Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme
BackgroundCommunication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management progr...
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| Veröffentlicht in: | Quality & safety in health care 2010-08, Vol.19 (4), p.360-364 |
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| creator | Neily, Julia Mills, Peter D Lee, Pamela Carney, Brian West, Priscilla Percarpio, Katherine Mazzia, Lisa Paull, Douglas E Bagian, James P |
| description | BackgroundCommunication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities.MethodsFacilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1=‘no impact’ and 5=‘significant impact.’ We used logistic regression to examine implementation of briefing/debriefing.ResultsNinety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4–5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4–5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03).ConclusionsSites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme. |
| doi_str_mv | 10.1136/qshc.2008.031005 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_856047495</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>856047495</sourcerecordid><originalsourceid>FETCH-LOGICAL-b432t-a178c234fba0f38945878f11c2feff69f5cec8ff6e6a9218dad487a3f7ece0a33</originalsourceid><addsrcrecordid>eNqFkTtvFDEURkcIREKgp0KWKCjQLH6OPaJCKwhICTQ8JBrrruc662UeG9uL4Dfwp_Ew2RQ0qWzL5_uurk5VPWV0xZhoXl2nrVtxSs2KCkapuledMqlVLVrK7h_vpjUn1aOUdpSylrfsYXXCadMKztVp9ecSu-CgJxlhIDlCGMN4RWDsiJvAbedHGEneIvmJGSOMiWwR-rwl0A0FTiWTwzS-JpASpjTgmP_Fw7AHl8m0hH2IKRPBiQcX-pADpmPvPk5XEYYBH1cPPPQJn9ycZ9WXd28_r9_XF5_OP6zfXNQbKXiugWnjuJB-A9SX7aQy2njGHPfofdN65dCZcsMGWs5MB500GoTX6JCCEGfVi6W3TL4-YMp2CMlh38OI0yFZoxoqtWzVnaSWplWtUbKQz_8jd9MhjmUNy7Q2RkrVzH10oVycUoro7T6GAeJvy6idjdrZqJ2N2sVoiTy7KT5sBuxuA0eFBagXoKjAX7f_EH_YRgut7Meva8uVbM6_f1P2svAvF34z7O4e_xehqbrW</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1778844565</pqid></control><display><type>article</type><title>Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme</title><source>MEDLINE</source><source>BMJ Journals - NESLi2</source><creator>Neily, Julia ; Mills, Peter D ; Lee, Pamela ; Carney, Brian ; West, Priscilla ; Percarpio, Katherine ; Mazzia, Lisa ; Paull, Douglas E ; Bagian, James P</creator><creatorcontrib>Neily, Julia ; Mills, Peter D ; Lee, Pamela ; Carney, Brian ; West, Priscilla ; Percarpio, Katherine ; Mazzia, Lisa ; Paull, Douglas E ; Bagian, James P</creatorcontrib><description>BackgroundCommunication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities.MethodsFacilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1=‘no impact’ and 5=‘significant impact.’ We used logistic regression to examine implementation of briefing/debriefing.ResultsNinety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4–5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4–5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03).ConclusionsSites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme.</description><identifier>ISSN: 1475-3898</identifier><identifier>EISSN: 1475-3901</identifier><identifier>DOI: 10.1136/qshc.2008.031005</identifier><identifier>PMID: 20693225</identifier><language>eng</language><publisher>England: BMJ Publishing Group Ltd</publisher><subject>Adult ; Aviation ; Behavior ; Clinical outcomes ; Communication ; crew resource management ; Efficiency ; Health administration ; Health Facilities - standards ; Health Resources - organization & administration ; Healthcare quality improvement ; Hospital administration ; Humans ; Inservice Training ; Intensive Care Units - standards ; Interviews ; Leadership ; Operating Rooms - standards ; Patient Care Team - standards ; Patient safety ; Planning ; Process Assessment (Health Care) - methods ; safety culture ; Success ; Teamwork ; United States ; United States Department of Veterans Affairs</subject><ispartof>Quality & safety in health care, 2010-08, Vol.19 (4), p.360-364</ispartof><rights>2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Copyright: 2010 (c) 