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Teamwork in Rural Emergency Health Care: A Simulation-Based Cross-over Study of Co-located and Distributed Teams
Hanna Morian1, Magnus Hultin, Marie Lindkvist
1From the Department of Nursing (H.M., K.J., M.Hä.), Umeå University, Umeå, Sweden; Department of Diagnostics and Intervention, Anaesthesia and Critical Care Medicine (M.Hu.), Umeå University, Umeå, Sweden; Department of Epidemiology and Global Health (M.L.), Umeå University, Umeå, Sweden; Center for Advanced Medical Simulation and Training (J.C., H.D.), Karolinska University Hospital, Stockholm, Sweden; Department of Clinical Science, Intervention, and Technology (J.C., H.D.), Karolinska Institutet, Stockholm, Sweden; Department of Research, Education and Development (T.NA), Simulation Centre West, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
Introduction:
Despite the increasing use of distributed healthcare teams, performance evaluation is largely lacking. This study examined rural emergency health care in Sweden to determine the effect of teams being either co-located or distributed with remote physicians accessible via telemedicine.
Method:
In this crossover study, 17 three-person teams were video recorded during co-located and distributed simulated scenarios. Team performance in the video recordings was evaluated using the TEAM instrument.
Results:
Co-located scenarios had significantly higher Total ratings for the instrument (items 1-11), in the teamwork domain (items 3-9), and in overall performance (item 12) compared with distributed scenarios ( P < 0.005). Item-level analysis revealed that co-located teams were better at completing tasks on time (item 4) and showed greater adaptability to changing situations (item 7).
Conclusions:
The higher rating of the performance of co-located teams underscores the challenges facing distributed teams. Given that distributed healthcare teams are a reality in rural areas in northern Sweden, education and training must be adapted to address these challenges. This adaptation is crucial for ensuring high-quality patient care by distributed teams.
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