Improving Ad Hoc Medical Team Performance with an Innovative "I START-END" Communication Tool

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Communication

Background:

• Non-operating room settings present unique challenges due to unfamiliarity.
• Effective communication and crisis resource management are crucial in urgent medical scenarios.

Purpose of the Study:

• To evaluate the impact of the "I START-END" communication tool on anesthesia residents in simulated urgent non-operating room scenarios.
• To assess the tool's effectiveness in improving technical skills, non-technical skills, and teamwork.

Main Methods:

• A mixed-methods pre/post observational study involving 47 anesthesia residents.
• Residents participated in three simulations: baseline, post-training, and 3-6 months later.
• Performance was assessed using technical skill checklists, Anesthesia Non-Technical Skills (ANTS) scores, and the Mayo High Performance Teamwork Scale for actual Code Blue events.

Main Results:

• Residents reported the tool provided an organized approach, improving information gathering and resource planning.
• Significant improvement in technical skills was observed 3-6 months post-training.
• Debriefing at Code Blues occurred twice as often in residents trained with the I START-END tool.

Conclusions:

• The I START-END tool effectively operationalizes Crisis Resource Management (CRM) principles for non-operating room settings.
• The tool enhances residents' ability to communicate, obtain information, and collaborate effectively.
• It fosters an organized and proactive approach to managing urgent, unfamiliar clinical situations.