دورية أكاديمية
Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis.
| العنوان: | Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis. |
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| المؤلفون: | Bhangu A; School of Medicine, Faculty of Health Sciences, Queen's University, Unit 505 - 91 King Street East, Kingston, ON, K7L 2Z8, Canada. abhangu@qmed.ca., Notario L; Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.; Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada., Pinto RL; Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Pannell D; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada., Thomas-Boaz W; Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.; Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada., Freedman C; Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada., Tien H; Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Ornge, Mississauga, ON, Canada., Nathens AB; Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.; Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada., da Luz L; Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.; Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada. |
| المصدر: | CJEM [CJEM] 2022 Jun; Vol. 24 (4), pp. 419-425. Date of Electronic Publication: 2022 Apr 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: England NLM ID: 100893237 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1481-8043 (Electronic) Linking ISSN: 14818035 NLM ISO Abbreviation: CJEM Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2021- : [London] : Springer Original Publication: Ottawa : Canadian Medical Association, c1999- |
| مواضيع طبية MeSH: | Patient Care Team* , Teach-Back Communication*, Clinical Competence ; Communication ; Humans ; Leadership ; Resuscitation |
| مستخلص: | Objectives: Communication among trauma team members in the trauma bay is vulnerable to errors, which may impact patient outcomes. We used the previously validated trauma-non-technical skills (T-NOTECHS) tool to identify communication gaps during patient management in the trauma bay and to inform development strategies to improve team performance. Methods: Two reviewers independently assessed non-technical skills of team members through video footage at Sunnybrook Health Sciences Centre. Team performance was measured using T-NOTECHS across five domains using a five-point Likert scale (lower score indicating worse performance): (1) leadership; (2) cooperation and resource management; (3) communication and interaction; (4) assessment and decision making; (5) situation awareness/coping with stress. Secondary outcomes assessed the number of callouts, closed loop communications and parallel conversations. Results: The study included 55 trauma activations. Injury severity score (ISS) was used as a measure of trauma severity. A case with an ISS score ≥ 16 was considered severe. ISS was ≥ 16 in 37% of cases. Communication and interaction scored significantly lower compared to all other domains (p < 0.0001). There were significantly more callouts and completed closed loop communications in more severe cases compared to less severe cases (p = 0.017 for both). Incomplete closed loop communications and parallel conversations were identified, irrespective of case severity. Conclusion: A lower communication score was identified using T-NOTECHS, attributed to incomplete closed loop communications and parallel conversations. Through video review of trauma team activations, opportunities for improvement in communication can be identified by the T-NOTECHS tool, as well as specifically identifying callouts and closed loop communication. This process may be useful for trauma programs as part of a quality improvement program on communication skills and team performance. (© 2022. The Author(s), under exclusive licence to Canadian Association of Emergency Physicians (CAEP)/ Association Canadienne de Médecine d'Urgence (ACMU).) |
| التعليقات: | Comment in: CJEM. 2022 Jun;24(4):351-352. (PMID: 35699919) |
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| فهرسة مساهمة: | Keywords: Callout; Closed loop communication; Communication; Nontechnical skills; T-NOTECHS; Team performance Local Abstract: [Publisher, French] RéSUMé: OBJECTIFS : La communication entre les membres de l'équipe de traumatologie dans la salle de traumatologie est vulnérable aux erreurs, ce qui peut avoir un impact sur les résultats des patients. Nous avons utilisé l'outil de compétences non techniques en traumatologie (T-NOTECHS) précédemment validé pour identifier les lacunes en matière de communication pendant la prise en charge des patients dans la salle de traumatologie et pour informer les stratégies de développement visant à améliorer les performances de l'équipe. MéTHODES: Deux examinateurs ont évalué de manière indépendante les compétences non techniques des membres de l'équipe au moyen de séquences vidéo réalisées au Sunnybrook Health Sciences Centre. La performance de l'équipe a été mesurée à l'aide de la T-NOTECHS dans cinq domaines à l'aide d'une échelle de Likert à cinq points (un score plus bas indiquant une performance plus faible) : (1) leadership ; (2) coopération et gestion des ressources ; (3) communication et interaction ; (4) évaluation et prise de décision ; (5) conscience de la situation/ gestion du stress. Les résultats secondaires ont évalué le nombre d'appels, de communications en boucle fermée et de conversations parallèles. RéSULTATS: L'étude a porté sur 55 activations de traumatismes. Le score de gravité des blessures (ISS) a été utilisé comme mesure de la gravité du traumatisme. Un cas présentant un score ISS ≥ 16 était considéré comme grave. L'ISS était ≥ 16 dans 37 % des cas. La communication et l'interaction ont obtenu des scores significativement plus faibles par rapport à tous les autres domaines (p<0,0001). Il y avait significativement plus d'appels et de communications en boucle fermée terminées dans les cas plus graves que dans les cas moins graves (p = 0.017 pour les deux). Des communications incomplètes en boucle fermée et des conversations parallèles ont été identifiées, indépendamment de la gravité du cas. CONCLUSION: Un score de communication plus faible a été identifié en utilisant le T-NOTECHS, attribué à des communications incomplètes en boucle fermée et à des conversations parallèles. Grâce à l'examen vidéo des activations de l'équipe de traumatologie, les possibilités d'amélioration de la communication peuvent être identifiées par l'outil T-NOTECHS, ainsi que l'identification spécifique des appels et de la communication en boucle fermée. Ce processus peut être utile pour les programmes de traumatologie dans le cadre d'un programme d'amélioration de la qualité sur les compétences de communication et la performance de l'équipe. |
| تواريخ الأحداث: | Date Created: 20220412 Date Completed: 20220616 Latest Revision: 20220724 |
| رمز التحديث: | 20221213 |
| مُعرف محوري في PubMed: | PMC9002216 |
| DOI: | 10.1007/s43678-022-00295-z |
| PMID: | 35412259 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. | تدمد: | 1481-8043 |
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| DOI: | 10.1007/s43678-022-00295-z |