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A Microdebriefing Crisis Resource Management Program for Simulated Pediatric Resuscitation in a Community Hospital: A
Farrukh N Jafri1, Doreen Mirante, Kelly Ellsworth
1From the Albert Einstein College of Medicine (F.N.J., R.T., D.J.S.), New York City; Departments of Emergency Medicine (F.N.J., D.M., J.S., K.W., S.Y., J.T., R.T., D.J.S.) and Critical Care (K.E.), White Plains Hospital, White Plains; Integrative Neuroscience Binghamton University (N.D.), Binghamton; Department Ambulatory Surgery (S.Y.), White Plains Hospital, White Plains, NY; and MGH Institute of Health Professions (A.K., R.A.E.), Boston, MA.
Introduction:
Crisis Resource Management (CRM) is a team training tool used in healthcare to enhance team performance and improve patient safety. Our program intends to determine the feasibility of high-fidelity simulation for teaching CRM to an interprofessional team in a community hospital and whether a microdebriefing intervention can improve performance during simulated pediatric resuscitation.
Methods:
We conducted a single-center prospective interventional study with 24 teams drawn from 4 departments. The program was divided into an initial assessment simulation case (pre), a 40-minute microdebriefing intervention, and a final assessment simulation case (post). Post and pre results were analyzed for each team using t tests and Wilcoxon signed-rank tests. Primary outcome measures included (a) completion of program, (b) percent enrollment, (c) participant reaction, and (d) support of continued programs on completion. Secondary outcomes included (a) change in teamwork performance, measured by the Clinical Teamwork Scale; (b) change in time to initiation of chest compressions and defibrillation; and (c) pediatric advanced life support adherence, measured by the Clinical Performance Tool.
Results:
We successfully completed a large-scale training program with high enrollment. Twenty-four teams with 162 participants improved in Clinical Teamwork Scale scores (42.8%-57.5%, P < 0.001), Clinical Performance Tool scores (61.7%-72.1%, P < 0.001), and time to cardiopulmonary resuscitation initiation (70.6-34.3 seconds, P < 0.001).
Conclusions:
Our center ran a well-attended, well-received interprofessional program in a community hospital site demonstrating that teaching CRM skills can improve simulated team performance in a diverse experienced cohort.
