Team Culture Training Initiative in a Midwestern Surgical Unit
Rodgers, Elizabeth C.
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Session presented on Saturday, April 9, 2016, and Friday, April 8, 2016: Objective and Background: The objective was to implement a standardized communication tool into a mid-western hospital's surgical team to improve safety culture survey response scores, after initiating a team training model. This tool can improve the process of reading back critical surgical information in the operating room. Effective teamwork and communication continues to be identified as a root cause for patient errors in hospitals (Minnesota Department of Health, 2012). Successful collaboration of the operating room team is vital to safe patient care and communication. The perception of teamwork has been rated poorly by hospital employees within recent studies (Agency for Healthcare Research and Quality, 2014). In a midwestern community hospital, teamwork perception reported by surgical RNs was rated at a t-test result of 68.46, compared to the national mean of 70.95 (NDNQI, 2013) Critical event reviews have discovered that readback of critical information was a cause of error, and an interdisciplinary team revealed that a standardized tool is necessary to improve quality of care. Methods: The team culture training was focused on utilization of an evidence-based approach, TeamSTEPPS, combined with the tactics of partnership, collaboration and communication to improve culture. TEAMSTEPPS is an evidence-based framework with specific communication tools that can be adapted by teams to improve communication (AHRQ, 2014). The TEAMSTEPPS tool was implemented after staff attended an in-service where they learned key TeamSTEPPS tools. The facility where this project was implemented individualized the standardized tool and introduced this tool into practice in July 2014. The interdisciplinary team was chose to use the debrief tool at the end of the surgical procedure and last less than three minutes. Results: Overall, the staff satisfaction with the debrief tool was rated highly. There was a significant increase in the AHRQ question that related to how mistakes led to positive changes. In 2014 this was reported at 85% compared to 2012 at 72%. The teams perception of safety was assessed using the 'Safety Attitudes Questionnaire' (Carney, West, Neily, and Mills, 2011, p. 182) with a pre-post test design. The surgical team's response for feeling comfortable when something doesn't seem right showed a 22% increase from 2012 to 2014. Conclusion: In summary, this project shows the impact of implementing partnerships with staff in initiation of standardized tools to improve communication. The debrief tool was created by the interprofessional, guiding team. These members were involved in recent critical events in the department, and were engaged in this process. These team members then led the larger group in an educational intervention of one of the processes in TeamSTEPPS.