Enhancing Communication in Surgery Through Team Training Interventions: A Systematic Literature Review

Gillespie, Brigid Mary; Chaboyer, Wendy; Murray, Patrick Stuart

doi:10.1016/j.aorn.2010.02.015

Cited by 59 publications

(54 citation statements)

References 36 publications

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“…Key search terms included ‘team-training’, ‘teamwork training’, ‘teamwork training interventions’, ‘crew resource management’, ‘TeamSTEPPS’ and related terms. Following identification of relevant reviews with searches terminating in 2008,13 200912 21 and 2010,24 25 a search of PubMed and PSNet was completed to identify additional primary studies published between 1 January 2011 and 31 December 2012. Studies were excluded if they were only descriptive in nature, if conducted in non-English-speaking populations or if primarily targeting students or trainees.…”

Section: Methodsmentioning

confidence: 99%

Team-training in healthcare: a narrative synthesis of the literature

2014

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BackgroundPatients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings.MethodsA PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes.ResultsBoth simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice.ConclusionsOverall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.

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Section: Methodsmentioning

confidence: 99%

Team-training in healthcare: a narrative synthesis of the literature

2014

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“…Team training is also an important tool to improve teamwork (1,3). This may reduce risks and reduce tension between professions during surgery and increase patient safety.…”

Section: Interaction Between Team Members In the Operating Theatrementioning

confidence: 99%

Respecting as a basic teamwork process in the operating theatre - A qualitative study of theatre nurses who work in interdisciplinary surgical teams of what they see as important factors in this collaboration

Kaldheim¹,

Slettebø²

2016

NSF

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Background: Studies show that working as a team in the operating theatre can be a challenge, and that surgical teams are not so cohesive as might be expected.Methods: A qualitative approach with exploratory design was used, inspired by grounded theory (GT) as a methodology. The data are from semi-structured, open questions, interviews with eight female theatre nurses from four Norwegian operational units.Results: The study shows that the most important factor in the social process between theatre nurses co-operating with other team members, is respecting. This includes interactions where: the attitudes expressed make team members feel valued; team members show an understanding for each other; team members communicate constructively. The leader's role is to encourage the right attitudes, focusing on respect for one another.Conclusion: The study shows that cooperation is an inter-human process, which requires the presence of multiple factors in the relations between professionals. Organizational factors also play a decisive role in enhancing the quality of inter-disciplinary work. Strengthening teamwork can be a complex task in a multidisciplinary surgical team where conflicting professional identities exist. Here, organisational factors play a crucial role in improving the quality of interdisciplinary collaboration.Key words: Professions, social structure, team communication, interdisciplinary collaboration and respect. INTERACTION BETWEEN TEAM MEMBERS IN THE OPERATING THEATRE IntroductionOperating theatres are high-intensity, often high-stress, environments where team members must work together to provide patient-centered care. The working day for interdisciplinary surgical teams is often characterized by heavy workloads and demanding requirements for efficient use of time and resources (1 -4). An interdisciplinary surgical team is composed of a selection of specialized nurses (one to two nurse anaesthetists and two theatre nurses), physicians (one anaesthetist physician), and surgeons (one to two operators) (5). These teams are typically put together ad-hoc. Team memberships do not carry over from day to day (5).Salas et al. (6) define a team as "a distinguishable set of two or more people who interact dynamically, interdependently, and adaptively toward a common and valued goal, objective or mission, who have each been assigned specific roles or functions to perform, and who have limited life span of membership" (6, p. 4). Team members perform dynamic and interdependent tasks, sharing and adapting to common goals and carrying out specified roles and functions (7). Teamwork is an essential component of patient safety (1,8). Collaboration happens when multiple health workers from different professional backgrounds work together to deliver the highest quality of health care (9). Studies show that collaboration as an interdisciplinary surgical team in the operating theatre can be a challenge. "Group norms, roles, and the way one treats each other says something about how well the group works" (10, p. 92). ...

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“…Perhaps with a larger sample size we may have been able to demonstrate such a relationship. There is little doubt that preoperative prebriefings facilitate open disclosure of relevant information, and as such, represents a shift away from monological communication to dialogical communication in surgery 17 19. Yet, despite prebriefings being a mandated practice in the study hospital, it appeared that the team tripartite (anaesthesia, surgery, nursing) in our study were accustomed to thinking and working independently rather than working in a unitary manner, a notion echoed elsewhere 15 23 24 37.…”

Section: Discussionmentioning

confidence: 65%