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Sustaining Teamwork Behaviors Through Reinforcement of TeamSTEPPS Principles
Soo-Hoon Lee1, Harpal S Khanuja2, Renee J Blanding3
1From the Old Dominion University, Norfolk, Virginia.
Background:
Teamwork training improves short-term teamwork behaviors. However, improvements are often not sustained.
Question/Purpose:
The purpose of this study was to explore the extent to which teamwork reinforcement activities for orthopedic surgery teams lead to sustained teamwork behaviors.
Methods:
Seven months after 104 staff from an orthopedic surgical unit were trained in Team Strategies and Tools to Enhance Performance and Patient Safety principles, 4 reinforcement activities were implemented regarding leadership and communication: lectures with videos on leadership skills for nursing staff; an online self-paced learning program on communication skills for nursing staff; a 1-page summary on leadership skills e-mailed to surgical staff; and a 1-hour perioperative grand rounds on Team Strategies and Tools to Enhance Performance and Patient Safety principles for anesthesia staff and new staff. Twenty-four orthopedic surgical teams were evaluated on teamwork behaviors during surgery by 2 observers before and after the reinforcement period using the Observational Teamwork Assessment for Surgery tool.
Results:
After reinforcement, leadership (P = 0.022) and communication (P = 0.044) behaviors improved compared with prereinforcement levels. Specifically, nursing staff improved in leadership (P = 0.016) and communication (P = 0.028) behaviors, surgical staff improved in leadership behaviors (P = 0.009), but anesthesia staff did not improve in any teamwork behaviors.
Conclusions:
Sustained improvement in teamwork behaviors requires reinforcement.
Level Of Evidence:
Level III, prospective pre-post cohort study.
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