Skip to main content
Erschienen in: Journal of General Internal Medicine 12/2008

01.12.2008 | Innovations in Education

A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

verfasst von: Niraj L. Sehgal, MD, MPH, Michael Fox, RN, Arpana R. Vidyarthi, MD, Bradley A. Sharpe, MD, Susan Gearhart, RN, Thomas Bookwalter, PharmD, Jack Barker, PhD, Brian K. Alldredge, PharmD, Mary A. Blegen, PhD, RN, Robert M. Wachter, MD, The Triad for Optimal Patient Safety (TOPS) Project

Erschienen in: Journal of General Internal Medicine | Ausgabe 12/2008

Einloggen, um Zugang zu erhalten

ABSTRACT

INTRODUCTION

Communication and teamwork failures are a common cause of adverse events. Residency programs, with a mandate to teach systems-based practice, are particularly challenged to address these important skills.

AIM

To develop a multidisciplinary teamwork training program focused on teaching teamwork behaviors and communication skills.

SETTING

Internal medicine residents, hospitalists, nurses, pharmacists, and all other staff on a designated inpatient medical unit at an academic medical center.

PROGRAM DESCRIPTION

We developed a 4-h teamwork training program as part of the Triad for Optimal Patient Safety (TOPS) project. Teaching strategies combined didactic presentation, facilitated discussion using a safety trigger video, and small-group scenario-based exercises to practice effective communication skills and team behaviors. Development, planning, implementation, delivery, and evaluation of TOPS Training was conducted by a multidisciplinary team.

PROGRAM EVALUATION

We received 203 evaluations with a mean overall rating for the training of 4.49 ± 0.79 on a 1–5 scale. Participants rated the multidisciplinary educational setting highly at 4.59 ± 0.68.

