Speaking Up Is Related to Better Team Performance in Simulated Anesthesia Inductions

Kolbe, Michaela; Burtscher, Michael J.; Wacker, Jürgen; Grande, Bastian; Nohynkova, Renata; Manser, Tanja; Spahn, Donat R.; Grote, Gudela

doi:10.1213/ane.0b013e318269cd32

Cited by 131 publications

(80 citation statements)

References 43 publications

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“…The vignettes were based on actual cases and were designed by the authors based on review of the literature,1 12 33 40 personal experience and consultation with medical and surgical residents, nursing leadership and experts in patient safety. The two vignettes were designed to determine whether respondents' perceived likelihood of speaking up differed between a traditional patient safety threat and a professionalism-related safety threat while accounting for any differences in the perceived potential for harm.…”

Section: Methodsmentioning

confidence: 99%

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents

et al. 2017

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Section: Methodsmentioning

confidence: 99%

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents

et al. 2017

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“…For example, there was empirical evidence that talking to the room is important for ACT performance in command and control,39 medical emergencies3 55 and in anaesthesia 34 45. Likewise, there was growing empirical evidence on the relevance of speaking up behaviour in ATCs in aviation56 and healthcare such as the operating room38 and anaesthesia 57 58. That is, the studies listed in the fifth column of online supplementary table S1 provided the empirical basis of the framework of coordination behaviour in ACTs.…”

Section: Resultsmentioning

confidence: 99%

Co-ACT—a framework for observing coordination behaviour in acute care teams

2013

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“…Speaking up is associated with improved clinical performance in anesthesia and surgical teams. 25,29,30 Because team members do not have to remember items when using the APIC, it serves as a tool for overcoming the limitations of prospective memory; that is, remembering to perform actions at the appropriate time. 31 Prospective memory is susceptible to failure (e.g., forgetting to check the suction device because of imposed time pressure) when disturbances occur.…”

Section: Discussionmentioning

confidence: 99%

“…This measure has been tested for interrater reliability and used to assess team performance in a number of studies. 23,25 Supplemental Table 1 (Supplemental Digital Content, http://links.lww.com/AA/B89) outlines the complete data collection protocol used in this study.…”

Section: Methodsmentioning

confidence: 99%

An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams

Tscholl

Weiss

Kolbe

et al. 2016

Survey of Anesthesiology

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BACKGROUND: An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked). METHODS: A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork. RESULTS: One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (P < 0.001), knowledge of critical information: 100% vs 90% (P < 0.001), perception of safety: 91% vs 84% (P < 0.001), perception of teamwork: 90% vs 86% (P = 0.028), and clinical performance: 93% vs 93% (P = 0.60). CONCLUSIONS: This study provides empirical evidence that the use of a preinduction checklist significantly improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams-all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork. The WHO Guidelines for Safe Surgery also encourage a formal inspection of the anesthetic equipment, breathing circuit, medications, and a patient's anesthetic risk before each case.The reason for introducing the separate anesthesia preinduction checklist (APIC), in addition to the already introduced WHO surgical safety checklist, was that the WHO surgical safety checklist contains only a few supercritical anesthesia items (e.g., checks of saturation sensor, but not electrocardiogram or blood pressure monitoring).In this study, we sought to evaluate whether the APIC complementing the WHO surgical safety checklist is suited to improve 5 team-level outcomes, each shown to be critical surrogate end points for patient safety: information exchange, knowledge of critical information, team members' perceptions of both safety and teamwork, and clinical performance. Figure 1 outlines the series of subitems assessed for the outcome scores: information exchange, knowledge of critical information, and clinical performance...

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Speaking Up Is Related to Better Team Performance in Simulated Anesthesia Inductions

Abstract: This study provides empirical evidence and shows mechanisms for the positive relationship between speaking-up behavior and technical team performance.

Cited by 131 publications

References 43 publications

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents

Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents

Co-ACT—a framework for observing coordination behaviour in acute care teams

An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams

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