scholarly journals Multi-professional simulation-based team training in obstetric emergencies for improving patient outcomes and trainees' performance

2020 ◽  
Author(s):  
Annemarie F Fransen ◽  
Joost van de Ven ◽  
Franyke R Banga ◽  
Ben Willem J Mol ◽  
S Guid Oei
Keyword(s):  
Patient Outcomes ◽  
Team Training ◽  
Simulation Based ◽  
Obstetric Emergencies

scholarly journals Reducing door-to-needle times in stroke thrombolysis to 13 min through protocol revision and simulation training: a quality improvement project in a Norwegian stroke centre

2019 ◽  
Vol 28 (11) ◽  
pp. 939-948 ◽  
Author(s):  
Soffien Chadli Ajmi ◽  
Rajiv Advani ◽  
Lars Fjetland ◽  
Kathinka Dehli Kurz ◽  
Thomas Lindner ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Patient Outcomes ◽  
Treatment Protocol ◽  
Team Training ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
In Situ Simulation ◽  
Simulation Based ◽  
Stroke Thrombolysis

BackgroundIn eligible patients with acute ischaemic stroke, rapid revascularisation is crucial for good outcome. At our treatment centre, we had achieved and sustained a median door-to-needle time of under 30 min. We hypothesised that further improvement could be achieved through implementing a revised treatment protocol and in situ simulation-based team training sessions. This report describes a quality improvement project aiming to reduce door-to-needle times in stroke thrombolysis.MethodsAll members of the acute stroke treatment team were surveyed to tailor the interventions to local conditions. Through a review of responses and available literature, the improvement team suggested changes to streamline the protocol and designed in situ simulation-based team training sessions. Implementation of interventions started in February 2017. We completed 14 simulation sessions from February to June 2017 and an additional 12 sessions from November 2017 to March 2018. Applying Kirkpatrick’s four-level training evaluation model, participant reactions, clinical behaviour and patient outcomes were measured. Statistical process control charts were used to demonstrate changes in treatment times and patient outcomes.ResultsA total of 650 consecutive patients, including a 3-year baseline, treated with intravenous thrombolysis were assessed. Median door to needle times were significantly reduced from 27 to 13 min and remained consistent after 13 months. Risk-adjusted cumulative sum charts indicate a reduced proportion of patients deceased or bedridden after 90 days. There was no significant change in balancing measures (stroke mimics, fatal intracranial haemorrhage and prehospital times).ConclusionsImplementing a revised treatment protocol in combination with in situ simulation-based team training sessions for stroke thrombolysis was followed by a considerable reduction in door-to-needle times and improved patient outcomes. Additional work is needed to assess sustainability and generalisability of the interventions.

Cost-effectiveness of simulation-based team training in obstetric emergencies (TOSTI study)

2017 ◽  
Vol 216 ◽  
pp. 130-137 ◽  
Author(s):  
J. van de Ven ◽  
G.J. van Baaren ◽  
A.F. Fransen ◽  
P.J. van Runnard Heimel ◽  
B.W. Mol ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Team Training ◽  
Simulation Based ◽  
Obstetric Emergencies

scholarly journals Evaluation of the effect of multidisciplinary simulation-based team training on patients, staff and organisations: protocol for a stepped-wedge cluster-mixed methods study of a national, insurer-funded initiative for surgical teams in New Zealand public hospitals

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e032997 ◽  
Author(s):  
Jennifer Weller ◽  
Jennifer Anne Long ◽  
Peter Beaver ◽  
David Cumin ◽  
Chris Frampton ◽  
...  
Keyword(s):  
New Zealand ◽  
Patient Outcomes ◽  
Team Training ◽  
Training Intervention ◽  
Surgical Patient ◽  
Ethic Committee Approval ◽  
Stepped Wedge ◽  
Simulation Based ◽  
Surgical Teams ◽  
Multidisciplinary Simulation

IntroductionNetworkZ is a national, insurer-funded multidisciplinary simulation-based team-training programme for all New Zealand surgical teams. NetworkZ is delivered in situ, using full-body commercial simulators integrated with bespoke surgical models. Rolled out nationally over 4 years, the programme builds local capacity through instructor training and provision of simulation resources. We aim to improve surgical patient outcomes by improving teamwork through regular simulation-based multidisciplinary training in all New Zealand hospitals.Methods and analysisOur primary hypothesis is that surgical patient outcomes will improve following NetworkZ. Our secondary hypotheses are that teamwork processes will improve, and treatment injury claims will decline. In addition, we will explore factors that influence implementation and sustainability of NetworkZ and identify organisational changes following its introduction. The study uses a stepped-wedge cluster design. The intervention will roll out at yearly intervals to four cohorts of five District Health Boards. Allocation to cohort was purposive for year 1, and subsequently randomised. The primary outcome measure is Days Alive and Out of Hospital at 90 days using patient data from an existing national administrative database. Secondary outcomes measures will include analysis of postoperative complications and treatment injury claims, surveys of teamwork and safety culture, in-theatre observations and stakeholder interviews.Ethics and disseminationWe believe this is the first surgical team training intervention to be implemented on a national scale, and a unique opportunity to evaluate a nation-wide team-training intervention for healthcare teams. By using a pre-existing large administrative data set, we have the potential to demonstrate a difference to surgical patient outcomes. This will be of interest to those working in the field of healthcare teamwork, quality improvement and patient safety. New Zealand Health and Disability Ethic Committee approval (#16/NTB/143).Trial registration numberAustralian and New Zealand Clinical Trials Registry ID ACTRN12617000017325 and the Universal Trial Number is U1111-1189-3992.

