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Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams.

Publication ,  Journal Article
Arriaga, AF; Gawande, AA; Raemer, DB; Jones, DB; Smink, DS; Weinstock, P; Dwyer, K; Lipsitz, SR; Peyre, S; Pawlowski, JB; Muret-Wagstaff, S ...
Published in: Annals of surgery
March 2014

To test the feasibility of implementing a standardized teamwork training program with full operating room teams in multiple institutions, driven by malpractice insurer support and incentives.Failures in intraoperative teamwork are among the leading causes of preventable patient injury and death in surgical patients. Teamwork training, particularly using simulation, can be an effective intervention but is difficult to scale.A malpractice insurer convened a collaborative with 4 Harvard-affiliated simulation programs to develop a standardized operating room teamwork training curriculum, including principles of communication, assertiveness, and use of the World Health Organization Surgical Safety Checklist. Participant teams were compensated for lost operative time via malpractice premium discounts, continuing education credits, and compensation for lost wages. The course was delivered through a simulation program involving the management of intraoperative emergency scenarios. Participants were surveyed for their perceptions of the program and of its impact on clinical practice.A total of 221 active operating room staff members participated in the program. Each team contained at least 1 attending surgeon, 1 attending anesthesiologist, and 1 operating room nurse (mean size per team: 7 ± 2 participants). No study dates were cancelled because of lack of attendance. The survey response rate was 99% (218/221). Overall, the vast majority of participants found the scenarios realistic [94% (95% confidence interval: 90.9%, 97.2%)], appropriately challenging [95.4% (92.6%, 98.2%)], relevant to their practice [96.3% (93.8%, 98.8%)], and found the training would help them provide safer patient care [92.6% (89.1%, 96.1%)]. Surgeons reported their greatest personal deficit as communication skills. Operating room nurses and anesthesiologists reported a greater need than surgeons to work on personal assertiveness.A standardized multicenter team training program involving full operative teams is feasible with high-fidelity simulation and modest compensation for lost time. The vast majority of the multidisciplinary participants believed the course to have had a meaningful impact on their approach to clinical practice.

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Published In

Annals of surgery

DOI

EISSN

1528-1140

ISSN

0003-4932

Publication Date

March 2014

Volume

259

Issue

3

Start / End Page

403 / 410

Related Subject Headings

  • Surgery
  • Pilot Projects
  • Patient Simulation
  • Patient Care Team
  • Operating Rooms
  • Manikins
  • Insurance Carriers
  • Humans
  • Education, Medical
  • Curriculum
 

Citation

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ICMJE
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Arriaga, A. F., Gawande, A. A., Raemer, D. B., Jones, D. B., Smink, D. S., Weinstock, P., … Harvard Surgical Safety Collaborative, . (2014). Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams. Annals of Surgery, 259(3), 403–410. https://doi.org/10.1097/sla.0000000000000342
Arriaga, Alexander F., Atul A. Gawande, Daniel B. Raemer, Daniel B. Jones, Douglas S. Smink, Peter Weinstock, Kathy Dwyer, et al. “Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams.Annals of Surgery 259, no. 3 (March 2014): 403–10. https://doi.org/10.1097/sla.0000000000000342.
Arriaga AF, Gawande AA, Raemer DB, Jones DB, Smink DS, Weinstock P, et al. Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams. Annals of surgery. 2014 Mar;259(3):403–10.
Arriaga, Alexander F., et al. “Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams.Annals of Surgery, vol. 259, no. 3, Mar. 2014, pp. 403–10. Epmc, doi:10.1097/sla.0000000000000342.
Arriaga AF, Gawande AA, Raemer DB, Jones DB, Smink DS, Weinstock P, Dwyer K, Lipsitz SR, Peyre S, Pawlowski JB, Muret-Wagstaff S, Gee D, Gordon JA, Cooper JB, Berry WR, Harvard Surgical Safety Collaborative. Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams. Annals of surgery. 2014 Mar;259(3):403–410.

Published In

Annals of surgery

DOI

EISSN

1528-1140

ISSN

0003-4932

Publication Date

March 2014

Volume

259

Issue

3

Start / End Page

403 / 410

Related Subject Headings

  • Surgery
  • Pilot Projects
  • Patient Simulation
  • Patient Care Team
  • Operating Rooms
  • Manikins
  • Insurance Carriers
  • Humans
  • Education, Medical
  • Curriculum