by Holly Hayes
The Association of periOperative Registered Nurses (AORN) published an article in their December journal titled, “Enhancing Communication in Surgery Through Team Training Interventions: A Systematic Literature Review.” The article quotes The Joint Commission’s (TJC) October 2007 Sentinel Events Statistics which stated communication failure was the root cause of approximately 70% of healthcare sentinel events. The TJC defined a sentinel event as an “unanticipated event in a healthcare setting resulting in death or serious physical or psychological injury to a patient.”
The authors’ initial literature search identified 854 potential team training interventions; further screening reduced that number to 18 studies for review with 12 of those studies meeting the criteria for inclusion in the final sample. The results of the review, as described in the full text of the article, suggest overwhelming evidence that team training can improve team-based outcomes.
The authors also conclude:
The success of any team training intervention introduced into the clinical milieu lies in its sustainability over time. Clearly, the tendency for the effects of interventions to decay and for teams to regress over time also must be considered when defining the effectiveness of such interventions. Sustainability requires well-publicized institutional support and action at all levels in the organization and substantial commitment of institutional resources in the creation of team training policies and protocols, as well as regular retraining. We recommend that team training programs incorporate team coaches who are able to provide on-the-job support, similar to the TeamSTEPPS program. Equally important to this effort is the provision of timely and well-executed feedback on team- and patient-based outcomes. Team training is not a one-day or single-session event; therefore, teamwork behaviors need to be acknowledged and reinforced in mentoring sessions and annual performance evaluations. This will maintain behaviors over time and embed integration of teamwork into the organizational culture. In complex health care environments, teams do not exist in isolation and, as such, the effectiveness of any team training intervention cannot be appropriately evaluated without considering the larger system in which the team operates.
As the healthcare industry continues to work to improve quality, decrease costs and respond to the Patient Protection and Affordable Care Act, the lessons gleaned from the literature review performed by Brigid M. Gillespie, RN, Cert Periop, BHlth Sc (Hons), PhD; Wendy Chaboyer, RN, BSc, MN, PhD; and Patrick Murray, M Mgt Av about OR team training may be applicable in other healthcare settings.
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Holly Hayes is a mediator at Karl Bayer, Dispute Resolution Expert where she focuses on mediation of health care disputes. Holly holds a B.A. from Southern Methodist University and a Masters in Health Administration from Duke University. She can be reached at holly@karlbayer.com.
