Team Strategies and Tools to Enhance Team Performance in Simulation Training on a Perinatal Unit

ABSTRACT

Significance/Background

The cause of medical errors and adverse events in healthcare is multifactorial and includes faulty systems, processes, and conditions that can lead individuals to make mistakes. These mistakes are estimated to cause between 210,000 and 400,000 preventable deaths each year in the United States and are often caused by ineffective communication and teamwork failures among interdisciplinary team members. Effective communication is crucial, especially during critical events as this impacts health care quality and patient safety.

Aims

The project's aim was to implement the identified best practice of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) 3.0 to improve communication and teamwork during critical events on a perinatal unit.

Implementation Plan

This was an evidence-based practice project consisting of 2 h of TeamSTEPPS didactic and interactive instruction followed by using the TeamSTEPPS concepts during 2 h of critical event simulation training to assess the perception of communication and teamwork of a multidisciplinary team on a perinatal unit. The multidisciplinary team members included labor and delivery nurses, mother/baby nurses, hospital aides, ward clerks, obstetrical technicians, obstetricians, and midwives.

Outcomes

Using the TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ), the perception of communication and teamwork was compared pre- and post-implementation. Communication and teamwork mean scores from pre to post increased by 61% and 56%, respectively. The mean posttest scores improved for each of the T-TPQ measures, indicating the intervention had an impact on each of the dimensions of the TeamSTEPPS approach, including team function, team leadership, situational monitoring, mutual support, and communication (p < 0.01) and Cohen's d _z , of 0.82–1.32 provided evidence of a large effect.

Linking Evidence to Action

This evidence-based practice project provided clear and specific guidance for communicating and strengthening teamwork during perinatal critical events. Implementing TeamSTEPPS strategies can provide a safe environment for patients and a positive work environment where teamwork and communication are encouraged.