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Cioffi SPB, Benuzzi L, Herbolzheimer M, Marrano E, Bellio G, Kluijfhout WP, Wijdicks FJ, Hättich A, Talving P, Bulger E, Tilsed J, Mariani D, Valcarcel CR, Mohseni S, Brundage S, Yanez C, Verbruggen JPAM, Hildebrand F, Schipper IB, Gaarder C, Cimbanassi S, Kurihara H, Bass GA. Identifying and addressing mentorship gaps in European trauma and emergency surgical training. Results from the Young European Society of Trauma and Emergency Surgery (yESTES) mentorship survey. Eur J Trauma Emerg Surg 2024:10.1007/s00068-024-02610-y. [PMID: 39120653 DOI: 10.1007/s00068-024-02610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Accepted: 07/14/2024] [Indexed: 08/10/2024]
Abstract
PURPOSE European training pathways for surgeons dedicated to treating severely injured and critically ill surgical patients lack a standardized approach and are significantly influenced by diverse organizational and cultural backgrounds. This variation extends into the realm of mentorship, a vital component for the holistic development of surgeons beyond mere technical proficiency. Currently, a comprehensive understanding of the mentorship landscape within the European trauma care (visceral or skeletal) and emergency general surgery (EGS) communities is lacking. This study aims to identify within the current mentorship environment prevalent practices, discern existing gaps, and propose structured interventions to enhance mentorship quality and accessibility led by the European Society for Trauma and Emergency Surgery (ESTES). METHODS Utilizing a structured survey conceived and promoted by the Young section of the European Society of Trauma and Emergency Surgery (yESTES), we collected and analyzed responses from 123 ESTES members (both surgeons in practice and in training) across 20 European countries. The survey focused on mentorship experiences, challenges faced by early-career and female surgeons, the integration of non-technical skills (NTS) in mentorship, and the perceived role of surgical societies in facilitating mentorship. RESULTS Findings highlighted a substantial mentorship experience gap, with 74% of respondents engaging in mostly informal mentorship, predominantly centered on surgical training. Notably, mentorship among early-career surgeons and trainees was less reported, uncovering a significant early-career gap. Female surgeons, representing a minority within respondents, reported a disproportionately poorer access to mentorship. Moreover, while respondents recognized the importance of NTS, these were inadequately addressed in current mentorship practices. The current mentorship input of surgical societies, like ESTES, is viewed as insufficient, with a call for structured programs and initiatives such as traveling fellowships and remote mentoring. CONCLUSIONS Our survey underscores critical gaps in the current mentorship landscape for trauma and EGS in Europe, particularly for early-career and female surgeons. A clear need exists for more formalized, inclusive mentorship programs that adequately cover both technical and non-technical skills. ESTES could play a pivotal role in addressing these gaps through structured interventions, fostering a more supportive, inclusive, and well-rounded surgical community.
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Affiliation(s)
- Stefano Piero Bernardo Cioffi
- Department of Surgery, University of Rome Sapienza, Rome, Italy.
- General Surgery Trauma Team, Niguarda Hospital, Milan, Italy.
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria.
