BMJ quality & safety
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BMJ quality & safety · Jun 2013
High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training.
In situ simulation training is a team-based training technique conducted on actual patient care units using equipment and resources from that unit, and involving actual members of the healthcare team. We describe our experience with in situ simulation training in a major children's medical centre. ⋯ In situ simulations can identify latent safety threats, identify knowledge gaps, and reinforce teamwork behaviours when used as part of an organisation-wide safety programme.
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BMJ quality & safety · Jun 2013
Leaders' and followers' individual experiences during the early phase of simulation-based team training: an exploratory study.
A growing body of evidence shows that team training can develop essential team skills and contribute to better patient outcomes. Current simulation-based team training (SBTT) programmes most often include targets and feedback focused on the whole team and/or leader, ignoring the follower as a unique entity. By considering followers' individual experiences, and tailoring behavioural targets for training and feedback, SBTT could be improved. Our aim was to explore the individual experiences and behaviours of leaders and followers during the early phase of SBTT, and we hypothesised that leaders and followers would show different responses. ⋯ The increased self-efficacy enables a positive learning outcome after only three scenarios. Individual experiences and behaviours differed between the role of leader and that of follower. By shedding further light on leaders' and followers' individual experiences and behaviours, targets for training and feedback could be specified in order to improve SBTT.
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BMJ quality & safety · Jun 2013
Systematic simulation-based team training in a Swedish intensive care unit: a diverse response among critical care professions.
Teamwork-that is, collaboration and communication-is an important factor for safe healthcare, but professions perceive the quality of teamwork differently. ⋯ All team members benefited from the SBTT in an authentic composed team, but this was expressed differently for the respective professions.
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BMJ quality & safety · Jun 2013
In situ simulation: detection of safety threats and teamwork training in a high risk emergency department.
Implement and demonstrate feasibility of in situ simulations to identify latent safety threats (LSTs) at a higher rate than lab-based training, and reinforce teamwork training in a paediatric emergency department (ED). ⋯ In situ simulation is a practical method for the detection of LSTs and to reinforce team training behaviours. Embedding in situ simulation as a routine expectation positively affected operations and the safety climate in a high risk clinical setting.
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BMJ quality & safety · Jun 2013
Comparative StudyContextual information influences diagnosis accuracy and decision making in simulated emergency medicine emergencies.
It is well documented that adaptations in cognitive processes with increasing skill levels support decision making in multiple domains. We examined skill-based differences in cognitive processes in emergency medicine physicians, and whether performance was significantly influenced by the removal of contextual information related to a patient's medical history. ⋯ Our findings have implications for scenario design and the manipulation of contextual information during simulation training.