TEAMWORK AND ERROR IN NEONATAL INTENSIVE CARE

医疗差错及其导致的不良事件是常见且昂贵的。一些研究人员和医学研究所（Institute of Medicine）等有影响力的团体认为，应该改善团队运作，作为减少错误和提高患者安全的一种方法。然而，团队合作与医疗差错之间的关系存在着根本性的问题。其中许多问题已经为航空业和领导这项工作的研究小组提供了答案，这是为本提案而组建的研究小组的关键组成部分。我们假设，包括团队合作的特定错误管理行为与在新生儿重症监护病房（NICU）的初始复苏和前90分钟护理期间向早产儿提供护理的错误相关。为了验证这个和其他假设，我们将：1。通过与新生儿重症监护室人员进行焦点小组讨论，将团队合作和错误的航空模式应用于新生儿重症监护室团队。2. 分析在两个关键时期记录的前瞻性早产儿队列的录像带：最初复苏和进入新生儿重症监护病房的前90分钟。3. 我们还将使用目标1和目标2的数据，以及我们之前在该组织中工作的数据，来设计一种干预措施，以改善这些行为，并解决影响错误频率的组织和专业文化因素。

Medical errors and the adverse events they lead to are common and expensive. Some researchers and influential groups like the Institute of Medicine believe that team functioning should be improved as one method of decreasing errors and improving patient safety. However, fundamental questions exist about the relationships among teamwork and error in healthcare. Many of these questions have been answered for the aviation industry and the research group that led that effort is a critical element of the research team assembled for this proposal. We hypothesize that specific error management behaviors that comprise teamwork are correlated with errors in delivering care to pre-term infants during their initial resuscitation and during the first 90 minutes of care in the neonatal intensive care unit (NICU). To test this and other hypotheses we will: 1. Adapt the aviation model of teamwork and error to NICU teams by conducting focus groups with NICU personnel. 2. Analyze videotapes of a prospective cohort of pre-term infants recorded during two critical periods: initial resuscitation and the first 90 minutes of admission to the NICU. 3. We will also use the data derived from Aims 1 and 2, along with data from our previous work in this organization, to design an intervention to improve these behaviors and address elements of the organizational and professional culture that influence the frequency of error.