| | - Laura Benuzzi
- General Surgery Trauma Team, Niguarda Hospital, Milan, Italy
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
| | - Marit Herbolzheimer
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
- Department for Trauma Surgery, BG Trauma Center Murnau, Murnau, Germany
| | - Enrico Marrano
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
- Department of General Surgery, Germans Trias I Pujol University Hospital, Barcelona, Badalona, Spain
| | - Gabriele Bellio
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
- Emergency Surgery Unit, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Wouter Pieter Kluijfhout
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
- Department of Traumasurgery, OLVG Amsterdam, Amsterdam, The Netherlands
| | - Frans-Jasper Wijdicks
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
- Department of Trauma Surgery, Diakonessenhuis Hospital Utrecht, Utrecht, The Netherlands
| | - Annika Hättich
- Young-ESTES, European Society for Trauma and Emergency Surgery, St. Polten, Austria
- Department for Trauma and Orthopaedic Surgery, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Peep Talving
- Institute of Clinical Medicine, University of Tartu, University Hospital, Puusepa 8, Tartu, Estonia
| | - Eileen Bulger
- Harborview Medical Center, University of Washington, Seattle, WA, USA
| | - Jonathan Tilsed
- Hull Royal Infirmary, Anlaby Road, Hu3 2Jz, Hull, England, UK
- UEMS Division of Emergency Surgery, Liverpool, UK
| | - Diego Mariani
- Asst Ovest Milanese, Chirurgia Generale E Urgenza, Legnano, Italy
| | | | - Shahin Mohseni
- Department of Surgery, Sheikh Shakhbout Medical City (SSMC), Abu Dhabi, United Arab Emirates
| | - Susan Brundage
- Department of Surgery, R Adams Cowley Shock Trauma Center, Baltimore, USA
| | - Carlos Yanez
- General and Acute Care Surgery Department, San Jorge University Hospital, Huesca, Spain
| | - Jan P A M Verbruggen
- Department of Trauma Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frank Hildebrand
- Department of Orthopaedics Trauma and Reconstructive Surgery, University Hospital RWTH, Aachen, Germany
| | - Inger B Schipper
- Trauma Surgery Department, University of Leiden, Leiden University Medical Center, Leiden, The Netherlands
| | - Christine Gaarder
- Department of Traumatology, Oslo University Hospital Ullevål (OUH U), Olso, Norway
| | - Stefania Cimbanassi
- General Surgery Trauma Team, Niguarda Hospital, Milan, Italy
- Department of Surgical Pathophysiology and Transplantation, State University of Milan, Milan, Italy
| | - Hayato Kurihara
- Emergency Surgery Unit, IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- State University of Milan, Milan, Italy
| | - Gary Alan Bass
- Division of Traumatology, Surgical Critical Care and Emergency Surgery, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, USA
- Center for Peri-Operative Research and Transformation (C-PORT), University of Pennsylvania, Philadelphia, USA
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Mathis MR, Janda AM, Yule SJ, Dias RD, Likosky DS, Pagani FD, Stakich-Alpirez K, Kerray FM, Schultz ML, Fitzgerald D, Sturmer D, Manojlovich M, Krein SL, Caldwell MD. Nontechnical Skills for Intraoperative Team Members. Anesthesiol Clin 2023; 41:803-818. [PMID: 37838385 PMCID: PMC10703542 DOI: 10.1016/j.anclin.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Nontechnical skills, defined as the set of cognitive and social skills used by individuals and teams to reduce error and improve performance in complex systems, have become increasingly recognized as a key contributor to patient safety. Efforts to characterize, quantify, and teach nontechnical skills in the context of perioperative care continue to evolve. This review article summarizes the essential behaviors for safety, described in taxonomies for nontechnical skills assessments developed for intraoperative clinical team members (eg, surgeons, anesthesiologists, scrub practitioners, perfusionists). Furthermore, the authors describe emerging methods to advance understanding of the impact of nontechnical skills on perioperative outcomes.
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Affiliation(s)
- Michael R Mathis
- Department of Anesthesiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA.
