Longitudinal Team Training Programme in a Norwegian Surgical Ward: a Qualitative Study of Nurses' and Physicians' Experiences with Teamwork Skills

Overview

Journal BMJ Open

Specialty General Medicine

Date 2020 Jul 10

PMID 32641327

Citations 3

Authors

Randi Ballangrud

Karina Aase

Anne Vifladt

Affiliations

Soon will be listed here.

Abstract

Objectives: Teamwork and interprofessional team training are fundamental to ensuring the continuity of care and high-quality outcomes for patients in a complex clinical environment. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based team training programme intended to facilitate healthcare professionals' teamwork skills. The aim of this study is to describe healthcare professionals' experiences with teamwork in a surgical ward before and during the implementation of a longitudinal interprofessional team training programme.

Design: A qualitative descriptive study based on follow-up focus group interviews.

Setting: A combined gastrointestinal surgery and urology ward at a hospital division in a Norwegian hospital trust.

Participants: A convenience sample of 11 healthcare professionals divided into three professionally based focus groups comprising physicians (n=4), registered nurses (n=4) and certified nursing assistants (n=3).

Interventions: The TeamSTEPPS programme was implemented in the surgical ward from May 2016 to June 2017. The team training programme included the three phases: (1) assessment and planning, (2) training and implementation and (3) sustainment.

Results: Before implementing the team training programme, healthcare professionals were essentially satisfied with the teamwork skills within the ward. During the implementation of the programme, they experienced that team training led to greater awareness and knowledge of their common teamwork skills. Improved teamwork skills were described in relation to a more systematic interprofessional information exchange, consciousness of leadership-balancing activities and resources, the use of situational monitoring tools and a shared understanding of accountability and transparency.

Conclusions: This study suggests that the team training programme provides healthcare professionals with a set of tools and terminology that promotes a common understanding of teamwork, hence affecting behaviour and communication in their daily clinical practice at the surgical ward.

Trial Registration Number: ISRCTN13997367.

Citing Articles

Teamwork between registered nurses and unlicensed assistive personnel in acute care settings: A scoping review.

Wong K, Chua W, Griffiths P, Goh Q, Low K, Tan J Int J Nurs Stud Adv. 2025; 8:100293.

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Ambulance professionals' experiences of teamwork in the context of a team training programme - a qualitative study.

Myhr K, Ballangrud R, Aase K, Vifladt A BMC Emerg Med. 2024; 24(1):108.

PMID: 38956498 PMC: 11218233. DOI: 10.1186/s12873-024-01018-6.

Patients' Perceptions of Quality of Care: A Teamwork Intervention Study in a Surgical Ward.

Hall-Lord M, Ballangrud R SAGE Open Nurs. 2022; 8:23779608221076814.

PMID: 35155776 PMC: 8829721. DOI: 10.1177/23779608221076814.

Longitudinal team training program in a Norwegian surgical ward: a qualitative study of nurses' and physicians' experiences with implementation.

Ballangrud R, Aase K, Vifladt A BMC Health Serv Res. 2021; 21(1):725.

PMID: 34294085 PMC: 8299676. DOI: 10.1186/s12913-021-06732-6.

References

Subbe C, Kruger M, Rutherford P, Gemmel L . Validation of a modified Early Warning Score in medical admissions. QJM. 2001; 94(10):521-6. DOI: 10.1093/qjmed/94.10.521. View

Sun R, Marshall D, Sykes M, Maruthappu M, Shalhoub J . The impact of improving teamwork on patient outcomes in surgery: A systematic review. Int J Surg. 2018; 53:171-177. DOI: 10.1016/j.ijsu.2018.03.044. View

Eddy K, Jordan Z, Stephenson M . Health professionals' experience of teamwork education in acute hospital settings: a systematic review of qualitative literature. JBI Database System Rev Implement Rep. 2016; 14(4):96-137. DOI: 10.11124/JBISRIR-2016-1843. View

ODea A, OConnor P, Keogh I . A meta-analysis of the effectiveness of crew resource management training in acute care domains. Postgrad Med J. 2014; 90(1070):699-708. DOI: 10.1136/postgradmedj-2014-132800. View

