TEAMWORK AND ERROR IN NEONATAL INTENSIVE CARE

医疗差错及其导致的不良事件很常见，代价也很高。一些研究人员和医学研究所等有影响力的组织认为，团队运作应该得到改善，作为减少差错和提高患者安全性的一种方法。然而，团队合作和医疗保健中的错误之间的关系存在根本问题。对于航空业来说，这些问题中的许多都得到了回答，领导这一努力的研究小组是为这项提议组建的研究小组的关键要素。我们假设，组成团队合作的特定错误管理行为与早产儿在新生儿重症监护病房(NICU)最初复苏期间和最初90分钟护理期间的护理错误相关。为了验证这一假设和其他假设，我们将：1。通过与NICU人员进行焦点小组，使团队合作和错误的航空模型适用于NICU团队。2.分析在两个关键时期记录的预期早产儿队列的录像带：最初的复苏和进入NICU的前90分钟。3.我们还将使用目标1和目标2得出的数据，以及我们在本组织以前的工作数据，设计一种干预措施，以改进这些行为，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.