Team training matters for patient outcome
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Transcript of Team training matters for patient outcome
Team training mattersfor patient outcome
Stefan Gisin, MD
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Critical Incident Reporting System (CIRS)
New culture for Patient Safetyand Error Handling
Crisis Resource Management (CRM)
Guidelines & Algorithms
Use of Simulation
TEAM TRAINING
Patient safety
Emergency Situation
• 3 important facts:
– Characteristics of crisis situation• Not influenceable!
– Knowledge and competences• Can be improved!
– Multidisciplinary teamwork• Can be improved!
Simulation
• Collaboration Swissair / Anesthesiology Basel
Aviation US Airways 1549
Aviation Training
Umbilical Cord Prolapse
Umbilical Cord Prolapse
Confidential enquiries UK (CEMACH,CESDI)
• Potentially avoidable!– 50% maternal deaths
– 75% intrapartum related deaths
• Contributing factors– Communication problems
– Absent or poor teamwork
– Poor interpersonal relationship
• Fire drills“ for better management of obstetrical emergencies– Multiprofessional
– Teamwork training
– Annual repetition of training for all staff
– CTG-courses every 6 months
• 1 day emergency training interprofessional every 2 months
• Decrease interval decision delivery :
25 vs 14,5 min p <0.001
• Increase in recommended actions to alleviate cord compression
34,7% vs 82,3% p=0.003
Siassakos D et al BJOG 2009
Emergency C-section
Simulation
Retrospective analysis 1998 – 1999 (8430 births)
Intervention 2000: multiprofessional training
Neonatal outcome
86/10.000 births 44/10.000 births
27/10.000 births 13/10.000 births
Results 2001 – 2003 (11’030 births): 50% reduction APGAR < 6 50% reduction hypoxic-ischemic encephalopathy 70% reduction plexus injuries after shoulder dystocia
Neonatal outcome
Neonatal outcome
Surgical outcome
Surgical outcome
… 50% greater decline in risk-adjusted mortality …
Surgical outcome
Teamwork
Teamwork
Team oriented medical simulation
спасибо[email protected]