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重要组成部分。在临床医生之间的护理过渡（交接）期间，高质量的沟通可能尤其重要。在这个为期两年的准实验质量改进项目中，当护理从手术室转移到麻醉后护理室（PACU）时，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。使用多基线、交错进入、前瞻性队列设计和重复测量，将在两个 PACU 中引入新的培训干预措施（快速评估和改进团队合作的模拟培训 - STRAIT）。主要假设是，对 PACU 人员进行基于模拟的沟通技能培训将显着提高交接质量。我们还假设此类培训将增强 PACU 的沟通文化和护理质量。我们的三个目标是： 1) 制定 PACU 交接培训干预措施 (STRAIT)； 2) 确定STRAIT是否改善PACU切换质量； 3) 研究单一集中培训干预对 PACU 沟通文化和结果的影响。在对实际患者交接进行初始两个月基线观察后，来自一个 PACU 的临床医生将接受 STRAIT。第二个 PACU 的培训将于九个月后开始。每日现场观察的结果将在干预期间反馈给临床医生。 STRAIT 将包括使用人体模型和标准化临床医生的预备网络教学和体验式学习。在每次培训课程之前，临床医生都会进行录像模拟交接。各个临床医生的模拟切换表现将在培训（目标 1）前后在切换有效性的四个维度上进行比较：信息传输；使用最佳证据移交策略；人际交往能力；和团队行为。临床医生也会对自己的交接进行评分。对于目标 2，训练有素的观察员将在 STRAIT 前后的实际 PACU 交接中应用相同有效性维度的缩写指标。对于目标 3，我们将评估临床医生对沟通文化调查以及选定的 PACU 特定过程和结果测量的反应在培训前与培训后的差异。 STRAIT 有效性的成功证明将导致该方法快速传播到其他临床交接情况。