Enhancing Resuscitation Performance: The Impact of Team Resource Management and In-Situ Simulation on Teamwork and...

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Quality Improvement

Background:

• Effective ward resuscitation demands both technical proficiency and strong teamwork.
• Traditional resuscitation drills often neglect crucial teamwork skills.
• Team Resource Management (TRM) focuses on optimizing teamwork in high-stakes environments.

Purpose of the Study:

• To assess if a concise TRM curriculum, integrated with in-situ simulations, enhances resuscitation quality.
• To evaluate the impact of TRM training on the safety culture within hospital wards.
• To determine the effectiveness of TRM in improving resuscitation protocol adherence (RPA).

Main Methods:

• Retrospective analysis of a hospital-wide quality improvement project.
• Ward teams (physicians, nurses) underwent three training cycles over 12 months.
• Each cycle included online TRM modules and in-situ simulations with debriefs; RPA, Safety Attitudes Questionnaire (SAQ), and Teamwork Perception Questionnaire (TPQ) were measured.

Main Results:

• Resuscitation Protocol Adherence (RPA) significantly increased from 76.5% to 92.6% (p = 0.030).
• Improvements were most notable in the 'Transmission of Rescue Information' domain (62.5% to 90.6%, p = 0.028).
• No significant changes were observed in composite SAQ or TPQ scores, indicating no immediate shift in overall safety culture.

Conclusions:

• Three low-fidelity TRM in-situ simulations effectively boosted RPA, particularly enhancing team communication.
• Short, repeated TRM drills can rapidly improve process reliability in resuscitation.
• Sustained coaching and reinforcement are likely necessary for achieving broader, lasting cultural transformation in safety.