A regional patients safety training initiative for multidisciiplinary clinical teams

Abstract

Introduction: Worldwide government initiatives are the proof that simulation is increasingly recognised as being a vital component of building a safer healthcare system. Its use is particularly recommended to enhance human factors’ training and should be mandatory for healthcare staff training. Human errors negatively impact patient outcomes and are exacerbated in a clinical environment characterised by unpredictability, particularly during crisis situations. Rapid clinical assessments, good decision making and effective team working are some of the urgent interventions necessary during acute decline in patient stability. Methods: With the aim of increasing patient safety and ahead of the report from the Chief Medical Officer for England we secured Continuing Professional Development funding from the regional health authority to put in place a one-year simulation programme to train existing multiprofessional clinical teams using elements of the TeamSTEPPS package. Part of the programme also focuses on training senior clinicians as patient safety simulation facilitators. The clinical teams invited to take part in these sessions through the clinical managers include staff from A&E, ITU, Theatre, Obstetrics, Cardiology, and Respiratory care. The programme of each day is tailored to the clinical area concerned and includes a series of presentations, workshops, and relevant high-fidelity scenarios which offer participants the opportunity to put in practice the tools or principles they have been introduced to just before. The content of the workshops and selection of the tools to be presented (i.e. SBAR, 2-challenge rule, check backs, STEP...) are based on a needs analysis carried out by one of the researchers and based on the staff interviews and discussion with senior clinicians from the concerned areas. Each simulation session is attended by two similar teams from two of the five local hospitals but only one team at a time is ever involved in a scenario so the others can critically observe what happens and learn from their peers’ performance. The faculty facilitating each session includes staff from the University’s simulation centre and clinicians from the participating hospitals attending the session who have been trained as patient safety simulation facilitators. A research project is being organised alongside this training programme to investigate whether this intervention is changing the team climate and practice of the teams involved using feedback questionnaires and pre/post-intervention focused interviews. We hope to improve the non-technical skills of the participants through the introduction of a few tools from the TeamSTEPPS package. Discussion/Conclusions: One of the measurable outcomes of this initiative will be the adoption or rejection in the workplace of the tools presented and whether it correlates with the number of reported patient safety incidents. In addition to 30 new simulation facilitators, 300-450 hospital staff including doctors and nurses from different specialties, physiotherapists, midwives, operating department practitioners, radiographers, healthcare assistants, and porters are expected to take part and benefit from the training. The results of the study will be presented next year.