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Enhancing Resuscitation Performance: The Impact of Team Resource Management and In-Situ Simulation on Teamwork and
Ming-Yuan Hsieh1, An-Kuo Chou1,2, Cheng-Heng Liu3,4
1Center for Quality Management, National Taiwan University Hospital, Hsinchu Branch, Hsinchu.
Background:
Ward resuscitation requires both technical and teamwork skills, however conventional drills rarely address teamwork. We evaluated whether a brief Team Resource Management (TRM) curriculum combined with in-situ simulations could improve the quality of resuscitation and safety culture.
Methods:
This retrospective study analyzed data from a hospital-wide quality-improvement project at a 250-bed regional hospital. Ward teams (physicians, nursing specialists, and nurses) completed three training cycles at baseline, 6 months, and 12 months. Each cycle included 30-min online modules plus two in-situ simulations with TRM-focused debriefs. The primary outcome was resuscitation protocol adherence (RPA) using a 28-item checklist based on the 2020 ILCOR recommendations. The secondary outcomes were Safety Attitudes Questionnaire (SAQ) and Teamwork Perception Questionnaire (TPQ) scores.
Results:
Fifty-three of 94 eligible staff (56%) provided complete responses. The mean RPA rate increased from 76.5 ± 16.5% at baseline to 92.6 ± 9.7% after cycle three (p = 0.030), primarily driven by improvements in the "Transmission of Rescue Information" domain (62.5% vs. 90.6%, p = 0.028). No significant changes occurred in composite SAQ/TPQ scores.
Conclusions:
Three low-fidelity TRM in-situ simulations significantly increased the rate of RPA, particularly team communication, without immediate changes in the overall safety culture. Short, recurring TRM drills rapidly enhanced process reliability; sustained coaching may be needed for broader cultural transformation.
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