, Shan W Liu6, Carlos A Jr Camargo6, Tobias Lindner7, Anna Slagman7, David W Bates8, Karim Tazarourte, Sara J Singer9, Anita Toussi10, Shamai Grossman1, Abdelouahab Bellou. 1. From the Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Teaching Hospital of Harvard Medical School, Harvard Medical School, Boston, Massachusetts. 2. Department of Emergency Medicine, Dr Sulaiman Alhabib Hospital, Dubai, United Arab Emirates. 3. STRATUS Center for Medical Simulation, Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School. 4. MS Knowledge Services, Beth Israel Deaconess Medical Center, Boston, Massachusetts. 5. The National Medical Library, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates. 6. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. 7. Division of Emergency and Acute Medicine (CVK, CCM), Charité University Medicine, Berlin, Germany. 8. Department of Healthcare Quality, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts. 9. Department of Medicine, Division of Primary Care, Stanford University School of Medicine, Stanford, California. 10. ∥Department of Emergency Medicine, Union Hospital Terre Haute and Clinton IN, Simulation Center for Health Care Education, Indiana State University, Terre Haute, Indiana.
Abstract
OBJECTIVES: This study aimed to narratively summarize the literature reporting on the effect of teamwork and communication training interventions on culture and patient safety in emergency department (ED) settings. METHODS: We searched PubMed, EMBASE, Psych Info CINAHL, Cochrane, Science Citation Inc, the Web of Science, and Educational Resources Information Centre for peer-reviewed journal articles published from January 1, 1988, to June 8, 2018, that assessed teamwork and communication interventions focusing on how they influence patient safety in the ED. One additional search update was performed in July 2019. RESULTS: Sixteen studies were included from 8700 screened publications. The studies' design, interventions, and evaluation methods varied widely. The most impactful ED training interventions were End-of-Course Critique, Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), and crisis resource management (CRM)-based training. Crisis resource management and TeamSTEPPS CRM-based training curriculum were used in most of the studies. Multiple tools, including the Kirkpatrick evaluation model, the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, the TeamSTEPPS Teamwork Attitudes Questionnaire, the Safety Attitudes Questionnaire, and the Communication and Teamwork Skills Assessment, were used to assess the impact of such interventions. Improvements in one of the domains of safety culture and related domains were found in all studies. Four empirical studies established improvements in patient health outcomes that occurred after simulation CRM training (Kirkpatrick 4), but there was no effect on mortality. CONCLUSIONS: Overall, teamwork and communication training interventions improve the safety culture in ED settings and may positively affect patient outcome. The implementation of safety culture programs may be considered to reduce incidence of medical errors and adverse events.
OBJECTIVES: This study aimed to narratively summarize the literature reporting on the effect of teamwork and communication training interventions on culture and patient safety in emergency department (ED) settings. METHODS: We searched PubMed, EMBASE, Psych Info CINAHL, Cochrane, Science Citation Inc, the Web of Science, and Educational Resources Information Centre for peer-reviewed journal articles published from January 1, 1988, to June 8, 2018, that assessed teamwork and communication interventions focusing on how they influence patient safety in the ED. One additional search update was performed in July 2019. RESULTS: Sixteen studies were included from 8700 screened publications. The studies' design, interventions, and evaluation methods varied widely. The most impactful ED training interventions were End-of-Course Critique, Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), and crisis resource management (CRM)-based training. Crisis resource management and TeamSTEPPS CRM-based training curriculum were used in most of the studies. Multiple tools, including the Kirkpatrick evaluation model, the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, the TeamSTEPPS Teamwork Attitudes Questionnaire, the Safety Attitudes Questionnaire, and the Communication and Teamwork Skills Assessment, were used to assess the impact of such interventions. Improvements in one of the domains of safety culture and related domains were found in all studies. Four empirical studies established improvements in patient health outcomes that occurred after simulation CRM training (Kirkpatrick 4), but there was no effect on mortality. CONCLUSIONS: Overall, teamwork and communication training interventions improve the safety culture in ED settings and may positively affect patient outcome. The implementation of safety culture programs may be considered to reduce incidence of medical errors and adverse events.
Authors: Meabh Cullinane; Stefanie A Zugna; Helen L McLachlan; Michelle S Newton; Della A Forster Journal: BMJ Open Date: 2022-05-27 Impact factor: 3.006