Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study

D Siassakos, K Bristowe, TJ Draycott, J Anqouri, H Hambly, CJ Winter, JF Crofts, LP Hunt, RA Fox

Research output: Contribution to journalArticle (Academic Journal)

88 Citations (Scopus)

Abstract

OBJECTIVE: To identify specific aspects of teamworking associated with greater clinical efficiency in simulated obstetric emergencies. DESIGN: Cross-sectional secondary analysis of video recordings from the Simulation & Fire-drill Evaluation (SaFE) randomised controlled trial. SETTING: Six secondary and tertiary maternity units. SAMPLE: A total of 114 randomly selected healthcare professionals, in 19 teams of six members. METHODS: Two independent assessors, a clinician and a language communication specialist identified specific teamwork behaviours using a grid derived from the safety literature. MAIN OUTCOME MEASURES: Relationship between teamwork behaviours and the time to administration of magnesium sulfate, a validated measure of clinical efficiency, was calculated. RESULTS: More efficient teams were likely to (1) have stated (recognised and verbally declared) the emergency (eclampsia) earlier (Kendall's rank correlation coefficient τ(b) = -0.53, 95% CI from -0.74 to -0.32, P=0.004); and (2) have managed the critical task using closed-loop communication (task clearly and loudly delegated, accepted, executed and completion acknowledged) (τ(b) = 0.46, 95% CI 0.17-0.74, P=0.022). Teams that administered magnesium sulfate within the allocated time (10 minutes) had significantly fewer exits from the labour room compared with teams who did not: a median of three (IQR 2-5) versus six exits (IQR 5-6) (P=0.03, Mann-Whitney U-test). CONCLUSIONS: Using administration of an essential drug as a valid surrogate of team efficiency and patient outcome after a simulated emergency, we found that more efficient teams were more likely to exhibit certain team behaviours relating to better handover and task allocation.
Translated title of the contributionClinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study
Original languageEnglish
Pages (from-to)596 - 607
Number of pages12
JournalBJOG: An International Journal of Obstetrics and Gynaecology
Volume118(5)
DOIs
Publication statusPublished - Apr 2011

Fingerprint Dive into the research topics of 'Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study'. Together they form a unique fingerprint.

Cite this