| | - Allison M Janda
- Department of Anesthesiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Steven J Yule
- Department of Clinical Surgery, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, Scotland
| | - Roger D Dias
- Department of Emergency Medicine, Brigham & Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Donald S Likosky
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Francis D Pagani
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Korana Stakich-Alpirez
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Fiona M Kerray
- Department of Clinical Surgery, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XU, Scotland
| | - Megan L Schultz
- Department of Cardiac Surgery, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - David Fitzgerald
- Department of Clinical Sciences, Medical University of South Carolina College of Health Professions, A 151 Rutledge Avenue, Charleston, SC 29403, USA
| | - David Sturmer
- Department of Perfusion, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
| | - Milisa Manojlovich
- School of Nursing, University of Michigan, 426 N Ingalls Street, Ann Arbor, MI 48104, USA
| | - Sarah L Krein
- Department of Internal Medicine, University of Michigan and Veterans Affairs Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, USA
| | - Matthew D Caldwell
- Department of Anesthesiology, University of Michigan Medical School, 1500 East Medical Center Drive, Ann Arbor, MI 48109, USA
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Keller DS, Alli VV, Winslow ER, Goldberg JE, Tsutsumi A, Ahuja V. Video-based Coaching: Current Status and Role in Surgical Practice, Part II- Practical Implementation and Risk Mitigation from the Society for Surgery of the Alimentary Tract, Health Care Quality and Outcomes Committee. J Gastrointest Surg 2023; 27:2876-2884. [PMID: 37973766 DOI: 10.1007/s11605-023-05866-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/07/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Video-based surgical coaching is gaining traction within the surgical community. It has an increasing adoption rate and growing recognition of its utility, especially an advanced continuous professional growth tool, for continued educational purposes. This method offers instructional flexibility in real-time remote settings and asynchronous feedback scenarios. In our first paper, we delineated fundamental principles for video-based coaching, emphasizing the customization of feedback to suit individual surgeon's needs. METHOD In this second part of the series, we review into practical applications of video-based coaching, focusing on quality improvements in a team-based setting, such as the trauma bay. Additionally, we address the potential risks associated with surgical video recording, storage, and distribution, particularly regarding medicolegal aspects. We propose a comprehensive framework to facilitate the implementation of video coaching within individual healthcare institutions. RESULTS Our paper examines the legal and ethical framework and explores the potential benefits and challenges, offering insights into the real-world implications of this educational approach. CONCLUSION This paper contributes to the discourse on integrating video-based coaching into continuous professional development. It aims to facilitate informed decision-making in healthcare institutions, considering the adoption of this innovative educational quality tool.
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Affiliation(s)
- Deborah S Keller
- Lankenau Medical Center, Lankenau Institute for Medical Research, Wynnewood, PA, USA
| | - Vamsi V Alli
- Division of Minimally Invasive Surgery/Bariatrics, Department of Surgery, Penn State Hershey Medical Center, Hershey, PA, USA
| | - Emily R Winslow
- Division of Hepatopancreatic Biliary Surgery, Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Joel E Goldberg
- Division of General and Gastrointestinal Surgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Ayaka Tsutsumi
- Department of Surgery, Yale School of Medicine, New Haven, CT, USA
| | - Vanita Ahuja
- Department of Surgery, Yale School of Medicine, New Haven, CT, USA.
- Department of Surgery, Veterans Affairs Connecticut Healthcare, Yale School of Medicine, New Haven, CT, USA.
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Alexander EG, Denny F, Gordon MW, McKiernan C, Lowe DJ. Evaluation of video review tools for assessing non-technical skills in emergency department resuscitation teams: a systematic review. BMC Emerg Med 2023; 23:141. [PMID: 38030981 PMCID: PMC10687788 DOI: 10.1186/s12873-023-00895-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND AND IMPORTANCE Use of video review in medicine is established in contexts such as surgery. Although not widely used in the emergency department (ED), some centres use it to evaluate non-technical skills (NTS) to support teaching and quality improvement. OBJECTIVE There is no consensus on assessment of NTS using video review in the ED and the purpose of this review was to identify tools used in this context. DESIGN, SETTING AND PARTICIPANTS Studies were identified using Embase, Medline, CINAHL and Google Scholar. Inclusion criterion for the review was NTS of resuscitation teams working within the ED were assessed using video review. A systematic search method was used, and results were synthesised after search criteria was checked by two independent reviewers. Authors settled on the same 9 studies eligible for inclusion. OUTCOME MEASURES AND ANALYSIS Reliability and validity of tools identified for use in this context. Due to the heterogeneity of studies, no meta-analysis occurred. MAIN RESULTS There are 9 studies included in the review. The review was registered with PROSPERO (Ref No: CRD42022306129). Four unique tools were identified - 6 studies used T-NOTECHS, 1 used TTCA-24, 1 used CALM and 1 used the Communication tool. T-NOTECHS is validated in the literature for use in this context. CONCLUSION T-NOTECHS is the tool of choice for assessing ED teams in this context.