Sandelowski M . Whatever happened to qualitative description?. Res Nurs Health. 2000; 23(4):334-40. DOI: 10.1002/1098-240x(200008)23:4<334::aid-nur9>3.0.co;2-g. View

Harkanen M, Ahonen J, Kervinen M, Turunen H, Vehvilainen-Julkunen K . The factors associated with medication errors in adult medical and surgical inpatients: a direct observation approach with medication record reviews. Scand J Caring Sci. 2014; 29(2):297-306. DOI: 10.1111/scs.12163. View

Capella J, Smith S, Philp A, Putnam T, Gilbert C, Fry W . Teamwork training improves the clinical care of trauma patients. J Surg Educ. 2010; 67(6):439-43. DOI: 10.1016/j.jsurg.2010.06.006. View

Forse R, Bramble J, McQuillan R . Team training can improve operating room performance. Surgery. 2011; 150(4):771-8. DOI: 10.1016/j.surg.2011.07.076. View

De Meester K, Verspuy M, Monsieurs K, Van Bogaert P . SBAR improves nurse-physician communication and reduces unexpected death: a pre and post intervention study. Resuscitation. 2013; 84(9):1192-6. DOI: 10.1016/j.resuscitation.2013.03.016. View

10.

Haig K, Sutton S, Whittington J . SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf. 2006; 32(3):167-75. DOI: 10.1016/s1553-7250(06)32022-3. View

11.

Elo S, Kyngas H . The qualitative content analysis process. J Adv Nurs. 2008; 62(1):107-15. DOI: 10.1111/j.1365-2648.2007.04569.x. View

12.

Zegers M, de Bruijne M, de Keizer B, Merten H, Groenewegen P, van der Wal G . The incidence, root-causes, and outcomes of adverse events in surgical units: implication for potential prevention strategies. Patient Saf Surg. 2011; 5:13. PMC: 3127749. DOI: 10.1186/1754-9493-5-13. View

13.

Ballangrud R, Husebo S, Aase K, Aaberg O, Vifladt A, Berg G . "Teamwork in hospitals": a quasi-experimental study protocol applying a human factors approach. BMC Nurs. 2017; 16:34. PMC: 5492228. DOI: 10.1186/s12912-017-0229-z. View

14.

Downey C, Tahir W, Randell R, Brown J, Jayne D . Strengths and limitations of early warning scores: A systematic review and narrative synthesis. Int J Nurs Stud. 2017; 76:106-119. DOI: 10.1016/j.ijnurstu.2017.09.003. View

15.

Young-Xu Y, Neily J, Mills P, Carney B, West P, Berger D . Association between implementation of a medical team training program and surgical morbidity. Arch Surg. 2011; 146(12):1368-73. DOI: 10.1001/archsurg.2011.762. View

16.

Mayer C, Cluff L, Lin W, Willis T, Stafford R, Williams C . Evaluating efforts to optimize TeamSTEPPS implementation in surgical and pediatric intensive care units. Jt Comm J Qual Patient Saf. 2011; 37(8):365-74. DOI: 10.1016/s1553-7250(11)37047-x. View

17.

Rhee A, Valentin-Salgado Y, Eshak D, Feldman D, Kischak P, Reich D . Team Training in the Perioperative Arena: A Methodology for Implementation and Auditing Behavior. Am J Med Qual. 2016; 32(4):369-375. DOI: 10.1177/1062860616662703. View

18.

Johnston M, Arora S, King D, Bouras G, Almoudaris A, Davis R . A systematic review to identify the factors that affect failure to rescue and escalation of care in surgery. Surgery. 2015; 157(4):752-63. DOI: 10.1016/j.surg.2014.10.017. View

19.

Sacks G, Shannon E, Dawes A, Rollo J, Nguyen D, Russell M . Teamwork, communication and safety climate: a systematic review of interventions to improve surgical culture. BMJ Qual Saf. 2015; 24(7):458-67. DOI: 10.1136/bmjqs-2014-003764. View

20.

Reeves S, Clark E, Lawton S, Ream M, Ross F . Examining the nature of interprofessional interventions designed to promote patient safety: a narrative review. Int J Qual Health Care. 2017; 29(2):144-150. DOI: 10.1093/intqhc/mzx008. View