2010, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b432t-a178c234fba0f38945878f11c2feff69f5cec8ff6e6a9218dad487a3f7ece0a33</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://qualitysafety.bmj.com/content/19/4/360.full.pdf$$EPDF$$P50$$Gbmj$$H</linktopdf><linktohtml>$$Uhttps://qualitysafety.bmj.com/content/19/4/360.full$$EHTML$$P50$$Gbmj$$H</linktohtml><link.rule.ids>114,115,314,780,784,3194,23570,27923,27924,77371,77402</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20693225$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neily, Julia</creatorcontrib><creatorcontrib>Mills, Peter D</creatorcontrib><creatorcontrib>Lee, Pamela</creatorcontrib><creatorcontrib>Carney, Brian</creatorcontrib><creatorcontrib>West, Priscilla</creatorcontrib><creatorcontrib>Percarpio, Katherine</creatorcontrib><creatorcontrib>Mazzia, Lisa</creatorcontrib><creatorcontrib>Paull, Douglas E</creatorcontrib><creatorcontrib>Bagian, James P</creatorcontrib><title>Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme</title><title>Quality & safety in health care</title><addtitle>Qual Saf Health Care</addtitle><description>BackgroundCommunication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities.MethodsFacilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1=‘no impact’ and 5=‘significant impact.’ We used logistic regression to examine implementation of briefing/debriefing.ResultsNinety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4–5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4–5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03).ConclusionsSites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme.</description><subject>Adult</subject><subject>Aviation</subject><subject>Behavior</subject><subject>Clinical outcomes</subject><subject>Communication</subject><subject>crew resource management</subject><subject>Efficiency</subject><subject>Health administration</subject><subject>Health Facilities - standards</subject><subject>Health Resources - organization & administration</subject><subject>Healthcare quality improvement</subject><subject>Hospital administration</subject><subject>Humans</subject><subject>Inservice Training</subject><subject>Intensive Care Units - standards</subject><subject>Interviews</subject><subject>Leadership</subject><subject>Operating Rooms - standards</subject><subject>Patient Care Team - standards</subject><subject>Patient safety</subject><subject>Planning</subject><subject>Process Assessment (Health Care) - methods</subject><subject>safety culture</subject><subject>Success</subject><subject>Teamwork</subject><subject>United States</subject><subject>United States Department of Veterans Affairs</subject><issn>1475-3898</issn><issn>1475-3901</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkTtvFDEURkcIREKgp0KWKCjQLH6OPaJCKwhICTQ8JBrrruc662UeG9uL4Dfwp_Ew2RQ0qWzL5_uurk5VPWV0xZhoXl2nrVtxSs2KCkapuledMqlVLVrK7h_vpjUn1aOUdpSylrfsYXXCadMKztVp9ecSu-CgJxlhIDlCGMN4RWDsiJvAbedHGEneIvmJGSOMiWwR-rwl0A0FTiWTwzS-JpASpjTgmP_Fw7AHl8m0hH2IKRPBiQcX-pADpmPvPk5XEYYBH1cPPPQJn9ycZ9WXd28_r9_XF5_OP6zfXNQbKXiugWnjuJB-A9SX7aQy2njGHPfofdN65dCZcsMGWs5MB500GoTX6JCCEGfVi6W3TL4-YMp2CMlh38OI0yFZoxoqtWzVnaSWplWtUbKQz_8jd9MhjmUNy7Q2RkrVzH10oVycUoro7T6GAeJvy6idjdrZqJ2N2sVoiTy7KT5sBuxuA0eFBagXoKjAX7f_EH_YRgut7Meva8uVbM6_f1P2svAvF34z7O4e_xehqbrW</recordid><startdate>201008</startdate><enddate>201008</enddate><creator>Neily, Julia</creator><creator>Mills, Peter D</creator><creator>Lee, Pamela</creator><creator>Carney, Brian</creator><creator>West, Priscilla</creator><creator>Percarpio, Katherine</creator><creator>Mazzia, Lisa</creator><creator>Paull, Douglas E</creator><creator>Bagian, James P</creator><general>BMJ Publishing Group Ltd</general><general>BMJ Publishing Group LTD</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope></search><sort><creationdate>201008</creationdate><title>Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme</title><author>Neily, Julia ; Mills, Peter D ; Lee, Pamela ; Carney, Brian ; West, Priscilla ; Percarpio, Katherine ; Mazzia, Lisa ; Paull, Douglas E ; Bagian, James P</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b432t-a178c234fba0f38945878f11c2feff69f5cec8ff6e6a9218dad487a3f7ece0a33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adult</topic><topic>Aviation</topic><topic>Behavior</topic><topic>Clinical outcomes</topic><topic>Communication</topic><topic>crew resource management</topic><topic>Efficiency</topic><topic>Health administration</topic><topic>Health Facilities - standards</topic><topic>Health Resources - organization & administration</topic><topic>Healthcare quality improvement</topic><topic>Hospital