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分析手术室中的跨专业团队合作:使用常规和替代方法的探索性观察研究。

Analyzing interprofessional teamwork in the operating room: An exploratory observational study using conventional and alternative approaches.

机构信息

Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, Canada.

Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.

出版信息

J Interprof Care. 2023 Sep 3;37(5):715-724. doi: 10.1080/13561820.2023.2171373. Epub 2023 Feb 5.

DOI:10.1080/13561820.2023.2171373
PMID:36739535
Abstract

Intraoperative teamwork is vital for patient safety. Conventional tools for studying intraoperative teamwork typically rely on behaviorally anchored rating scales applied at the individual or team level, while others capture narrative information across several units of analysis. This prospective observational study characterizes teamwork using two conventional tools (Operating Theatre Team Non-Technical Skills Assessment Tool [NOTECHS]; Team Emergency Assessment Measure [TEAM]), and one alternative approach (modified-Systems Engineering Initiative for Patient Safety [SEIPS] model). We aimed to explore the advantages and disadvantages of each for providing feedback to improve teamwork practice. Fifty consecutive surgical cases at a Canadian academic hospital were recorded with the OR Black Box®, analyzed by trained raters, and summarized descriptively. Teamwork performance was consistently high within and across cases rated with NOTECHS and TEAMS. For cases analyzed with the modified-SEIPS tool, both optimal and suboptimal teamwork behaviors were identified, and team resilience was frequently observed. NOTECHS and TEAM provided summative assessments and overall pattern descriptions, while SEIPS facilitated a deeper understanding of teamwork processes. As healthcare organizations continue to prioritize teamwork improvement, SEIPS may provide valuable insights regarding teamwork behavior and the broader context influencing performance. This may ultimately enhance the development and effectiveness of multi-level teamwork interventions.

摘要

术中团队合作对于患者安全至关重要。用于研究术中团队合作的传统工具通常依赖于个体或团队层面的行为锚定评分量表,而其他工具则在多个分析单元中捕获叙述性信息。这项前瞻性观察研究使用两种传统工具(手术室团队非技术技能评估工具[NOTECHS];团队紧急评估量表[TEAM])和一种替代方法(改良的患者安全系统工程倡议[SEIPS]模型)来描述团队合作。我们旨在探索每种工具在提供反馈以改善团队合作实践方面的优缺点。在加拿大一家学术医院进行的连续 50 例手术中使用 OR 黑盒®进行了记录,由经过培训的评估员进行了分析,并进行了描述性总结。NOTECHS 和 TEAMS 对案例的评分显示,团队合作表现始终在案例内部和案例之间保持高度一致。对于使用改良 SEIPS 工具进行分析的案例,既可以识别出最佳的团队合作行为,也可以识别出次优的团队合作行为,并且经常观察到团队的适应能力。NOTECHS 和 TEAM 提供总结性评估和整体模式描述,而 SEIPS 则有助于更深入地了解团队合作过程。随着医疗保健组织继续优先重视团队合作的改善,SEIPS 可能会提供有关团队合作行为以及影响绩效的更广泛背景的宝贵见解。这最终可能会增强多层次团队合作干预措施的发展和有效性。

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