• Barthélémy Bertrand, Jean-Noël Evain, Juliette Piot, Rémi Wolf, Pierre-Marie Bertrand, Vincent Louys, Hugo Terrisse, Jean-Luc Bosson, Pierre Albaladejo, and Julien Picard.
• Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France; Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France; TIMC-IMAG Laboratory, UMR, CNRS 5525, Grenoble Alpes University, Grenoble, France.
• Br J Anaesth. 2021 Apr 1; 126 (4): 854-861.

BackgroundPositive communication behaviour within anaesthesia teams may decrease stress response and improve clinical performance. We aimed to evaluate the effect of positive communication during medical handover on the subsequent team-based clinical performance in a simulated critical situation. We also assessed the effect of positive communication behaviour on stress response.MethodsThis single-centre RCT involved anaesthesia teams composed of a resident and a nurse in a high-fidelity scenario of anaesthesia-related paediatric laryngospasm after a standardised handover. During the handover, similar information was provided to all teams, but positive communication behaviour was adopted only for teams in the intervention group. Primary outcome was team-based clinical performance, assessed by an independent blinded observer, using video recordings and a 0-to 100-point scenario-specific scoring tool. Three categories of tasks were considered: safety checks before the incision, diagnosis/treatment of laryngospasm, and crisis resource management/non-technical skills. Individual stress response was monitored by perceived level of stress and HR variability.ResultsThe clinical performance of 64 anaesthesia professionals (grouped into 32 teams) was analysed. The mean (standard deviation) team-based performance score in the intervention group was 44 (10) points vs 35 (12) in the control group (difference: +8.4; CI95% [0.4-16.4]; P=0.04). The effects were homogeneous over the three categories of tasks. Perceived level of stress and HR variability were not significantly different between groups.ConclusionsPositive communication behaviour between healthcare professionals during medical handover improved team-based performance in a simulation-based critical situation.Clinical Trial RegistrationNCT03375073.Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

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