DISCUSSION

We developed a multidisciplinary teamwork training program that was highly rated by all participating disciplines. The key was creating a shared forum to learn about and discuss interdisciplinary communication and teamwork.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Zurück zum Zitat Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. Qual Saf Health Care. 2005;14(6)401–7. Dec.PubMedCrossRef Arora V, Johnson J, Lovinger D, Humphrey HJ, Meltzer DO. Communication failures in patient sign-out and suggestions for improvement: a critical incident analysis. Qual Saf Health Care. 2005;14(6)401–7. Dec.PubMedCrossRef
2.
Zurück zum Zitat Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6)614–21. Jun.PubMedCrossRef Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6)614–21. Jun.PubMedCrossRef
3.
Zurück zum Zitat Greenberg CC, Regenbogen SE, Studdert DM, et al.. Patterns of communication breakdowns resulting in injury to surgical patients. J Am Coll Surg. 2007;204(4)533–40. Apr.PubMedCrossRef Greenberg CC, Regenbogen SE, Studdert DM, et al.. Patterns of communication breakdowns resulting in injury to surgical patients. J Am Coll Surg. 2007;204(4)533–40. Apr.PubMedCrossRef
4.
Zurück zum Zitat Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: an insidious contributor to medical mishaps. Acad Med. 2004;79(2)186–94. Feb.PubMedCrossRef Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: an insidious contributor to medical mishaps. Acad Med. 2004;79(2)186–94. Feb.PubMedCrossRef
5.
Zurück zum Zitat Tan H. Debriefing after critical incidents for anaesthetic trainees. Anaesth Intensive Care. 2005;33(6)768–72. Dec.PubMed Tan H. Debriefing after critical incidents for anaesthetic trainees. Anaesth Intensive Care. 2005;33(6)768–72. Dec.PubMed
7.
Zurück zum Zitat Awad SS, Fagan SP, Bellows C, et al.. Bridging the communication gap in the operating room with medical team training. Am J Surg. 2005;190(5)770–4. Nov.PubMedCrossRef Awad SS, Fagan SP, Bellows C, et al.. Bridging the communication gap in the operating room with medical team training. Am J Surg. 2005;190(5)770–4. Nov.PubMedCrossRef
8.
Zurück zum Zitat Nielsen PE, Goldman MB, Mann S, et al.. Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized controlled trial. Obstet Gynecol. 2007;109(1)48–55. Jan.PubMed Nielsen PE, Goldman MB, Mann S, et al.. Effects of teamwork training on adverse outcomes and process of care in labor and delivery: a randomized controlled trial. Obstet Gynecol. 2007;109(1)48–55. Jan.PubMed
9.
Zurück zum Zitat Morey JC, Simon R, Jay GD, et al.. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res. 2002;37(6)1553–81. Dec.PubMedCrossRef Morey JC, Simon R, Jay GD, et al.. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res. 2002;37(6)1553–81. Dec.PubMedCrossRef
10.
Zurück zum Zitat Risser DT, Rice MM, Salisbury ML, Simon R, Jay GD, Berns SD. The potential for improved teamwork to reduce medical errors in the emergency department. The MedTeams Research Consortium. Ann Emerg Med. 1999;34(3)373–83. Sep.PubMedCrossRef Risser DT, Rice MM, Salisbury ML, Simon R, Jay GD, Berns SD. The potential for improved teamwork to reduce medical errors in the emergency department. The MedTeams Research Consortium. Ann Emerg Med. 1999;34(3)373–83. Sep.PubMedCrossRef
11.
Zurück zum Zitat Thomas EJ, Sexton JB, Lasky RE, Helmreich RL, Crandell DS, Tyson J. Teamwork and quality during neonatal care in the delivery room. J Perinatol. 2006;26(3)163–9. Mar.PubMedCrossRef Thomas EJ, Sexton JB, Lasky RE, Helmreich RL, Crandell DS, Tyson J. Teamwork and quality during neonatal care in the delivery room. J Perinatol. 2006;26(3)163–9. Mar.PubMedCrossRef
12.
Zurück zum Zitat Sherwood G, Thomas E, Bennett DS, Lewis P. A teamwork model to promote patient safety in critical care. Crit Care Nurs Clin North Am. 2002;14(4)333–40. Dec.PubMedCrossRef Sherwood G, Thomas E, Bennett DS, Lewis P. A teamwork model to promote patient safety in critical care. Crit Care Nurs Clin North Am. 2002;14(4)333–40. Dec.PubMedCrossRef
13.
Zurück zum Zitat Barrett J, Gifford C, Morey J, Risser D, Salisbury M. Enhancing patient safety through teamwork training. J Healthc Risk Manag. 2001;21(4)57–65. Fall.PubMed Barrett J, Gifford C, Morey J, Risser D, Salisbury M. Enhancing patient safety through teamwork training. J Healthc Risk Manag. 2001;21(4)57–65. Fall.PubMed
14.
Zurück zum Zitat Kachalia A, Studdert DM. Professional liability issues in graduate medical education. JAMA. 2004;292(9)1051–6. Sep 1.PubMedCrossRef Kachalia A, Studdert DM. Professional liability issues in graduate medical education. JAMA. 2004;292(9)1051–6. Sep 1.PubMedCrossRef
15.
Zurück zum Zitat AAMC. Policy guidance on graduate medical education: assuring quality patient care and quality education. Acad Med. 2003;78(1)112–6. Jan. AAMC. Policy guidance on graduate medical education: assuring quality patient care and quality education. Acad Med. 2003;78(1)112–6. Jan.
16.
Zurück zum Zitat Singh H, Thomas EJ, Petersen LA, Studdert DM. Medical errors involving trainees: a study of closed malpractice claims from 5 insurers. Arch Intern Med. 2007;167(19)2030–6. Oct 22.PubMedCrossRef Singh H, Thomas EJ, Petersen LA, Studdert DM. Medical errors involving trainees: a study of closed malpractice claims from 5 insurers. Arch Intern Med. 2007;167(19)2030–6. Oct 22.PubMedCrossRef
17.
Zurück zum Zitat Russell J, Sklar D, Bagian J, et al. Patient Safety and Graduate Medical Education. Washington DC: Association of American Medical Colleges; 2003. Report No. 1. Russell J, Sklar D, Bagian J, et al. Patient Safety and Graduate Medical Education. Washington DC: Association of American Medical Colleges; 2003. Report No. 1.
19.
Zurück zum Zitat Greenfield LJ. Doctors and nurses: a troubled partnership. Ann Surg. 1999;230(3)279–88. Sep.PubMedCrossRef Greenfield LJ. Doctors and nurses: a troubled partnership. Ann Surg. 1999;230(3)279–88. Sep.PubMedCrossRef
20.
