Dietl Johanna Elisa, Derksen Christina, Keller Franziska Maria, Lippke Sonia
Health Psychology and Behavioral Medicine, School of Business, Social and Decision Science, Constructor University, Bremen, Germany.
Klinikum Bremerhaven Reinkenheide gGmbH, Treatment Center for Psychiatry, Psychotherapy and Psychosomatic, Bremerhaven, Germany.
Front Psychol. 2023 Jun 15;14:1164288. doi: 10.3389/fpsyg.2023.1164288. eCollection 2023.
Effective teamwork and communication are imperative for patient safety and quality care. Communication errors and human failures are considered the main source of patient harm. Thus, team trainings focusing on communication and creating psychologically safe environments are required. This can facilitate challenging communication and teamwork scenarios, prevent patient safety risks, and increase team performance perception. The sparse research concerning communication interventions calls for an understanding of psychological mechanisms. Therefore, this study investigated mechanisms of an interpersonal team intervention targeting communication and the relation of psychological safety to patient safety and team performance perception based on the applied input-process-output model of team effectiveness.
Before and after a 4-h communication intervention for multidisciplinary teams, a paper-pencil survey with = 137 healthcare workers from obstetric units of two university hospitals was conducted. Changes after the intervention in perceived communication, patient safety risks, and team performance perception were analyzed tests. To examine psychological mechanisms regarding psychological safety and communication behavior, mediation analyses were conducted.
On average, perceived patient safety risks were lower after the intervention than before the intervention ( = 3.220, = 0.735; = 2.887, = 0.902). This change was statistically significant ( (67) = 2.760, =.007). However, no such effect was found for interpersonal communication and team performance perception. The results illustrate the mediating role of interpersonal communication between psychological safety and safety performances operationalized as perceived patient safety risks ( = -0.163, 95% CI [-0.310, -0.046]) and team performance perception ( = 0.189, 95% CI [0.044, 0.370]).
This study demonstrates the psychological mechanisms of communication team training to foster safety performances and psychological safety as an important predecessor for interpersonal communication. Our results highlight the importance of teamwork for patient safety. Interpersonal and interprofessional team training represents a novel approach as it empirically brings together interpersonal communication and collaboration in the context of patient safety. Future research should work on follow-up measures in randomized-controlled trials to broaden an understanding of changes over time.
有效的团队协作与沟通对于患者安全和优质护理至关重要。沟通失误和人为失误被认为是对患者造成伤害的主要来源。因此，需要开展侧重于沟通并营造心理安全环境的团队培训。这有助于应对具有挑战性的沟通和团队协作场景，预防患者安全风险，并提高团队对自身表现的认知。关于沟通干预措施的研究较少，这就需要了解其心理机制。因此，本研究基于团队有效性的投入 - 过程 - 产出模型，调查了针对沟通的人际团队干预机制，以及心理安全与患者安全和团队表现认知之间的关系。
在对多学科团队进行为期4小时的沟通干预前后，对来自两家大学医院产科单位的137名医护人员进行了纸笔调查。采用测试分析干预后在沟通认知、患者安全风险和团队表现认知方面的变化。为了检验关于心理安全和沟通行为的心理机制，进行了中介分析。
平均而言，干预后感知到的患者安全风险低于干预前（干预前均值 = 3.220，标准差 = 0.735；干预后均值 = 2.887，标准差 = 0.902）。这种变化具有统计学意义（t(67) = 2.760，p =.007）。然而，在人际沟通和团队表现认知方面未发现此类效果。结果表明，人际沟通在心理安全与以感知到的患者安全风险衡量的安全表现（β = -0.163，95%置信区间[-0.310, -0.046]）以及团队表现认知（β = 0.189，95%置信区间[0.044, 0.370]）之间起中介作用。
本研究展示了沟通团队培训促进安全表现和心理安全的心理机制，心理安全是人际沟通的重要前提。我们的结果强调了团队协作对患者安全的重要性。人际和跨专业团队培训是一种新颖的方法，因为它在患者安全背景下将人际沟通与协作通过实证结合在一起。未来的研究应致力于随机对照试验中的后续措施，以拓宽对随时间变化的理解。
