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Pilot testing of a model for insurer-driven, large-scale multicenter simulation training for operating room teams
Alexander F Arriaga1, Atul A Gawande, Daniel B Raemer
1*Brigham and Women's Hospital, Department of Surgery, Boston, MA; †Brigham and Women's Hospital, Department of Anesthesiology, Pain, and Perioperative Medicine, Boston, MA; ‡Harvard School of Public Health, Department of Health Policy and Management, Boston, MA; §Ariadne Labs, Boston, MA; ¶Brigham and Women's Hospital, Center for Surgery and Public Health, Boston MA; ‖Massachusetts General Hospital, Department of Anesthesia, Critical Care, and Pain Medicine, Boston, MA; **The Center for Medical Simulation, Cambridge, MA; ††Beth Israel Deaconess Medical Center, Department of Surgery, Boston, MA; ‡‡Beth Israel Deaconess Medical Center, Carl J. Shapiro Simulation and Skills Center, Boston, MA; §§Brigham and Women's Hospital, STRATUS Center for Medical Simulation, Boston, MA; ¶¶Boston Children's Hospital, Department of Anesthesia, Division of Critical Care Medicine, Boston, MA; ‖‖Boston Children's Hospital Simulator Program, Boston, MA; ***Risk Management Foundation of the Harvard Medical Institutions (CRICO/RMF), Cambridge, MA; †††Brigham and Women's Hospital, Department of Medicine, Boston, MA; ‡‡‡University of Rochester, Department of Surgery, Rochester, NY; §§§Beth Israel Deaconess Medical Center, Department of Anesthesia and Critical Care, Boston, MA; ¶¶¶Massachusetts General Hospital, Department of Surgery, Boston, MA; ‖‖‖Harvard Medical School, Gilbert Program in Medical Simulation, Boston, MA; and ****Massachusetts General Hospital, Department of Emergency Medicine, Boston, MA.
Implementing standardized teamwork training for operating room teams is feasible, showing high participant satisfaction and perceived impact on patient safety. This approach, supported by malpractice insurers, effectively scales simulation-based interventions.
Area of Science:
- Medical Education
- Patient Safety
- Surgical Team Training
Background:
- Intraoperative teamwork failures are a primary cause of preventable patient harm.
- Simulation-based teamwork training is effective but challenging to implement broadly.
Purpose of the Study:
- To assess the feasibility of a standardized, multi-institutional teamwork training program for entire operating room teams.
- To evaluate the impact of insurer-supported incentives on program participation and perceived effectiveness.
Main Methods:
- Developed a standardized operating room teamwork curriculum focusing on communication, assertiveness, and safety checklists.
- Utilized high-fidelity simulation for intraoperative emergency scenarios.
- Offered malpractice premium discounts and continuing education credits as incentives.
Main Results:
- 221 staff from 4 institutions participated, with teams including surgeons, anesthesiologists, and nurses.
- 99% survey response rate indicated high participant satisfaction with realism, relevance, and challenge.
- 92.6% believed the training would enhance patient care; identified communication and assertiveness as key areas for improvement.
Conclusions:
- A standardized, multicenter operating room team training program is feasible using high-fidelity simulation and modest compensation.
- Multidisciplinary teams perceived the training as impactful for their clinical practice and patient safety.
