The Evidence-based Relation
Literature Review
Prepared by:
American Institutes for Research, University of Central Florida, University of Miami Center for Patient Safety
Investigators:
David P. Baker, Ph.D. (AIR)
Sigrid Gustafson, Ph.D. (AIR)
Jeff Beaubien, Ph.D. (AIR)
Eduardo Salas, Ph.D. (UCF)
Paul Barach, M.D. (UMCPS)
The science of team performance and training can help the medical community improve patient safety. This report, commissioned by the Agency for Healthcare Research and Quality (AHRQ), assesses the status of relevant team training research from aviation and other domains and applies this research to the field of medicine. It additionally provides a comprehensive review and evaluation of current medical team training initiatives and their effectiveness.
Select to download print version (PDF File, 259 KB). PDF Help.
Contents
Front Matter (PDF File, 30 KB; PDF Help)
Abstract
Summary
Report
Chapter 1. Introduction (PDF
File, 32 KB; PDF Help)
Background
The Structure of the Evaluation
Methodology
Chapter 2. Training Teams (PDF
File, 59 KB; PDF Help)
Definitional Issues Concerning Teams and Teamwork
What is a "Team"?
Training Teams
Summary
Chapter 3. Team Training in High-risk Contexts (PDF
File, 23 KB; PDF Help)
Team Training in Commercial Aviation
Evolution of the Crew Resource Management (CRM) Model in Commercial Aviation
CRM Summary
Team Training in the Military
Summary
Chapter 4. Medical Team Training (PDF
File, 101 KB; PDF Help)
The Case for Medical Team Training
The Donabedian Model of Patient Safety
Structure of Review
Anesthesia Crisis Resource Management
The MedTeams™ Program
The Medical Team Management (MTM) Program
Additional Medical Team Training Programs
Summary
Chapter 5. Conclusions and Recommendations (PDF
File, 25 KB; PDF Help)
Conclusion 1: The medical field lacks a theoretical model of team performance
Conclusion 2: The science of team performance and training can help the medical community to improve patient safety
Conclusion 3: Research has already identified many of the competencies necessary for effective teamwork in medical environments
Conclusion 4: A number of proven instructional strategies are available for promoting effective teamwork
Conclusion 5: Team training strategies must be further adapted to suit medical needs
Conclusion 6: The medical community
has made considerable progress in designing and implementing team training
across a number of settings
Conclusion 7: The impact of medical CRM training on patient safety outcomes has not been determined
Conclusion 8: The institutionalization of medical team training across different medical settings has not been addressed
Chapter 6. Research Needs: Where Do We Go From Here? (PDF
File, 20 KB; PDF Help)
Research Need 1: A medical team performance model
Research Need 2: Teamwork process and outcome measures, relative to medicine
Research Need 3: More efficient practices for evaluating medical team training programs
Research Need 4: Team performance diagnostics
Research Need 5: Simulation-based training applications
References (PDF File, 45 KB; PDF Help)
Tables and Figures
Table 1. Primary teamwork competencies (PDF File, 14 KB; PDF Help)
Table 2. Individual and team-level training strategies (PDF File, 12 KB)
Figure 1. Framework for designing an effective team training program (PDF
File, 20 KB)
Figure 2. The Donabedian Model of Patient Safety (PDF File, 54 KB)
AHRQ Publication No. 05-0053
Current as of July 2005
Internet Citation:
Baker DP, Gustafson S, Beaubien J, Salas E, Barach P. Medical Teamwork and Patient Safety: The Evidence-based Relation. Literature Review. AHRQ Publication No. 05-0053, April 2005. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/medteam/