Communication failures pose a significant and ongoing threat to patient safety. The current modes of training in educational silos foster poor teamwork and lack a shared model for high‐quality patient care. A growing emphasis on teaching system‐based practice, including teamwork and communication, to current and future providers is essential but remains challenging.
We describe the development and implementation of and learning from a multidisciplinary teamwork training program at a university teaching hospital
We have been leading a collaborative unit‐based patient safety project called the Triad for Optimal Patient Safety (TOPS). The 3‐hospital pilot study featured a dynamic and newly developed 4‐hour training program to promote teamwork, communication, and collaborative interdisciplinary care. Participants included internal medicine residents, hospitalists, nurses, pharmacists, discharge planners, unit clerks, and therapists. The curricular content began with a brief overview of patient safety and the role communication plays in contributing to medical errors. Participants then watched the powerful video Do No Harm, followed by a facilitated discussion regarding how both systems and individuals contribute to error. Prior to breaking into small groups, a nurse‐teamwork expert and commercial airline pilot introduced principles of crew resource management and specific communication skills (eg, SBAR) in framing teambuilding behaviors. Finally, trained facilitators worked through patient‐related scenarios to provide an opportunity to practice new skills, engage in interdisciplinary discussion, and discuss methods to work effectively in busy and complex patient care environments. We trained more than 325 participants over several sessions. Overall, the training program was well received, as 99% of participants “would recommend it to others,” and the average rating for the course was 4.5 out of 5.
Teaching teamwork and communication requires a focus on acquiring new skills that can be immediately applied in practice. Breaking traditional educational silos is equally important in implementation, as “getting everyone in the same room” drives the change. A multidisciplinary training curriculum has many challenges including: (1) creating content that applies to all disciplines, (2) developing a planning team represented by the disciplines targeted for training, and (3) performing scheduling and logistics. The latter is particularly challenging for residents and can be a real obstacle if the training curriculum comes without mandated participation and scheduled relief from clinical duties. Finally, as with any quality improvement or educational program, careful evaluation of the training experience is critical, both to drive future efforts and to build on initial training.
N. Sehgal, MD, MPH, None; A. Vidyarthi, None; B. Sharpe, None; M. Fox, None; T. Bookwalter, None; R. Wachter, None.