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Enhancing Clinical Confidence, Communication, and Teamwork Through In Situ Simulation in a Fertility Clinic Procedure Room
Meats, Amanda
Meats, Amanda
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Abstract
Problem: Poor team performance and miscommunication contributes to 61% of sentinel events inhealthcare worldwide. A highly competent and skilled health care team are required to ensurepatient safety. Perioperative care can be particularly high-risk and complicated. Multidisciplinaryteams are expected to work interdependently and collaboratively to meet the needs of the patient.However, the multidisciplinary nature of perioperative teams can present barriers to patientsafety because of disciplinary silos, hierarchy, and professional rivalries. Barriers to patientsafety can occur through ineffective teamwork, collaboration, and poor communication. Failuresin interprofessional teamwork and communication can lead to compromised patient care, staffdistress, tension, and inefficiency.Aims: The primary aim of this project was to implement multidisciplinary emergency simulationdrills to improve staff confidence, communication, and teamwork in an outpatient reproductiveendocrinology fertility clinic procedure room at a large Midwestern academic hospital. Asecondary aim was to perform an economic evaluation of costs associated with the simulationsand return on investment for the clinic to determine feasibility of maintaining the simulations inthe clinic.Method: This project used a quality improvement design. Quantitative data was collectedthrough the Quality and Safety Self-Efficacy Scale (QSSES) and the TeamSTEPPS TeamworkPerceptions Questionnaire (T-TPQ). Simulation specialists used the Teamwork Evaluation ofNon-Technical Skills (TENTS) observational tool to evaluate team communication andteamwork. Qualitative data was also collected during the debriefing sessions. Data was analyzedand reported by theme.ivResults: The mean score of the QSSES and TTPQ increased from pre-simulation to immediatelypost simulation. The one-month post simulation scores were higher than the immediate postsimulation scores, however, they were still lower than the pre-simulation score, indicating animprovement in participants confidence in teamwork and collaboration. The TENTS scores forteam one showed a reduction in all elements from simulation one to simulation two except forsituation monitoring which remained the same. The TENTS scores for team two showed animprovement in two of the elements, a reduction in one element, and one element remained thesame from simulation one to simulation two. Participants reported positive feedback for thesimulations during the debriefing sessions, and they requested more simulations in the future.The total cost to run the simulations was $7,675.79. The return on investment of running thesimulations is the improvement in team structure, leadership, situation monitoring, mutualsupport, and communication.Conclusion: Through the utilization of the TeamSTEPPS framework and in situ simulationtraining, the outpatient reproductive endocrinology fertility clinic was able to enhance clinicalconfidence, communication, and teamwork among the perioperative team. The benefits ofreducing patient safety errors and retaining staff outweigh the costs associated with thesimulations, and therefore should be continued.
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2022-08-31
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University of Kansas
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922348_1.pdf
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Nursing, Obstetrics, clinical confidence, communication, in situ simulation, simulation training, TeamSTEPPS, teamwork