A Human Factors Intervention in a Hospital - Evaluating the Outcome of a TeamSTEPPS Program in a Surgical Ward

Abstract

Background: Patient safety in hospitals is being jeopardized, since too many patients experience adverse events. Most of these adverse events arise from human factors, such as inefficient teamwork and communication failures, and the incidence of adverse events is greatest in the surgical area. Previous research has shown the effect of team training on patient safety culture and on different areas of teamwork. Limited research has investigated teamwork in surgical wards. The aim of this study was to evaluate the professional and organizational outcomes of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. Systems Engineering Initiative for Patient Safety 2.0 was used as a conceptual framework for the study. Methods: This study had a pre-post design with measurements at baseline and after 6 months and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and the study site was selected based on convenience and the leaders’ willingness to participate in the project. Survey data from healthcare professionals were used to evaluate the intervention. The organizational outcomes were measured by the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, and professional outcomes were measured by the TeamSTEPPS Teamwork Perceptions Questionnaire and the Collaboration and Satisfaction about Care Decisions in Teams Questionnaire. A paired t-test, a Wilcoxon signed-rank test, a generalized linear mixed model and linear regression analysis were used to analyze the data. Results: After six months, improvements were found in organizational outcomes in two patient safety dimensions. After 12 months, improvements were found in both organizational and professional outcomes, and these improvements occurred in three patient safety culture dimensions and in three teamwork dimensions. Furthermore, the results showed that one of the significant improved teamwork dimensions “Mutual Support” was associated with the Patient Safety Grade, after 12 months of intervention.Conclusion: These results demonstrate that the team training program had effect after 12 months of intervention. Future studies with larger sample sizes and stronger study designs are necessary to examine the causal effect of a team training intervention in this context.

Patient safety culture and associated factors in secondary health care of the Capital Region of Denmark: influence of specialty, healthcare profession and gender

“…Several reviews have demonstrated an effect of training emergency teams such as trauma-resuscitation surgical theatre teams 2 32. Recently, this has been shown for ward teams, too 33 34. Significant differences in PSC were found after a 12-month controlled study in two hospitals of a team-training intervention that focused on human factors, social and cognitive skills 34…”

Patients’ Perceptions of Quality of Care: A Teamwork Intervention Study in a Surgical Ward

“…The tools included in the TeamSTEPPS ® were implemented gradually during the intervention, and the teamwork competencies improved among the staff and thus improved patient safety in the surgical ward (Aaberg et al, 2021). The intervention affected the behavior and communication of the staff in their daily clinical practice at a surgical ward by allowing them to obtain a greater awareness and knowledge of their teamwork skills.…”

Pediatric Surgery Rounding Checklists

“…Daily rounds also serve as a rich learning environment for nurses, medical students, and surgeons-in-training, providing them the opportunity to observe and discuss best practices in care and develop their own clinical and diagnostic skills. Because of these contributing factors, the risk of adverse events in surgical care is higher than the 10% rate seen in overall hospital admissions (Aaberg et al, 2021; de Vries et al, 2008). Interestingly, most surgical errors occur outside the operating room, with many resulting from breakdowns in communication and teamwork (Greenberg et al, 2007).…”