Zurück zum Zitat Baggs JG, Schmitt MH, Mushlin AI, et al.. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9)1991–8. Sep.PubMedCrossRef Baggs JG, Schmitt MH, Mushlin AI, et al.. Association between nurse-physician collaboration and patient outcomes in three intensive care units. Crit Care Med. 1999;27(9)1991–8. Sep.PubMedCrossRef
21.
Zurück zum Zitat Donchin Y, Gopher D, Olin M, et al.. A look into the nature and causes of human errors in the intensive care unit. Crit Care Med. 1995;23(2)294–300. Feb.PubMedCrossRef Donchin Y, Gopher D, Olin M, et al.. A look into the nature and causes of human errors in the intensive care unit. Crit Care Med. 1995;23(2)294–300. Feb.PubMedCrossRef
22.
Zurück zum Zitat Knaus WA, Draper EA, Wagner DP, Zimmerman JE. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986;104(3)410–8. Mar.PubMed Knaus WA, Draper EA, Wagner DP, Zimmerman JE. An evaluation of outcome from intensive care in major medical centers. Ann Intern Med. 1986;104(3)410–8. Mar.PubMed
23.
Zurück zum Zitat Helmreich RL, Wilhelm JA. Outcomes of crew resource management training. Int J Aviat Psychol. 1991;1(4)287–300.CrossRef Helmreich RL, Wilhelm JA. Outcomes of crew resource management training. Int J Aviat Psychol. 1991;1(4)287–300.CrossRef
24.
Zurück zum Zitat Grogan EL, Stiles RA, France DJ, et al.. The impact of aviation-based teamwork training on the attitudes of health-care professionals. J Am Coll Surg. 2004;199(6)843–8. Dec.PubMedCrossRef Grogan EL, Stiles RA, France DJ, et al.. The impact of aviation-based teamwork training on the attitudes of health-care professionals. J Am Coll Surg. 2004;199(6)843–8. Dec.PubMedCrossRef
25.
Zurück zum Zitat Salas E, Burke CS, Bowers CA, Wilson KA. Team training in the skies: does crew resource management (CRM) training work? Hum Factors. 2001;43(4)641–74. Winter.PubMedCrossRef Salas E, Burke CS, Bowers CA, Wilson KA. Team training in the skies: does crew resource management (CRM) training work? Hum Factors. 2001;43(4)641–74. Winter.PubMedCrossRef
26.
Zurück zum Zitat Healy G, Barker J, Madonna G. Error reduction through team leadership: Applying aviation’s CRM model in the OR. Bull Am Coll Surg. 2006;91(2)10–5.PubMed Healy G, Barker J, Madonna G. Error reduction through team leadership: Applying aviation’s CRM model in the OR. Bull Am Coll Surg. 2006;91(2)10–5.PubMed
27.
Zurück zum Zitat Healy G, Barker J, Madonna G. Error reduction through team leadership: Seven principles of CRM applied to surgery. Bull Am Coll Surg. 2006;91(6)24–6.PubMed Healy G, Barker J, Madonna G. Error reduction through team leadership: Seven principles of CRM applied to surgery. Bull Am Coll Surg. 2006;91(6)24–6.PubMed
28.
Zurück zum Zitat Pizzi L, Goldfarb N, Nash D. Crew resource management and its application in medicine. San Francisco: UCSF-Stanford Evidence Based Practice Center, 2001:501–509. Pizzi L, Goldfarb N, Nash D. Crew resource management and its application in medicine. San Francisco: UCSF-Stanford Evidence Based Practice Center, 2001:501–509.
29.
Zurück zum Zitat Clancy CM, Tornberg DN. TeamSTEPPS: assuring optimal teamwork in clinical settings. Am J Med Qual. 2007;22(3)214–7. May-Jun.PubMedCrossRef Clancy CM, Tornberg DN. TeamSTEPPS: assuring optimal teamwork in clinical settings. Am J Med Qual. 2007;22(3)214–7. May-Jun.PubMedCrossRef
30.
Zurück zum Zitat Dunn EJ, Mills PD, Neily J, Crittenden MD, Carmack AL, Bagian JP. Medical team training: applying crew resource management in the Veterans Health Administration. Jt Comm J Qual Patient Saf. 2007;33(6)317–25. Jun.PubMed Dunn EJ, Mills PD, Neily J, Crittenden MD, Carmack AL, Bagian JP. Medical team training: applying crew resource management in the Veterans Health Administration. Jt Comm J Qual Patient Saf. 2007;33(6)317–25. Jun.PubMed
31.
Zurück zum Zitat Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13(Suppl 1):i85–90. Oct.PubMedCrossRef Leonard M, Graham S, Bonacum D. The human factor: the critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care. 2004;13(Suppl 1):i85–90. Oct.PubMedCrossRef
33.
Zurück zum Zitat Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. J Comm J Qual Patient Saf. 2006;32(3)167–75. Mar. Haig KM, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. J Comm J Qual Patient Saf. 2006;32(3)167–75. Mar.
34.
Zurück zum Zitat Shendell-Falik N, Feinson M, Mohr BJ. Enhancing patient safety: improving the handoff process through appreciative inquiry. J Nurs Adm. 2007;37(2)95–104.PubMedCrossRef Shendell-Falik N, Feinson M, Mohr BJ. Enhancing patient safety: improving the handoff process through appreciative inquiry. J Nurs Adm. 2007;37(2)95–104.PubMedCrossRef
35.
Zurück zum Zitat Vidyarthi AR, Arora V, Schnipper JL, Wall SD, Wachter RM. Managing discontinuity in academic medical centers: strategies for a safe and effective resident sign-out. J Hosp Med. 2006;1(4)257–266.PubMedCrossRef Vidyarthi AR, Arora V, Schnipper JL, Wall SD, Wachter RM. Managing discontinuity in academic medical centers: strategies for a safe and effective resident sign-out. J Hosp Med. 2006;1(4)257–266.PubMedCrossRef
36.
Zurück zum Zitat Chakraborti C, Boonyasai RT, Wright SM, Kern DE. A systematic review of teamwork training interventions in medical student and resident education. J Gen Intern Med. 2008;23(6)846–53. Jun.PubMedCrossRef Chakraborti C, Boonyasai RT, Wright SM, Kern DE. A systematic review of teamwork training interventions in medical student and resident education. J Gen Intern Med. 2008;23(6)846–53. Jun.PubMedCrossRef
Metadaten
Titel
A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience
verfasst von
Niraj L. Sehgal, MD, MPH
Michael Fox, RN
Arpana R. Vidyarthi, MD
Bradley A. Sharpe, MD
Susan Gearhart, RN
Thomas Bookwalter, PharmD
Jack Barker, PhD
Brian K. Alldredge, PharmD
Mary A. Blegen, PhD, RN
Robert M. Wachter, MD
The Triad for Optimal Patient Safety (TOPS) Project
Publikationsdatum
01.12.2008
Verlag
Springer-Verlag
Erschienen in
Journal of General Internal Medicine / Ausgabe 12/2008
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-008-0793-8

