From the Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Pediatric Residency Program, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
Pediatr Emerg Care. 2024 Mar 1;40(3):203-207. doi: 10.1097/PEC.0000000000002939. Epub 2023 Apr 11.
The shared mental model is essential to high-quality resuscitations. A structured callout (SCO) is often performed to establish the shared mental model, but the literature on SCOs is limited. The objectives of this study are to describe performance of SCOs during pediatric medical emergencies and to determine whether a SCO is associated with better teamwork.
This was a retrospective study in the resuscitation area of an academic pediatric emergency department, where performance of a SCO is a standard expectation. Only medical or nontrauma patients were eligible for inclusion. Data collection was performed by structured video review by 2 observers and verified by a third blinded observer. A SCO was defined as team leader (Pediatric Emergency Medicine fellow or faculty physician) verbalization of at least 1 element of the patient history/examination or an assessment of patient physiology and 1 element of the diagnostic or therapeutic plan. We independently measured teamwork using the Teamwork Emergency Assessment Measure (TEAM) tool.
We reviewed 60 patient encounters from the pediatric emergency department resuscitation area between April 2018 and June 2020. Median patient age was 6 years; the team leader was a Pediatric Emergency Medicine fellow in 55% of encounters. The physician team leader performed a SCO in 38 (63%) of patient encounters. The TEAM scores were collected for 46 encounters. Mean TEAM score (SD) was 42.3 (1.7) in patients with a SCO compared with 40.0 (3.0) in those without a SCO ( P = 0.007).
Performance of a SCO was associated with better teamwork, but the difference was of unclear clinical significance.
共享心智模型对于高质量的复苏至关重要。通常会进行结构化呼名（SCO）以建立共享心智模型，但有关 SCO 的文献有限。本研究的目的是描述儿科医疗紧急情况下 SCO 的执行情况，并确定 SCO 是否与更好的团队合作相关。
这是一项在学术儿科急诊复苏区进行的回顾性研究，在该区域，执行 SCO 是标准要求。只有医疗或非创伤患者有资格入选。数据采集由 2 名观察者进行结构化视频审查，并由第 3 名盲法观察者进行验证。SCO 定义为团队负责人（儿科急诊医学研究员或主治医生）对病史/检查的至少 1 项内容或对患者生理状况的评估以及诊断或治疗计划的 1 项内容进行口头表述。我们使用团队协作紧急评估工具（TEAM）独立测量团队合作。
我们回顾了 2018 年 4 月至 2020 年 6 月期间儿科急诊复苏区的 60 例患者就诊情况。患者中位年龄为 6 岁；在 55%的就诊中，团队负责人是儿科急诊医学研究员。在 38 次（63%）患者就诊中，医生团队负责人执行了 SCO。在 46 次就诊中收集了 TEAM 评分。与未进行 SCO 的患者相比（40.0[3.0]），进行 SCO 的患者的 TEAM 评分（均数[标准差]）为 42.3（1.7）（P=0.007）。
执行 SCO 与更好的团队合作相关，但差异的临床意义尚不清楚。
