J Pediatr Intensive Care 2019; 08(04): 195-203
DOI: 10.1055/s-0039-1688928
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Can Simulation Based-Team Training Impact Bedside Teamwork in a Pediatric Intensive Care Unit?

1   Department of Pediatrics, Division of Critical Care, Children’s Healthcare of Atlanta, Atlanta, Georgia, United States
2   Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
,
2   Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
,
Courtney McCracken
2   Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
,
Kiran B. Hebbar
1   Department of Pediatrics, Division of Critical Care, Children’s Healthcare of Atlanta, Atlanta, Georgia, United States
2   Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia, United States
› Author Affiliations
Further Information

Publication History

11 January 2019

28 March 2019

Publication Date:
16 May 2019 (online)

Abstract

Effective teamwork performance is essential to the delivery of high-quality and safe patient care. In this mixed methodological observational cohort study, we evaluated team performance immediately following a real medical crisis in a pediatric intensive care unit (PICU) following implementation of a simulation-based team training (SBTT) program. Comparison of teamwork skills when rated by study observers demonstrated a statistically significant improvement in 12 out of 15 composite teamwork skills during real emergency events following SBTT (p < 0.05). Pre- and post-SBTT intervention survey data demonstrated an improvement in the perception of teamwork, most notable in the area of shared mental model and situational awareness following SBTT. Study results suggest that teamwork behaviors and skills acquired during SBTT can translate into improved bedside performance in the PICU.

Note

This study was performed in the Division of Pediatric Critical Care at Children's Healthcare of Atlanta, Emory University. The paper falls under the nonhuman subject category and was approved by the Children's Healthcare of Atlanta Institutional Review Board.


Authors' Contributions

Dr. Colman performed background research, designed and conceptualized the study, collected data, prepared the article, and approved the final version as submitted. She had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Janet Figueroa and Courtney McCracken assisted in the study methodology, carried out the initial statistical analyses, developed the figures and tables, reviewed and revised the article, and approved the article as submitted. Dr. Hebbar conceptualized and designed the study, collected data, directed analysis, reviewed and revised the article, and approved the article as submitted.


 
  • References

  • 1 Dietz AS, Pronovost PJ, Mendez-Tellez PA. , et al. A systematic review of teamwork in the intensive care unit: what do we know about teamwork, team tasks, and improvement strategies?. J Crit Care 2014; 29 (06) 908-914
  • 2 Mazzocco K, Petitti DB, Fong KT. , et al. Surgical team behaviors and patient outcomes. Am J Surg 2009; 197 (05) 678-685
  • 3 Schmutz J, Manser T. Do team processes really have an effect on clinical performance? A systematic literature review. Br J Anaesth 2013; 110 (04) 529-544
  • 4 Hunziker S, Johansson AC, Tschan F. , et al. Teamwork and leadership in cardiopulmonary resuscitation. J Am Coll Cardiol 2011; 57 (24) 2381-2388
  • 5 Roberts NK, Williams RG, Schwind CJ. , et al. The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings. Am J Surg 2014; 207 (02) 170-178
  • 6 Kitch BT, Cooper JB, Zapol WM. , et al. Handoffs causing patient harm: a survey of medical and surgical house staff. Jt Comm J Qual Patient Saf 2008; 34 (10) 563-570
  • 7 Marsch SC, Müller C, Marquardt K, Conrad G, Tschan F, Hunziker PR. Human factors affect the quality of cardiopulmonary resuscitation in simulated cardiac arrests. Resuscitation 2004; 60 (01) 51-56
  • 8 Hunziker S, Tschan F, Semmer NK, Marsch S. Importance of leadership in cardiac arrest situations: from simulation to real life and back. Swiss Med Wkly 2013; 143: w13774
  • 9 Catchpole K, Mishra A, Handa A, McCulloch P. Teamwork and error in the operating room: analysis of skills and roles. Ann Surg 2008; 247 (04) 699-706
  • 10 Baker DP, Amodeo AM, Krokos KJ, Slonim A, Herrera H. Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire. Qual Saf Health Care 2010; 19 (06) e49
  • 11 Stelfox HT, Palmisani S, Scurlock C, Orav EJ, Bates DW. The “To Err is Human” report and the patient safety literature. Qual Saf Health Care 2006; 15 (03) 174-178
  • 12 Volk MS, Ward J, Irias N, Navedo A, Pollart J, Weinstock PH. Using medical simulation to teach crisis resource management and decision-making skills to otolaryngology housestaff. Otolaryngol Head Neck Surg 2011; 145 (01) 35-42
  • 13 Morgan L, Hadi M, Pickering S. , et al. The effect of teamwork training on team performance and clinical outcome in elective orthopaedic surgery: a controlled interrupted time series study. BMJ Open 2015; 5 (04) e006216
  • 14 Morey JC, Simon R, Jay GD. , et al. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res 2002; 37 (06) 1553-1581
  • 15 Gilfoyle E, Koot DA, Annear JC. , et al; Teams4Kids Investigators and the Canadian Critical Care Trials Group. Improved clinical performance and teamwork of pediatric interprofessional resuscitation teams with a simulation-based educational intervention. Pediatr Crit Care Med 2017; 18 (02) e62-e69
  • 16 Nora Colman JF, McCracken C, Figueroa J, Hebbar KB. Simulation-based team training improves team performance among pediatric intensive care staff. J Pediatr Intensive Care 2018 Doi: 10.1055/s-0038-1676469
  • 17 Volk MS. Improving team performance through simulation-based learning. Otolaryngol Clin North Am 2017; 50 (05) 967-987
  • 18 Guise JM, Deering SH, Kanki BG. , et al. Validation of a tool to measure and promote clinical teamwork. Simul Healthc 2008; 3 (04) 217-223
  • 19 Adler MD, Overly FL, Nadkarni VM. , et al; International Network for Simulation-Based Pediatric Innovation, Research and Education (INSPIRE) CPR Investigators. An approach to confederate training within the context of simulation-based research. Simul Healthc 2016; 11 (05) 357-362
  • 20 Chamberlain DA, Hazinski MF. , et al; European Resuscitation C. Education in resuscitation: an ILCOR symposium: Utstein Abbey: Stavanger, Norway: June 22–24, 2001. Circulation 2003; 108 (20) 2575-94
  • 21 Makary MA, Sexton JB, Freischlag JA. , et al. Operating room teamwork among physicians and nurses: teamwork in the eye of the beholder. J Am Coll Surg 2006; 202 (05) 746-752
  • 22 Lin Y, Cheng A. The role of simulation in teaching pediatric resuscitation: current perspectives. Adv Med Educ Pract 2015; 6 (05) 239-248
  • 23 Allan CK, Thiagarajan RR, Beke D. , et al. Simulation-based training delivered directly to the pediatric cardiac intensive care unit engenders preparedness, comfort, and decreased anxiety among multidisciplinary resuscitation teams. J Thorac Cardiovasc Surg 2010; 140 (03) 646-652
  • 24 Leipzig RM, Hyer K, Ek K. , et al. Attitudes toward working on interdisciplinary healthcare teams: a comparison by discipline. J Am Geriatr Soc 2002; 50 (06) 1141-1148
  • 25 Huang DT, Clermont G, Sexton JB. , et al. Perceptions of safety culture vary across the intensive care units of a single institution. Crit Care Med 2007; 35 (01) 165-176