scholarly journals Longitudinal team training program in a Norwegian surgical ward: a qualitative study of nurses’ and physicians’ experiences with implementation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Randi Ballangrud ◽  
Karina Aase ◽  
Anne Vifladt

Abstract Background Team training interventions to improve team effectiveness within healthcare are widely used. However, in-depth knowledge of how healthcare professionals experience such team training curricula and their implementation processes, as well as how contextual factors impact implementation, is currently missing. The aim of this study is therefore to describe healthcare professionals’ experiences with the implementation of a longitudinal interprofessional team training program in a surgical ward. Methods A descriptive design was applied based on qualitative semi-structured focus group interviews with 11 healthcare professionals. A convenience sample of physicians (n = 4), registered nurses (n = 4), and certified nursing assistants (n = 3) was divided into three professionally based focus groups, which were interviewed at three time intervals over a period of 1 year. Intervention The validated and evidence-based team training program Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) was implemented in a surgical ward at a hospital between January 2016 and June 2017. The team training program included three phases: 1) assessment and planning, 2) training and implementation, and 3) sustainment. Results Healthcare professionals’ experiences with the content of the team training program varied from valuing the different elements of it to seeing the challenges in implementing the elements in clinical practice. A one-day training course was found to be especially beneficial for interprofessional collaboration at the ward. Over time, the nursing staff seemed to maintain their motivation for the implementation of the tools and strategies, while the physicians became less actively involved. Contextual ward factors influenced the adoption and utilization of the tools and strategies of the program both positively and negatively. The healthcare professionals’ experienced the implementation of the team training program as positive for the patient safety culture at the ward in the forms of increased awareness of teamwork and open communication. Conclusions The study suggests that the implementation of a team training program in a surgical ward is dependent on a set of factors related to content, process, context, and impact. Knowledge on how and why a team training program work supports the transferability to clinical practice in further planning of team training measures. Trial registration The study is part of a larger research project with a study protocol that was registered retrospectively on 05.30.17, with the trial registration number ISRCTN13997367.

2020 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

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.Trial registration number: ISRCTN13997367 (retrospectively registered)


2021 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

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.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

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 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 6 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. Trial registration number ISRCTN13997367 (retrospectively registered).


2020 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Background Patient safety in hospitals is being jeopardized, as too many patients experience adverse events. Most of the 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 the study was to evaluate the outcome of a team training intervention among healthcare professionals in a surgical ward after 6 and 12 months. The 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, after 6 months and 12 months of intervention. The intervention was conducted in a urology and gastrointestinal surgery ward in Norway, and study site was selected based on the leaders’ willingness to participate in the project. Survey data from healthcare professionals, measured by the TeamSTEPPS Teamwork Perceptions Questionnaire, the Collaboration and Satisfaction about Care Decisions in Teams, and the unit-based sections of the Hospital Survey of Patient Safety Culture Questionnaire, were used to evaluate the intervention. 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, that was in three patient safety culture dimensions and three teamwork dimensions. The generalized linear mixed model estimates demonstrated that physicians had effect on two patient safety culture measures. Furthermore, results showed that teamwork was associated with the organizational outcome Patient Safety Grade.Conclusion These results demonstrate that the team training program had an effect after 12 months of implementation. Future studies are recommended to examine the causal effect of a team training intervention in this context, preferably with studies with larger sample sizes and stronger study designs.Trial registration number:ISRCTN13997367 (retrospectively registered)


2019 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Objectives: Interprofessional team training has a positive impact on team behavior and patient safety culture. The objective of the study was to explore the impact of an interprofessional teamwork intervention in a surgical ward on structure, process and outcome. In this paper, the implementation of the teamwork intervention is reported to expand the understanding of the future evaluation results of this study. Results: The evidence-based Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program in the ward was implemented in three phases according to the program’s implementation plan, which are built on Kotter’s organizational change model. In the first phase, a project group with the leaders and researchers was established and information about the project was given to all health care personnel in the ward. The second phase comprised six hours interprofessional team training for all frontline health care personnel followed by 12 months implementation of TeamSTEPPS tools and strategies. In the third phase, the implementation of the tools and strategies continued, and refresher training was conducted. Trial registration: Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date May 30, 2017. Keywords: Implementation, Inter-professional, Intervention, Patient safety, Surgical ward, Team training, TeamSTEPPS