Simulation-based team training in paediatric units

2017 ◽  
pp. e-61032
Author(s):  
Irene Rød ◽  
Ellen Irene Westby Moen ◽  
Solveig Struksnes
Keyword(s):  
Team Training ◽  
Simulation Based

Abstract 15595: Improved Clinical Performance and Teamwork of Pediatric Interprofessional Resuscitation Teams With a Simulation-Based Educational Intervention

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Elaine Gilfoyle ◽  
Deanna Koot ◽  
John Annear ◽  
Farhan Bhanji ◽  
Adam Cheng ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Strong Correlation ◽  
Clinical Performance ◽  
Team Training ◽  
Chest Compressions ◽  
Team Members ◽  
Pediatric Resuscitation ◽  
Time To Initiation ◽  
Simulation Based ◽  
Resuscitation Team

Introduction: Human errors occur during resuscitation despite individual knowledge of resuscitation guidelines. Poor teamwork has been implicated as a major source of such error; therefore interprofessional resuscitation teamwork training is essential. Hypothesis: A one-day team training course for pediatric interprofessional resuscitation team members improves adherence to PALS guidelines, team efficiency and teamwork in a simulated clinical environment. Methods: A prospective interventional study was conducted at 4 children’s hospitals in Canada with pediatric resuscitation team members (n=300, 51 teams). Educational intervention was a one-day simulation-based team training course involving interactive lecture, group discussions and 4 simulated resuscitation scenarios followed by debriefing. First scenario of the day was conducted prior to any training. Final scenario of the day was the same scenario, with modified patient history. Scenarios included standardized distractors designed to elicit and challenge specific teamwork behaviors. Primary outcome measure was change (before and after training) in adherence to PALS guidelines, as measured by the Clinical Performance Tool (CPT). Secondary outcome measures: change in times to initiation of chest compressions and defibrillation; and teamwork performance, as measured by the Clinical Teamwork Scale (CTS). Correlation between CPT and CTS scores was analyzed. Results: Teams significantly improved CPT scores (67.3% to 79.6%, P< 0.0001), time to initiation of chest compressions (60.8 sec to 27.1 sec, P<0.0001), time to defibrillation (164.8 sec to 122.0 sec, P<0.0001) and CTS scores (56.0% to 71.8%, P<0.0001). Significantly more teams defibrillated under AHA target of 2 minutes (10 vs. 27, P<0.01). A strong correlation was found between CPT and CTS (r=0.530, P<0.0001). Conclusions: Participation in a simulation-based team training educational intervention significantly improved surrogate measures of clinical performance, time to initiation of key clinical tasks, and teamwork during simulated pediatric resuscitation. A strong correlation between clinical and teamwork performance suggests that effective teamwork optimizes clinical performance of resuscitation teams.

Management of the deteriorating adult patient: does simulation-based education improve patient safety?

2021 ◽  
pp. 1-8
Author(s):  
Jacqueline Bennion ◽  
Stephanie K Mansell
Keyword(s):  
Human Factors ◽  
Adult Patient ◽  
Patient Outcomes ◽  
Improve Patient Safety ◽  
Low Grade ◽  
Contributing Factors ◽  
Educational Method ◽  
Simulation Based ◽  
The Impact

Failure to recognise the deteriorating patient can cause severe harm and is related to preventable death. Human factors are often identified as contributing factors. Simulation-based education is used to develop clinicians' human factors skills. This article discusses the evidence concerning the efficacy of simulation-based education for improving the recognition and management of the acutely deteriorating adult patient, and the limitations of simulation-based education. Findings demonstrated simulation-based education was the most effective educational method identified for training staff in recognising unwell patients. The evidence demonstrating the impact of simulation-based education on patient outcomes was equivocal. The quality of the evidence was low grade regarding the efficacy of simulation-based education on human factors. Further research is required to confirm the efficacy of simulation-based education for human factors and patient outcomes.

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