STRAIT: Simulation Training for Rapid Assessment and Improved Teamwork

STRAIT：快速评估和改进团队合作的模拟培训

• 批准号: 7236330
• 负责人: MATTHEW BRET WEINGER
• 金额: $ 29.59万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2008-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7236330
• 关键词: anesthesia; behavioral /social science research tag; clinical research; communication behavior; computer simulation; computer system design /evaluation; cooperative study; critical care nursing; health care personnel performance; health care quality; health services research tag; human subject; interdisciplinary collaboration; training

DESCRIPTION (PROVIDED BY APPLICANT): Effective communication between clinicians may be a crucial component of safe care. High-quality communication may be especially critical during care transitions between clinicians (handoffs). In this two-year quasi-experimental Quality Improvement project, we will use simulation learning to evaluate and improve communication and coordination between anesthesia providers and nurses as care is transitioned from the operating room to the post-anesthesia care unit (PACU). Using a multiple baseline, staggered entry, prospective cohort design with repeated measures, a new training intervention (Simulation Training for Rapid Assessment and Improved Teamwork - STRAIT) will be introduced into two PACUs. The primary hypothesis is that simulation-based communication skills training of PACU personnel will significantly improve the quality of handoffs. We also hypothesize that such training will enhance the PACU's culture of communication and quality of care. Our three Aims are to: 1) develop a training intervention (STRAIT) for PACU handoffs; 2) determine if STRAIT improves PACU handoff quality; and 3) study the impact of a single focused training intervention on the PACU's communication culture and outcomes. After an initial two-month baseline of observations of actual patient handoffs, clinicians from one PACU will receive STRAIT. Training in the second PACU will begin nine months later. The results of daily field observations will be fed back to clinicians during the intervention. STRAIT will consist of preparatory web didactics and experiential learning using both manikins and standardized clinicians. Prior to every training session, clinicians will perform a videotaped simulated handoff. Individual clinician's simulated handoff performance will be compared before and after their training (Aim 1) on four dimensions of handoff effectiveness: information transfer; use of best evidence handoff strategies; interpersonal skills; and team behaviors. Clinicians will also rate their own handoffs. For Aim 2, trained observers will apply abbreviated metrics of the same effectiveness dimensions to actual PACU handoffs pre- versus post-STRAIT. For Aim 3, we will assess pre- versus post-training differences in clinician responses to a communication culture survey as well as for selected PACU-specific process and outcome measures. Successful demonstration of STRAIT'S effectiveness will lead to rapid dissemination of the methods to other clinical handoff situations.

描述（由申请人提供）：临床医生之间的有效沟通可能是安全护理的关键组成部分。在临床医生之间的护理过渡期间，高质量的交流尤其至关重要。在这个为期两年的准实验质量改进项目中，我们将使用模拟学习来评估和改善麻醉提供者和护士之间的沟通和协调，因为护理从手术室过渡到麻醉后护理单元（PACU）。使用多个基线，交错的入口，带有重复措施的前瞻性队列设计，新的培训干预措施（用于快速评估和改进的团队合作的仿真培训 - 海峡 - 海峡）将被引入两个PACUS。主要的假设是，基于模拟的PACU人员的沟通技巧培训将显着提高切换质量。我们还假设这种培训将增强PACU的沟通和护理质量的文化。我们的三个目的是：1）为PACU交接开发培训干预措施（海峡）； 2）确定海峡是否提高了PACU交接质量； 3）研究单一重点培训干预对PACU的交流文化和结果的影响。在最初对实际患者交接的观察结果的两个月基线之后，来自PACU的临床医生将接受海峡。第二次PACU的培训将在九个月后开始。在干预期间，每日野外观察结果的结果将回馈给临床医生。海峡将包括使用Manikins和标准化临床医生的准​​备网络教学和体验式学习。在每次培训课程之前，临床医生将进行录像的模拟交接。在训练之前和之后，将比较单个临床医生的模拟交接表现（AIM 1）在四个方面的效力：信息传输；使用最佳证据交接策略；人际交往能力；和团队行为。临床医生还将对自己的交接进行评分。对于AIM 2，训练有素的观察者将对实际有效性维度的缩写指标应用于前与后期特征的实际PACU切换。对于AIM 3，我们将评估临床医生对通信文化调查以及选定的PACU特定过程和结果测量的临床医生反应的训练前差异。成功证明海峡的有效性将导致方法快速传播到其他临床交接情况下。