2019 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Objectives: Interprofessional team training has a positive impact on team behavior and patient safety culture. The objective of the study was to explore the impact of an interprofessional teamwork intervention in a surgical ward on structure, process and outcome. In this paper, the implementation of the teamwork intervention is reported to expand the understanding of the future evaluation results of this study. Results: The evidence-based Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program in the ward was implemented in three phases according to the program’s implementation plan, which are built on Kotter’s organizational change model. In the first phase, a project group with the leaders and researchers was established and information about the project was given to all health care personnel in the ward. The second phase comprised six hours interprofessional team training for all frontline health care personnel followed by 12 months implementation of TeamSTEPPS tools and strategies. In the third phase, the implementation of the tools and strategies continued, and refresher training was conducted. Trial registration: Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date May 30, 2017. Keywords: Implementation, Inter-professional, Intervention, Patient safety, Surgical ward, Team training, TeamSTEPPS


2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Objectives Interprofessional team training has a positive impact on team behavior and patient safety culture. The overall objective of the study was to explore the impact of an interprofessional teamwork intervention in a surgical ward on structure, process and outcome. In this paper, the implementation of the teamwork intervention is reported to expand the understanding of the future evaluation results of this study. Results The evidence-based Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program was implemented in three phases according to the program’s implementation plan, which are built on Kotter’s organizational change model. In the first phase, a project group with the leaders and researchers was established and information about the project was given to all health care personnel in the ward. The second phase comprised 6 h interprofessional team training for all frontline health care personnel followed by 12 months implementation of TeamSTEPPS tools and strategies. In the third phase, the implementation of the tools and strategies continued, and refresher training was conducted. Trial registration Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date May 30, 2017


2019 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Objectives: Interprofessional team training has a positive impact on team behavior and patient safety culture. The objective of the study was to explore the impact of an interprofessional teamwork intervention in a surgical ward on structure, process and outcome. In this paper, the implementation of the teamwork intervention is reported to expand the understanding of the future evaluation results of this study. Results: The evidence-based Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program in the ward was implemented in three phases according to the program’s implementation plan, which are built on Kotter’s organizational change model. In the first phase, a project group with the leaders and researchers was established and information about the project was given to all health care personnel in the ward. The second phase comprised six hours interprofessional team training for all frontline health care personnel followed by 12 months implementation of TeamSTEPPS tools and strategies. In the third phase, the implementation of the tools and strategies continued, and refresher training was conducted. Trial registration: Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date May 30, 2017. Keywords: Implementation, Inter-professional, Intervention, Patient safety, Surgical ward, Team training, TeamSTEPPS


2019 ◽  
Author(s):  
Oddveig Reiersdal Aaberg ◽  
Marie Louise Hall-Lord ◽  
Sissel Iren Eikeland Husebø ◽  
Randi Ballangrud

Abstract Objectives: Interprofessional team training has a positive impact on team behavior and patient safety culture. The objective of the study was to explore the impact of an interprofessional teamwork intervention in a surgical ward on structure, process and outcome. In this paper, the implementation of the teamwork intervention is reported to expand the understanding of the future evaluation results of this study. Results: The evidence-based Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) program in the ward was implemented in three phases according to the program’s implementation plan, which are built on Kotter’s organizational change model. In the first phase, a project group with the leaders and researchers was established and information about the project was given to all health care personnel in the ward. The second phase comprised six hours interprofessional team training for all frontline health care personnel followed by 12 months implementation of TeamSTEPPS tools and strategies. In the third phase, the implementation of the tools and strategies continued, and refresher training was conducted. Trial registration: Trial registration number (TRN) is ISRCTN13997367. The study was registered retrospectively with registration date May 30, 2017. Keywords: Implementation, Inter-professional, Intervention, Patient safety, Surgical ward, Team training, TeamSTEPPS


Sign in / Sign up

Export Citation Format

Share Document