1 Department of Radiology, Duke University Medical Center, DUMC Box 3808, Durham, NC 27710.
AJR Am J Roentgenol. 2015 Jan;204(1):105-10. doi: 10.2214/AJR.14.12775.
The goal of this study was to implement an evidence-based teamwork system to improve communication and teamwork skills among health care professionals (TeamSTEPPS) into an academic interventional ultrasound program and to assess safety and team-work climate across team members both before and after implementation.
Members of a change team (including master trainers) selected specific tools available within TeamSTEPPS to implement into an academic interventional ultrasound service. Tools selected were based on preimplementation survey data obtained from team members (n = 64: 11 attending faculty physicians, 12 clinical abdominal imaging fellows or residents, 17 sonographers, 19 nurses, and five technologist aides or administrative personnel). The survey included teamwork climate and safety climate domains from the Safety Attitudes Questionnaire. Four months after implementation, respondents were resurveyed and post-implementation data were collected.
Teamwork climate scores improved from a mean of 67.9 (SD, 12.8) before implementation to a mean of 87.8 (SD, 14.1) after implementation (t = -7.6; p < 0.001). Safety climate scores improved from a mean of 76.5 (SD, 12.8) before implementation to a mean of 88.3 (SD, 13.4) after implementation (t = -4.6; p < 0.001). In particular, teamwork items about "input being well received" and "speaking up" were the most responsive to the intervention.
The implementation of TeamSTEPPS tools was associated with statistically significant improvements in safety and teamwork metrics in an academic interventional ultrasound practice. The most notable improvements were seen in communication among team members and role clarification. We think that this model, which has been successfully implemented in many nonradiologic areas in medical care, is also applicable in imaging practice.
本研究旨在将循证团队协作系统(TeamSTEPPS)引入学术介入超声项目,以改善医疗保健专业人员的沟通和团队协作技能,并评估实施前后团队成员的安全性和团队协作氛围。
变革团队成员(包括主培训师)从 TeamSTEPPS 中选择特定工具,将其应用于学术介入超声服务。选择的工具基于从团队成员(n = 64:11 名主治医生、12 名临床腹部影像研究员或住院医师、17 名超声医师、19 名护士、5 名技师助手或行政人员)获得的实施前调查数据。调查包括安全态度问卷中的团队合作氛围和安全氛围领域。实施后四个月,对受访者进行了重新调查,并收集了实施后的数据。
实施后,团队合作氛围评分从实施前的平均 67.9(SD,12.8)提高到实施后的平均 87.8(SD,14.1)(t = -7.6;p < 0.001)。安全氛围评分从实施前的平均 76.5(SD,12.8)提高到实施后的平均 88.3(SD,13.4)(t = -4.6;p < 0.001)。特别是,关于“意见被充分采纳”和“积极发言”的团队合作项目对干预措施的反应最为明显。
在学术介入超声实践中,实施 TeamSTEPPS 工具与安全性和团队合作指标的显著改善相关。在团队成员之间的沟通和角色明确方面取得了最显著的改进。我们认为,这种已在医疗保健的许多非放射学领域成功实施的模式也适用于影像学实践。