Sluiter Judith K, Bos Albert P, Tol Dirk, Calff Mart, Krijnen Margot, Frings-Dresen Monique H W
Coronel Institute for Occupational and Environmental Health, Academic Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Intensive Care Med. 2005 Oct;31(10):1409-14. doi: 10.1007/s00134-005-2769-z. Epub 2005 Aug 27.
To study the implementation of multidisciplinary structured work shift evaluations at a pediatric intensive care unit (PICU) to enhance team communication.
Prospective, repeated measurements design, comparison of pre/post measurements and process measures in a Dutch tertiary care, university-affiliated PICU.
All 61 PICU staff members.
Implementing multidisciplinary structured work shift evaluations. Before the implementation phase the PICU team received feedback training and eight participants (four physicians, four nurses) were trained as "work shift evaluation leader."
Outcome measures covered: (a) quality and process of the implementation through prestructured checklists during the 3 months of implementation, (b) a subjective evaluation of a feedback training on team communication as anticipated action and on the level of communication (about patients and with colleagues), and (c) emotional exhaustion complaints and work-related fatigue. The interdisciplinary structured work shift evaluations were implemented successfully as planned during the work shift; all staff were trained ahead, and the process was followed almost completely. Almost two-thirds (62%) of the staff felt a positive influence on team communication. Almost all staff members (92%) were satisfied regarding communication with their colleagues after the intervention, compared to 76% before. Emotional exhaustion in the PICU team decreased significantly after the implementation, but no differences in work-related fatigue levels were found.
As organizational change the implementation of a multidisciplinary structured work shift evaluation at a PICU was successful and team communication improved. Emotional exhaustion decreased during the study period.
研究在儿科重症监护病房（PICU）实施多学科结构化轮班评估以加强团队沟通。
前瞻性、重复测量设计，在荷兰一家三级医疗、大学附属的PICU中比较实施前/后的测量结果及过程指标。
PICU的所有61名工作人员。
实施多学科结构化轮班评估。在实施阶段前，PICU团队接受了反馈培训，8名参与者（4名医生、4名护士）被培训为“轮班评估负责人”。
结果指标包括：（a）在实施的3个月期间，通过预先制定的检查表对实施的质量和过程进行评估；（b）对作为预期行动的团队沟通反馈培训以及沟通水平（关于患者和与同事之间）进行主观评估；（c）情绪耗竭投诉和与工作相关的疲劳。跨学科结构化轮班评估按计划在轮班期间成功实施；所有工作人员提前接受了培训，并且该过程几乎完全得到遵循。近三分之二（62%）的工作人员认为对团队沟通有积极影响。干预后，几乎所有工作人员（92%）对与同事的沟通感到满意，而干预前这一比例为76%。实施后，PICU团队的情绪耗竭显著降低，但在与工作相关的疲劳水平方面未发现差异。
作为一项组织变革，在PICU实施多学科结构化轮班评估取得了成功，团队沟通得到改善。在研究期间情绪耗竭有所下降。
