Seelandt Julia C, Schneider Jeannine, Kolbe Michaela, Grande Bastian
Simulation Center, University Hospital Zurich, Zurich, Switzerland.
Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
Front Med (Lausanne). 2024 Jul 26;11:1427061. doi: 10.3389/fmed.2024.1427061. eCollection 2024.
Debriefing enhances team learning, performance, and patient safety. Despite its benefits, it's underused. To address this, we developed an evidence-based debriefing app.
This pilot study, conducted at a Swiss hospital, evaluated team performance during two anesthesia inductions using the Team Performance Scale (TPS). Following the first induction, teams engaged with the Zurich Debriefing App, with debriefing sessions meticulously recorded for subsequent evaluation. To mitigate bias, raters underwent comprehensive TPS training. The debriefings were analyzed through the DE-CODE framework. We utilized paired t-tests to examine performance improvements and linear regressions to assess the impact of reflective statements on performance, moderated by psychological safety.
Team performance significantly improved from the first to the second induction ( (9) = -2.512, = 0.033). Senior physicians' ( = 8) reflective statements predicted post-assessment TPS scores ( = 0.732, = 0.061), while consultants ( = 7) and nurse anesthetists ( = 10) did not. Interaction analysis revealed no moderation effects, but a main effect indicated the significance of senior physicians' reflective statements.
This pilot study confirms the efficacy of the evidence-based debriefing app in enhancing anesthesia team performance. Senior physicians' reflective statements positively influenced performance; however, no moderation effects were observed. The study highlights the potential of debriefing apps to streamline and enhance team debriefing processes, with significant implications for improving clinical practice and patient safety. Further research is needed to validate these findings on a larger scale and optimize the integration of debriefing into routine clinical practice.
总结汇报可促进团队学习、提高绩效并提升患者安全。尽管有诸多益处，但它的使用并不充分。为解决这一问题，我们开发了一款基于证据的总结汇报应用程序。
这项在瑞士一家医院进行的试点研究，使用团队绩效量表（TPS）评估了两次麻醉诱导过程中的团队表现。在第一次诱导后，团队使用苏黎世总结汇报应用程序，总结汇报会议被详细记录以供后续评估。为减少偏差，评估人员接受了全面的TPS培训。通过DE-CODE框架对总结汇报进行分析。我们使用配对t检验来检查绩效改进情况，并使用线性回归来评估反思性陈述对绩效的影响，以心理安全感作为调节变量。
从第一次诱导到第二次诱导，团队绩效有显著提高（(9) = -2.512， = 0.033）。高级医师（ = 8）的反思性陈述可预测评估后的TPS分数（ = 0.732， = 0.061），而顾问医师（ = 7）和麻醉护士（ = 10）的反思性陈述则不能。交互分析未发现调节效应，但主效应表明高级医师的反思性陈述具有重要意义。
这项试点研究证实了基于证据的总结汇报应用程序在提高麻醉团队绩效方面的有效性。高级医师的反思性陈述对绩效有积极影响；然而，未观察到调节效应。该研究凸显了总结汇报应用程序在简化和加强团队总结汇报流程方面的潜力，对改善临床实践和患者安全具有重要意义。需要进一步开展研究以在更大规模上验证这些发现，并优化将总结汇报纳入常规临床实践的方式。
