Does teamwork improve performance in the operating room? A multilevel evaluation.
BACKGROUND
Medical care is a team effort, especially as patient cases are more complex. Communication, cooperation, and coordination are vital to effective care, especially in complex service lines such as the operating room (OR). Team training, specifically the TeamSTEPPS training program, has been touted as one methodology for optimizing teamwork among providers and increasing patient safety. Although such team-training programs have transformed the culture and outcomes of other dynamic, high-risk industries such as aviation and nuclear power, evidence of team training effectiveness in health care is still evolving. Although providers tend to react positively to many training programs, evidence that training contributes to important behavioral and patient safety outcomes is lacking.


METHODS
A multilevel evaluation of the TeamSTEPPS training program was conducted within the OR service line with a control location. The evaluation was a mixed-model design with one between-groups factor (TeamSTEPPS training versus no training) and two within-groups factors (time period, team). The groups were located at separate campuses to minimize treatment diffusion. Trainee reactions, learning, behaviors in the OR, and proxy outcome measures such as the Hospital Survey on Patient Safety Culture (HSOPS) and Operating Room Management Attitudes Questionnaire (ORMAQ) were collected.


RESULTS
All levels of evaluation demonstrated positive results. The trained group demonstrated significant increases in the quantity and quality of presurgical procedure briefings and the use of quality teamwork behaviors during cases. Increases were also found in perceptions of patient safety culture and teamwork attitudes.


CONCLUSIONS
The hospital system has integrated elements of TeamSTEPPS into orientation training provided to all incoming hospital employees, including nonclinical staff.
Weaver
Sallie J
SJ
Department of Psychology, Institute for Simulation and Training , University of Central Florida, Orlando, Florida, USA.
Rosen
Michael A
MA
DiazGranados
Deborah
D
Lazzara
Elizabeth H
EH
Lyons
Rebecca
R
Salas
Eduardo
E
Knych
Stephen A
SA
McKeever
Margie
M
Adler
Lee
L
Barker
Mary
M
King
Heidi B
HB
D000328:Adult; D000704:Analysis of Variance; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D007318:Inservice Training / Q000379:methods / Q000458:organization & administration; D007400:Interprofessional Relations; D008875:Middle Aged; D009873:Operating Rooms; D010348:Patient Care Team / Q000458:organization & administration*; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000379:methods / Q000458:organization & administration; D000078329:Workforce