• Matthew Gittinger, Sarah M Brolliar, James A Grand, Graham Nichol, and Rosemarie Fernandez.
• From the Division of Emergency Medicine (M.G., S.B., R.F.), University of Washington, Seattle, WA; Department of Psychology (J.G.), University of Maryland, College Park, MD; and Department of Medicine and ... more Harborview Center for Prehospital Emergency Care (G.N.), University of Washington, Seattle, WA. less
• Simul Healthc. 2017 Jun 1; 12 (3): 139-147.

IntroductionThis pilot study used a simulation-based platform to evaluate the effect of an automated mechanical chest compression device on team communication and patient management.MethodsFour-member emergency department interprofessional teams were randomly assigned to perform manual chest compressions (control, n = 6) or automated chest compressions (intervention, n = 6) during a simulated cardiac arrest with 2 phases: phase 1 baseline (ventricular tachycardia), followed by phase 2 (ventricular fibrillation). Patient management was coded using an Advanced Cardiovascular Life Support-based checklist. Team communication was categorized in the following 4 areas: (1) teamwork focus; (2) huddle events, defined as statements focused on re-establishing situation awareness, reinforcing existing plans, and assessing the need to adjust the plan; (3) clinical focus; and (4) profession of team member. Statements were aggregated for each team.ResultsAt baseline, groups were similar with respect to total communication statements and patient management. During cardiac arrest, the total number of communication statements was greater in teams performing manual compressions (median, 152.3; interquartile range [IQR], 127.6-181.0) as compared with teams using an automated compression device (median, 105; IQR, 99.5-123.9). Huddle events were more frequent in teams performing automated chest compressions (median, 4.0; IQR, 3.1-4.3 vs. 2.0; IQR, 1.4-2.6). Teams randomized to the automated compression intervention had a delay to initial defibrillation (median, 208.3 seconds; IQR, 153.3-222.1 seconds) as compared with control teams (median, 63.2 seconds; IQR, 30.1-397.2 seconds).ConclusionsUse of an automated compression device may impact both team communication and patient management. Simulation-based assessments offer important insights into the effect of technology on healthcare teams.

25 keywords...

hide…