A multicenter trial of aviation-style training for surgical teams.
A multicenter trial of aviation-style training for surgical teams.
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DOI：
10.1097/pts.0b013e3181f100ea
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发表时间：
2010-09-01
影响因子：
2.2
通讯作者：
Giddings, Tony A E B
中科院分区：
文献类型：
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作者：
Catchpole, Ken R;Dale, Trevor J;Giddings, Tony A E B
目的：本研究测量了来自不同专业的3个外科团队进行航空式团队培训的效果。它侧重于团队工作和沟通，特别是简报，超时，和汇报，并试图了解如何在团队技能的改进，可以在广泛的自然手术环境中实施，以提高安全性，质量和efficiency.METHOD：手术团队进行颌面，血管和神经外科进行了研究，在112个操作：51干预前和61干预后。人为因素专家为每个团队提供了长达2天的课堂培训，然后是6天的战区辅导。经过培训的观察员使用牛津NOTECHS和术前简报、切口前暂停和术后汇报的频率测量团队合作。安全态度问卷和人种学观察被用来提供上下文details.Results：有显着更多的时间（卡方= 18.17，P < 0.001），简报（卡方= 8.62，P = 0.004），和汇报（卡方= 8.58，P = 0.004）干预后。NOTECHS评分显示研究中心和干预之间存在相互作用（F2，106 = 7.57，P = 0.001）。安全态度问卷调查和人种学观察有助于了解这些difference.Conclusions：航空式的团队合作训练可以提高遵守和团队绩效，但这是由关键个人的态度和合作的影响，并减少了显着的潜在故障的效果。这项研究表明，需要改善组织和个人的管理因素，在国家卫生服务，如果培训病人的安全是有效的和持续的。它还显示了工作条件对质量改进的临床研究的影响。
AIMS: This study measured the effect of aviation-style team training on 3 surgical teams from different specialties. It focused on team working and communication, particularly briefing, time-out, and debriefing, and sought to understand how improvements in team skills could be implemented in a broad range of naturalistic surgical environments to improve safety, quality, and efficiency.METHOD: Surgical teams performing maxillofacial, vascular, and neurosurgery were studied during 112 operations: 51 before and 61 after intervention. Human factors experts delivered the training of up to 2 days in the classroom followed by 6 days of coaching in theater for each team. Trained observers measured teamwork using the Oxford NOTECHS and the frequency of preoperative briefings, pre-incision time-outs, and postoperative debriefings. The Safety Attitudes Questionnaire and ethnographic observations were used to provide contextual details.RESULTS: There were significantly more time-outs (chi = 18.17, P < 0.001), briefings (chi = 8.62, P = 0.004), and debriefings (chi = 8.58, P = 0.004) after the intervention. The NOTECHS scores showed an interaction between site and intervention (F2,106 = 7.57, P = 0.001). The Safety Attitudes Questionnaire and ethnographic observations helped understand these differences.CONCLUSIONS: Aviation-style teamwork training can increase compliance and team performance, but this was influenced by the attitude and collaboration of key individuals, and the effect was reduced by significant latent failures. This study demonstrates the need to improve organizational and personal management factors in the National Health Service if training in patient safety is to be effective and sustained. It also shows the influence of working conditions on clinical studies of quality improvement.