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Affiliation(s)
| | - Fraser Denny
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Malcom Wg Gordon
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - Cieran McKiernan
- University of Glasgow, Glasgow, UK
- Queen Elizabeth University Hospital, Glasgow, UK
| | - David J Lowe
- University of Glasgow, Glasgow, UK.
- Queen Elizabeth University Hospital, Glasgow, UK.
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
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Blaine KP, Dudaryk R, Milne AD, Moon TS, Nagy D, Sappenfield JW, Teng JJ. Training Anesthesiology Residents to Care for the Traumatically Injured in the United States. Anesth Analg 2023; 136:861-876. [PMID: 37058723 PMCID: PMC10079293 DOI: 10.1213/ane.0000000000006417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
Training and education for trauma anesthesiology have been predicated on 2 primary pathways: learning through peripheral "complex, massive transfusion cases"-an assumption that is flawed due to the unique demands, skills, and knowledge of trauma anesthesiology-or learning through experiential education, which is also incomplete due to its unpredictable and variable exposure. Residents may receive training from senior physicians who may not maintain a trauma-focused continuing medical education. Further compounding the issue is the lack of fellowship-trained clinicians and standardized curricula. The American Board of Anesthesiology (ABA) provides a section for trauma education in its Initial Certification in Anesthesiology Content Outline. However, many trauma-related topics also fall under other subspecialties, and the outline excludes "nontechnical" skills. This article focuses on the training of anesthesiology residents and proposes a tier-based approach to teaching the ABA outline by including lectures, simulation, problem-based learning discussions, and case-based discussions that are proctored in conducive environments by knowledgeable facilitators.
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Affiliation(s)
- Kevin P Blaine
- From the Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, Oregon
| | - Roman Dudaryk
- Department of Anesthesiology, University of Miami, Ryder Trauma Center, Miami, Florida
| | - Andrew D Milne
- Trauma Anaesthesia Group, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom
| | - Tiffany S Moon
- Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Joshua W Sappenfield
- Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida
| | - Justin J Teng
- Department of Anesthesia, The Permanente Medical Group, South Sacramento, California
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6
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Variation of in-hospital trauma team staffing: new resuscitation, new team. BMC Emerg Med 2022; 22:161. [PMID: 36109695 PMCID: PMC9479395 DOI: 10.1186/s12873-022-00715-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 09/07/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing.
Methods
Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night).
Results
All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members).
Conclusion
We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.
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7
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van Maarseveen OEC, Ham WHW, van Cruchten S, Duhoky R, Leenen LPH. Evaluation of validity and reliability of video analysis and live observations to assess trauma team performance. Eur J Trauma Emerg Surg 2022; 48:4797-4803. [PMID: 35817942 DOI: 10.1007/s00068-022-02004-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 05/15/2022] [Indexed: 11/03/2022]
Abstract
INTRODUCTION A trauma resuscitation is dynamic and complex process in which failures could lead to serious adverse events. In several trauma centers, evaluation of trauma resuscitation is part of a hospital's quality assessment program. While video analysis is commonly used, some hospitals use live observations, mainly due to ethical and medicolegal concerns. The aim of this study was to compare the validity and reliability of video analysis and live observations to evaluate trauma resuscitations. METHODS In this prospective observational study, validity was assessed by comparing the observed adherence to 28 advanced trauma life support (ATLS) guideline related tasks by video analysis to life observations. Interobserver reliability was assessed by calculating the intra class coefficient of observed ATLS related tasks by live observations and video analysis. RESULTS Eleven simulated and thirteen real-life resuscitations were assessed. Overall, the percentage of observed ATLS related tasks performed during simulated resuscitations was 10.4% (P < 0.001) higher when the same resuscitations were analysed using video compared to live observations. During real-life resuscitations, 8.7% (p < 0.001) more ATLS related tasks were observed using video review compared to live observations. In absolute terms, a mean of 2.9 (during simulated resuscitations) respectively 2.5 (during actual resuscitations) ATLS-related tasks per resuscitation were not identified using live observers, that were observed through video analysis. The interobserver variability for observed ATLS related tasks was significantly higher using video analysis compared to live observations for both simulated (video analysis: ICC 0.97; 95% CI 0.97-0.98 vs. live observation: ICC 0.69; 95% CI 0.57-0.78) and real-life witnessed resuscitations (video analyse 0.99; 95% CI 0.99-1.00 vs live observers 0.86; 95% CI 0.83-0.89). CONCLUSION Video analysis of trauma resuscitations may be more valid and reliable compared to evaluation by live observers. These outcomes may guide the debate to justify video review instead of live observations.
