Testing the effects of checklists on team behaviour during emergencies on general wards: An observational study using...

Area of Science:

• Medical Education
• Patient Safety
• Clinical Informatics

Background:

• Clinical teams face challenges in the acute management of deteriorating patients on general wards.
• Effective teamwork and adherence to critical steps are vital for patient safety during crises.

Purpose of the Study:

• To evaluate the impact of the Crisis Checklist App on teamwork and acute care management in simulated deteriorating patient scenarios.
• To assess if a mobile checklist application can improve clinical team performance and patient safety.

Main Methods:

• A before-and-after study was conducted in high-fidelity simulation centers across the Netherlands, Denmark, and the UK.
• Clinical teams completed crisis scenarios with and without the Crisis Checklist App, with teamwork assessed using the Mayo High Performance Teamwork scale.
• Secondary outcomes included time to complete safety-critical steps, omission rates, non-technical skills, and user self-assessments.

Main Results:

• The Crisis Checklist App significantly improved teamwork scores (mean difference 1.97, p < 0.001).
• Teams using the app completed safety-critical steps more frequently (40/95 vs 21/93) and faster (p = 0.005).
• Favorable effects were noted in situational awareness, decision-making, task management, and communication.

Conclusions:

• Implementation of the Crisis Checklist App in a simulated general ward setting improved clinical team performance.
• The mobile application enhanced teamwork and the rate and speed of completing safety-critical steps.
• The findings suggest the Crisis Checklist App is a valuable tool for improving acute care management and patient safety.