Measuring non-technical skills during prehospital advanced cardiac life support: A pilot study

Abstract

Aim To analyse non-technical skills of mobile medical teams during out-of-hospital cardiac arrests (OHCA) using the validated Team Emergency Assessment Measure (TEAM) tool. To research the correlation between non-technical skills and patient outcome. Methods Adult patients who experienced an out-of-hospital cardiac arrest between July 2016, and June 2018, and were treated by a mobile medical team from the University Hospital Leuven, were eligible for the study. Resuscitations were video recorded from the team leader’s perspective. Video recordings were reviewed and scored by emergency physicians, using the TEAM evaluation form. Results In total 114 OHCAs were analysed. The mean TEAM score was 34.4/44 (SD = 5.5). The mean item score was 3.1/4 (SD = 0.8). On average, ‘effective team communication’ had the lowest score (2.4), while ‘acting with composure and control’ and ‘following of approved standards/guidelines’ scored the highest (3.4). The average non-technical skills theme scores were 2.9 (SD = 0.9) for ‘Leadership’, 3.1 (SD = 0.8) for ‘Teamwork’ and 3.3 (SD = 0.7) for ‘Task management’. ‘Leadership’ was rated significantly lower than ‘Teamwork’ (p = 0.004) and ‘Task management’ (p < 0.001). No significant correlation was found between TEAM and return of spontaneous circulation (p = 0.574) or one month survival (p = 0.225). Conclusion The mean overall TEAM score was categorized as good. Task management scored high, while leadership and team communication received lower scores. Future training programs should thus focus on improving leadership and communication. In this pilot study no correlation was found between non-technical skills and survival.

Non-technical skills in pre-hospital care in the Czech Republic: a prospective multicentric observational study (NTS study)

“…CPR is “strictly” algorithm-driven, and thus it might be easier for the team leader to instruct the crew members and for team members to follow. Our results that are completely different from those of a recently published study of 114 cases of hospital cardiac arrest, where the leadership was evaluated as the worst [ 17 ]. This situation can be partly explained by the fact that the most common training, where aspects of NTS and leadership are also explained, are the Advanced Life Support courses of the European Resuscitation Council, which are widespread in the Czech Republic.…”

“…So far, similar results were published only from the hospital environment or simulations or clinical situations with a focus on one part of the non-technical skills or during events of out-of-hospital cardiac arrest only [ 6 , 15 – 17 ]. The presented data are comparable in terms of consistency and reliability, but also in terms of the values of the results with the original work, and sufficient data consistency and interrater variability was observed, calculated and published [ 7 – 11 , 16 , 18 ].…”

“…However, based on the pilot findings, the researchers used a simplified form for field supervisors to work in pre-hospital care. In this study we evaluated the situation on the spot, not later, for example from a video recording [ 17 ].…”