administration</topic><topic>Humans</topic><topic>Inservice Training</topic><topic>Intensive Care Units - standards</topic><topic>Interviews</topic><topic>Leadership</topic><topic>Operating Rooms - standards</topic><topic>Patient Care Team - standards</topic><topic>Patient safety</topic><topic>Planning</topic><topic>Process Assessment (Health Care) - methods</topic><topic>safety culture</topic><topic>Success</topic><topic>Teamwork</topic><topic>United States</topic><topic>United States Department of Veterans Affairs</topic><toplevel>online_resources</toplevel><creatorcontrib>Neily, Julia</creatorcontrib><creatorcontrib>Mills, Peter D</creatorcontrib><creatorcontrib>Lee, Pamela</creatorcontrib><creatorcontrib>Carney, Brian</creatorcontrib><creatorcontrib>West, Priscilla</creatorcontrib><creatorcontrib>Percarpio, Katherine</creatorcontrib><creatorcontrib>Mazzia, Lisa</creatorcontrib><creatorcontrib>Paull, Douglas E</creatorcontrib><creatorcontrib>Bagian, James P</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>Quality & safety in health care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neily, Julia</au><au>Mills, Peter D</au><au>Lee, Pamela</au><au>Carney, Brian</au><au>West, Priscilla</au><au>Percarpio, Katherine</au><au>Mazzia, Lisa</au><au>Paull, Douglas E</au><au>Bagian, James P</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme</atitle><jtitle>Quality & safety in health care</jtitle><addtitle>Qual Saf Health Care</addtitle><date>2010-08</date><risdate>2010</risdate><volume>19</volume><issue>4</issue><spage>360</spage><epage>364</epage><pages>360-364</pages><issn>1475-3898</issn><eissn>1475-3901</eissn><abstract>BackgroundCommunication is problematic in healthcare. The Veterans Health Administration is implementing Medical Team Training. The authors describe results of the first 32 of 130 sites to undergo the programme. This report is unique; it provides aggregate results of a crew resource-management programme for numerous facilities.MethodsFacilities were taught medical team training and implemented briefings, debriefings and other projects. The authors coached teams through consultative phone interviews over a year. Implementation teams self-reported implementation and rated programme impact: 1=‘no impact’ and 5=‘significant impact.’ We used logistic regression to examine implementation of briefing/debriefing.ResultsNinety-seven per cent of facilities implemented briefings and debriefings, and all implemented an additional project. As of the final interview, 73% of OR and 67% of ICU implementation teams self-reported and rated staff impact 4–5. Eighty-six per cent of OR and 82% of ICU implementation teams self-reported and rated patient impact 4–5. Improved teamwork was reported by 84% of OR and 75% of ICU implementation teams. Efficiency improvements were reported by 94% of OR implementation teams. Almost all facilities (97%) reported a success story or avoiding an undesirable event. Sites with lower volume were more likely to conduct briefings/debriefings in all cases for all surgical services (p=0.03).ConclusionsSites are implementing the programme with a positive impact on patients and staff, and improving teamwork, efficiency and safety. A unique feature of the programme is that implementation was facilitated through follow-up support. This may have contributed to the early success of the programme.</abstract><cop>England</cop><pub>BMJ Publishing Group Ltd</pub><pmid>20693225</pmid><doi>10.1136/qshc.2008.031005</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; BMJ Journals - NESLi2 |
| subjects | Adult Aviation Behavior Clinical outcomes Communication crew resource management Efficiency Health administration Health Facilities - standards Health Resources - organization & administration Healthcare quality improvement Hospital administration Humans Inservice Training Intensive Care Units - standards Interviews Leadership Operating Rooms - standards Patient Care Team - standards Patient safety Planning Process Assessment (Health Care) - methods safety culture Success Teamwork United States United States Department of Veterans Affairs |
| title | Medical team training and coaching in the veterans health administration; assessment and impact on the first 32 facilities in the programme |
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