title: Sustained Improvement in Neonatal Intensive Care Unit Safety Attitudes After Teamwork Training.
abstract: This study aimed to measure safety attitudes in the neonatal intensive care unit (NICU) before and serially after a compulsory, multidisciplinary teamwork and communication training initiative and novel sustainment program.
  
  
  
  Training was administered to NICU staff and subsequent sustainment efforts were directed at enculturating core principles over the following year. A modified Agency for Healthcare Research and Quality Survey on Patient Safety Culture was administered before as well as 3 and 12 months after training. Longitudinal survey results were compared with the national Agency for Healthcare Research and Quality survey data.
  
  
  
  Ninety-six percent of 350 NICU staff were trained over 2 months. Survey response rates were 84%, 71%, and 83% before, at 3 months, and at 12 months after training, respectively. Items with sustained improvement pertained to staff empowerment and patient hand-offs. The proportion of participants who agreed with the statement, "Staff feel free to question the decisions or actions of those with more authority" increased from 55% to 76% and 83% at 3 and 12 months, respectively (P < 0.0001). The proportion of participants who disagreed with the statement, "Things 'fall between the cracks' when transferring patients from one unit to another" increased from 36% to 48% and 52% at 3 and 12 months, respectively (P < 0.01). The only significant decline was for the statement, "We are actively doing things to improve patient safety." The proportion of respondents who agreed dropped from 93% to 83% at 3 months (P = 0.02).
  
  
  
  A novel sustainment program after teamwork and communication training measurably improved most staff safety attitudes over 1 year.
authors.affiliation: From the Women and Infants Hospital, Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Thomas
authors.initials: T
authors.lastname: Murphy
authors.forename: Abbot
authors.initials: A
authors.lastname: Laptook
authors.forename: Jesse
authors.initials: J
authors.lastname: Bender
mesh_terms: D001291:Attitude of Health Personnel; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000592:standards*; D008137:Longitudinal Studies; D008297:Male; D010348:Patient Care Team / Q000592:standards*; D061214:Patient Safety / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods*; D011795:Surveys and Questionnaires