Improving patient safety through leadership and team performance in simulations

项目总结 背景：有效的团队合作和团队表现对减少临床差错和安全至关重要 环境。团队科学文献指出了提高团队绩效的三个目标：团队设计 (组成)、团队训练和团队领导力。到目前为止，努力的重点是团队训练。然而，挑战 与这些计划的可行性、可持续性和有效性相关的问题已经确定。另外， 训练团队作为一个单位，虽然需要有效的训练结果，但对于临时应急小组来说，几乎是不可能的 以跨学科、高度可变的成员为特征的，在复杂、动态和时间的情况下运作 临床环境中的压力条件。这项拟议的研究将团队领导力和团队组成作为两个方面进行研究 在患者安全性研究中尚未研究的医疗急救团队绩效的重要中介因素。 目标：拟议研究的总体目标是(1)开发一种新的、基于证据的领导力培训 计划和(2)评估领导力培训和团队成员组成(陌生与熟悉)的影响 团队)使用基于模拟的研究平台对医疗应急团队的绩效进行评估。这将推动 AHRQ的患者安全使命：(1)为改进团队提供额外的机制(领导力培训) 性能和患者安全，克服与当前团队培训计划相关的挑战，(2)提供 健壮、诊断的团队绩效评估方法，可直接评估循证团队流程 (3)调查团队组成对团队绩效的影响，以及 患者安全关键行为。 方法：该项目建立在以前工作的基础上，分为三个具体目标： 目标1：评估医疗团队组成(陌生成员与熟悉成员)对医疗的影响 应急团队表现 目标2：开发和实施基于适应性学习的团队领导力培训计划 系统理论启发式 目标2a：评估团队领导力培训对医疗急救团队绩效的影响 目标3：评估团队领导力培训对陌生和熟悉医疗的不同影响 应急小组 本项目使用2(陌生与熟悉)×2(领导力培训与控制)完全交叉设计来评估影响 领导力培训和团队组成(陌生与熟悉)对特别医疗急救团队表现的影响。广告 临时医疗应急小组将由来自多家医院的紧急医疗护士和医生组成 机构。主要结果衡量标准是团队绩效，使用经过验证的模拟平台进行评估 (场景+团队流程措施+患者护理措施)。这些措施将共同代表一个准确的、 团队合作和任务合作的可靠表现。 好了！

PROJECT SUMMARY Background: Effective teamwork and team performance are critical to error mitigation and safety in the clinical environment. The team science literature identifies three targets for improving team performance: team design (composition), team training, and team leadership. To date, efforts have focused on team training. However, challenges associated with the feasibility, sustainability, and effectiveness of these programs have been identified. Additionally, training teams as a unit, while required for effective training outcomes, is nearly impossible for ad hoc emergency teams characterized by an interdisciplinary, highly variable membership that operates under complex, dynamic and time pressured conditions in a clinical setting. This proposed research focuses on team leadership and team composition as two important mediators of medical emergency team performance that have not been studied in patient safety research. Objective: The overall objective of the proposed research is to (1) develop a novel, evidence-based leadership training program and (2) evaluate the impact of both leadership training and team member composition (unfamiliar vs. familiar teams) on medical emergency team performance using a simulation-based research platform. This will advance the patient safety mission of AHRQ by (1) providing an additional mechanism (leadership training) for improving team performance and patient safety that overcomes challenges associated with current team training programs, (2) providing a robust, diagnostic method of evaluating team performance that directly assesses evidence-based team processes (coordination, back-up behavior, etc), and (3) investigating the impact of team composition on team performance and patient safety critical behaviors. Methods: This project builds upon previous work and is structured into three specific aims: Aim 1: To assess the impact of healthcare team composition (unfamiliar vs. familiar members) on medical emergency team performance Aim 2: To develop and implement a team leadership training program based on an Adaptive Learning System theoretical heuristic Aim 2a: To assess the impact of team leadership training on medical emergency team performance Aim 3: To assess the differential impact of team leadership training on unfamiliar vs. familiar medical emergency teams This project uses a 2 (unfamiliar vs. familiar) X 2 (leadership training vs. control) fully crossed design to evaluate impact of leadership training and team composition (unfamiliar vs. familiar) on ad hoc medical emergency team performance. Ad hoc medical emergency teams will be comprised of emergency medical nurses and physicians from multiple hospital institutions. The primary outcome measure is team performance, assessed using a validated simulation platform (scenario + team process measures + patient care measures). These measures will collectively represent an accurate, reliable representation of both teamwork and taskwork. !