Esce Antoinette, Rodeberg David A, Rothstein David H, Browne Marybeth, Wakeman Derek
Department of Surgery, University of Rochester School of Medicine, Rochester, New York.
Department of Surgery, Brody School of Medicine at East Carolina University, Greenville, North Carolina.
J Surg Res. 2018 Dec;232:559-563. doi: 10.1016/j.jss.2018.07.025. Epub 2018 Aug 7.
Team training programs adapt crew resource management principles from aviation to foster communication and prevent medical errors. Although multiple studies have demonstrated that team training programs such as TeamSTEPPS improve patient outcomes and safety across medical disciplines, limited data exist about their application to pediatric surgical teams. The purpose of this study was to investigate usage and perceptions of team training programs by pediatric surgeons and anesthesiologists. We hypothesized that team training programs are not widely available to pediatric surgical teams.
We performed an online survey of Pediatric Surgery (General, Plastic, Urologic, Orthopedic, Otolaryngologic, and Ophthalmologic) and Anesthesiology members of the American Academy of Pediatrics. The survey inquired about completion and perceptions regarding efficacy of team training programs. Simple descriptive statistics and a Student t-test were used to evaluate the data.
One hundred fifty-two pediatric surgeons and 12 anesthesiologists completed the survey with a 10% response rate. Over half of the respondents were general pediatric surgeons. Home institutions offered TeamSTEPPS or another crew resource management style team training program for 39% of respondents. Of those with a program, 77% of respondents had completed training. Although most (76%) who participated in team training programs did so by requirement, 90% found it helpful. Of the 61% of surgeons who said their institution did not offer team training programs, 60% said they would participate if one were offered and an additional 32% said they might participate. The biggest barriers to participation were not enough free time or that the team training program was not offered to their department.
Team training programs are considered beneficial among pediatric surgeons and anesthesiologists who have completed them. Unfortunately, despite substantial evidence showing training for team work improves team functioning and patient outcomes, many pediatric surgical teams do not have team training programs at their institutions. Further expansion of team training programs may be valuable to improving a culture of safety in children's hospitals.
团队培训项目借鉴航空领域的机组资源管理原则,以促进沟通并预防医疗差错。尽管多项研究表明,诸如团队策略与工具增强绩效系统(TeamSTEPPS)等团队培训项目可改善各医学学科的患者治疗效果及安全性,但关于其在小儿外科团队中的应用数据有限。本研究旨在调查小儿外科医生和麻醉医生对团队培训项目的使用情况及看法。我们假设团队培训项目在小儿外科团队中未广泛普及。
我们对美国儿科学会的小儿外科(普通、整形、泌尿、骨科、耳鼻喉科和眼科)及麻醉学成员进行了在线调查。该调查询问了团队培训项目的完成情况及对其效果的看法。使用简单描述性统计和学生t检验来评估数据。
152名小儿外科医生和12名麻醉医生完成了调查,回复率为10%。超过一半的受访者为普通小儿外科医生。39%的受访者所在的机构提供了团队策略与工具增强绩效系统或其他机组资源管理模式的团队培训项目。在有此类项目的受访者中,77%已完成培训。尽管大多数(76%)参加团队培训项目是出于要求,但90%的人认为该培训有帮助。在表示其所在机构未提供团队培训项目的61%的外科医生中,60%表示若有项目会参加,另有32%表示可能会参加。参与的最大障碍是没有足够的空闲时间或所在科室未提供团队培训项目。
团队培训项目在已完成培训的小儿外科医生和麻醉医生中被认为是有益的。不幸的是,尽管有大量证据表明团队合作培训可改善团队功能和患者治疗效果,但许多小儿外科团队所在机构并未开展团队培训项目。进一步扩大团队培训项目可能对改善儿童医院的安全文化很有价值。