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Affiliation(s)
- Oscar E C van Maarseveen
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.
| | - Wietske H W Ham
- Emergency Department, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Institute of Nursing Studies, University of Applied Science, Heidelberglaan 7, 3584 CS, Utrecht, The Netherlands
| | - Stijn van Cruchten
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Rauand Duhoky
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands.,Emergency Department, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Luke P H Leenen
- Department of Trauma Surgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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8
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Bhangu A, Notario L, Pinto RL, Pannell D, Thomas-Boaz W, Freedman C, Tien H, Nathens AB, da Luz L. Closed loop communication in the trauma bay: identifying opportunities for team performance improvement through a video review analysis. CAN J EMERG MED 2022; 24:419-425. [PMID: 35412259 PMCID: PMC9002216 DOI: 10.1007/s43678-022-00295-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 03/09/2022] [Indexed: 01/17/2023]
Abstract
Objectives Communication among trauma team members in the trauma bay is vulnerable to errors, which may impact patient outcomes. We used the previously validated trauma-non-technical skills (T-NOTECHS) tool to identify communication gaps during patient management in the trauma bay and to inform development strategies to improve team performance. Methods Two reviewers independently assessed non-technical skills of team members through video footage at Sunnybrook Health Sciences Centre. Team performance was measured using T-NOTECHS across five domains using a five-point Likert scale (lower score indicating worse performance): (1) leadership; (2) cooperation and resource management; (3) communication and interaction; (4) assessment and decision making; (5) situation awareness/coping with stress. Secondary outcomes assessed the number of callouts, closed loop communications and parallel conversations. Results The study included 55 trauma activations. Injury severity score (ISS) was used as a measure of trauma severity. A case with an ISS score ≥ 16 was considered severe. ISS was ≥ 16 in 37% of cases. Communication and interaction scored significantly lower compared to all other domains (p < 0.0001). There were significantly more callouts and completed closed loop communications in more severe cases compared to less severe cases (p = 0.017 for both). Incomplete closed loop communications and parallel conversations were identified, irrespective of case severity. Conclusion A lower communication score was identified using T-NOTECHS, attributed to incomplete closed loop communications and parallel conversations. Through video review of trauma team activations, opportunities for improvement in communication can be identified by the T-NOTECHS tool, as well as specifically identifying callouts and closed loop communication. This process may be useful for trauma programs as part of a quality improvement program on communication skills and team performance. Supplementary Information The online version contains supplementary material available at 10.1007/s43678-022-00295-z.
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Affiliation(s)
- Avneesh Bhangu
- School of Medicine, Faculty of Health Sciences, Queen's University, Unit 505 - 91 King Street East, Kingston, ON, K7L 2Z8, Canada.
| | - Lowyl Notario
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Ruxandra L Pinto
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Dylan Pannell
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Will Thomas-Boaz
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada.,Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Corey Freedman
- Department of Emergency Services, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Homer Tien
- Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,, Ornge, Mississauga, ON, Canada
| | - Avery B Nathens
- Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Luis da Luz
- Tory Regional Trauma Program and the Evaluative Clinical Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada.,Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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