Cognitive Aids for Role Definition (CARD) to improve interprofessional team crisis resource management: An exploratory study.
This study aimed to assess the perceived value of the Cognitive Aids for Role Definition (CARD) protocol for simulated intraoperative cardiac arrests. Sixteen interprofessional operating room teams completed three consecutive simulated intraoperative cardiac arrest scenarios: current standard, no CARD; CARD, no CARD teaching; and CARD, didactic teaching. Each team participated in a focus group interview immediately following the third scenario; data were transcribed verbatim and qualitatively analysed. After 6 months, participants formed eight new teams randomised to two groups (CARD or no CARD) and completed a retention intraoperative cardiac arrest simulation scenario. All simulation sessions were video recorded and expert raters assessed team performance. Qualitative analysis of the 16 focus group interviews revealed 3 thematic dimensions: role definition in crisis management; logistical issues; and the "real life" applicability of CARD. Members of the interprofessional team perceived CARD very positively. Exploratory quantitative analysis found no significant differences in team performance with or without CARD (p > 0.05). In conclusion, qualitative data suggest that the CARD protocol clarifies roles and team coordination during interprofessional crisis management and has the potential to improve the team performance. The concept of a self-organising team with defined roles is promising for patient safety.
a Department of Anesthesiology , The Ottawa Hospital , Ottawa , Ontario , Canada.
Tania Di
TD
Renna
a Department of Anesthesiology , The Ottawa Hospital , Ottawa , Ontario , Canada.
Simone
S
Crooks
b Department of Anesthesiology , The Ottawa Hospital Research Institute , Ottawa , Ontario , Canada.
Ashlee-Ann
AA
Pigford
c The Children's Hospital of Eastern Ontario Research Institute , Ottawa , Ontario , Canada.
Chantalle
C
Clarkin
a Department of Anesthesiology , The Ottawa Hospital , Ottawa , Ontario , Canada.
Amy B
AB
Fraser
d Faculty of Medicine , University of Ottawa , Ottawa , Ontario , Canada.
Alexandra C
AC
Bunting
e Department of Anesthesiology and Department of Innovation in Medical Education , Children's Hospital of Eastern Ontario , Ottawa , Ontario , Canada.
M Dylan
MD
Bould
f Department of Anesthesiology and Department of Innovation in Medical Education , The Ottawa Hospital , Ottawa , Ontario , Canada.
Sylvain
S
Boet
D017144:Focus Groups; D006323:Heart Arrest / Q000601:surgery; D006801:Humans; D033183:Interdisciplinary Communication; D007430:Intraoperative Care; D010348:Patient Care Team / Q000458:organization & administration*; D061214:Patient Safety; D010865:Pilot Projects; D024382:Professional Role
Cognitive aids; crisis resource management; interprofessional collaboration; interprofessional communication