Evaluation of Communication and Safety Behaviors During Hospital-Wide Code Response Simulation
Simulation in healthcare : journal of the Society for Simulation in Healthcare
INTRODUCTION: To understand the baseline quality of team communication behaviors at our organization, we implemented institution-wide simulation training and measured the performance of safety behaviors of ad hoc teams in emergent situations. METHODS: Clinicians participated in 2 interprofessional video-recorded simulation scenarios, each followed by debriefing. Using a standardized evaluation instrument, 2 reviewers independently evaluated the presence or absence of desired team safety behaviors, including escalating care, sharing a mental model, establishing leadership, thinking out loud, and identifying roles and responsibilities. We also scored the quality of sharing the mental model, closed-loop communication, and overall team performance on a 7-point scale. Discordant reviews were resolved with scoring by an additional reviewer. RESULTS: A total of 1404 clinicians participated in 398 simulation scenarios, resulting in 257 usable videos. Overall, teams exhibited desired behaviors at the following frequencies: escalating care, 85%; sharing mental models, 66%; verbally establishing leadership, 6%; thinking out loud, 87%; and identifying roles and responsibilities, 27%. Across all reviews, the quality of the graded behaviors (of 7 points) was 2.8 for shared mental models, 3.3 for closed-loop communication, and 3.2 for overall team performance. CONCLUSIONS: In a simulation setting with ad hoc teams, there was variable performance on completing safety behaviors and only a fair quality of graded communication behaviors. These results establish a baseline assessment of communication and teamwork behaviors and will guide future quality improvement interventions.
Ren, D., Abrams, A., Banigan, M., Batabyal, R., Chamberlain, J., Garrow, A., Izem, R., Nicholson, L., Ottolini, M., Patterson, M., Sarnacki, R., Walsh, H., & Zaveri, P. (2022). Evaluation of Communication and Safety Behaviors During Hospital-Wide Code Response Simulation. Simulation in healthcare : journal of the Society for Simulation in Healthcare, 17 (1). http://dx.doi.org/10.1097/SIH.0000000000000575