Weitere Artikel der Ausgabe 12/2008

Journal of General Internal Medicine 12/2008 Zur Ausgabe

Letter to the Editor

Author Reply

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Proximale Humerusfraktur: Auch 100-Jährige operieren?

01.05.2024 DCK 2024 Kongressbericht

Mit dem demographischen Wandel versorgt auch die Chirurgie immer mehr betagte Menschen. Von Entwicklungen wie Fast-Track können auch ältere Menschen profitieren und bei proximaler Humerusfraktur können selbst manche 100-Jährige noch sicher operiert werden.

Die „Zehn Gebote“ des Endokarditis-Managements

30.04.2024 Endokarditis Leitlinie kompakt

Worauf kommt es beim Management von Personen mit infektiöser Endokarditis an? Eine Kardiologin und ein Kardiologe fassen die zehn wichtigsten Punkte der neuen ESC-Leitlinie zusammen.

Strenge Blutdruckeinstellung lohnt auch im Alter noch

30.04.2024 Arterielle Hypertonie Nachrichten

Ältere Frauen, die von chronischen Erkrankungen weitgehend verschont sind, haben offenbar die besten Chancen, ihren 90. Geburtstag zu erleben, wenn ihr systolischer Blutdruck < 130 mmHg liegt. Das scheint selbst für 80-Jährige noch zu gelten.

Sind Frauen die fähigeren Ärzte?

30.04.2024 Gendermedizin Nachrichten

Patienten, die von Ärztinnen behandelt werden, dürfen offenbar auf bessere Therapieergebnisse hoffen als Patienten von Ärzten. Besonders gilt das offenbar für weibliche Kranke, wie eine Studie zeigt.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.