General Hospital Agitation Management Under the Lens of Leadership Theory and Health Care Team Best Practices Using TeamSTEPPS

Teamwork and burnout among healthcare workers from a public hospital in Colombia

Introduction. Previous reports have described a relationship between teamwork and burnout in health workers, involving variables associated with patients’ safety. Objective. To determine and describe the relationship between teamwork and burnout perceived by health workers from a tertiary-level hospital in Colombia. Materials and methods. We conducted a cross-sectional, observational, analytical study with a convenience sample of 510 participants. We applied the TeamSTEPPS Teamwork Perceptions Questionnaire and the Copenhagen Burnout Inventory to assess burnout. An additional survey was conducted to collect demographic and employment data. Data was collected digitally. Descriptive analyses were carried out to compare teamwork and burnout across units, by occupation, and according to the average number of hours worked per week. Finally, correlation matrices were calculated with the scores from both tests. Results. Teamwork levels were moderate to high, and 31.4% of workers reported moderate or high levels of burnout. No significant differences were found based on sex or work unit. Results from the TeamSTEPPS Teamwork Perceptions Questionnaire and the Copenhagen Burnout Inventory were correlated with a low and moderate strength of association, showing an inverse relationship between them. Conclusion. Teamwork and burnout may have an inverse relationship, where better teamwork results in a lower perception of burnout among healthcare workers. However, the results of this study should be interpreted with caution due to potential biases.

Beyond Crisis: Enhancing Behavioral Response Through a Conceptual Framework

ObjectiveThe objective was to present a conceptual model informed by existing literature surrounding behavioral health crises and response teams.MethodThe Behavioral Crisis Response Model (BCRM) was developed through a comprehensive literature review, synthesizing existing knowledge to clarify the structure, relationships, and processes between patients and Behavioral Response Teams (BRTs), focusing on published literature from 2018 to 2023. Themes to inform the BCRM were developed through iterative review and discussion with an expert panel.ResultsThe BCRM framework comprises five key domains: Patient-Centered Care, Preparation, Planning, Execution, and Evaluation. Each domain encompasses specific actions and strategies to ensure comprehensive and effective crisis intervention. The Patient-Centered Care domain ensures the patient remains the focus during a crisis. The Preparation domain focuses on readiness through training and resource verification. The Planning domain involves initial and risk assessments, followed by devising a tailored response plan. The Execution domain emphasizes the implementation of the response plan with adaptable leadership styles. The Evaluation domain involves debriefing, root cause analysis, and performance reviews to promote continuous improvement.ConclusionThe BCRM offers a patient-centered, structured approach to managing behavioral health crises and enhancing team cohesion and effectiveness. Further evaluation of adopting the BCRM is needed within health care institutions to improve patient outcomes, reduce harm, and advance better care quality.

TeamSTEPPS improves patient safety

BACKGROUND

Examine how Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) can be used to manage patient safety and improve the standard of care for patients.

METHODS

In order to improve key medical training in areas like surgical safety management, blood transfusion closed-loop management, drug safety management and identity recognition, we apply the TeamSTEPPS teaching methodology. We then examine the effects of this implementation on changes in pertinent indicators.

RESULTS

Our hospital's perioperative death rate dropped to 0.019%, unscheduled reoperations dropped to 0.11%, and defined daily doses fell to 24.85. Antibiotic usage among hospitalised patients declined to 40.59%, while the percentage of antibacterial medicine prescriptions for outpatient patients decreased to 13.26%. Identity recognition requirements were implemented at a rate of 94.5%, and the low-risk group's death rate dropped to 0.01%. Critical transfusion episodes were less common, with an incidence of 0.01%. The physician's TeamSTEPPS Teamwork Perceptions Questionnaire and Teamwork Attitudes Questionnaire scores dramatically improved following the TeamSTEPPS team instruction course.

CONCLUSION

An evidence-based team collaboration training programme called TeamSTEPPS combines clinical practice with team collaboration skills to enhance team performance in the healthcare industry and raise standards for medical quality, safety, and effectiveness.

Cross-Cultural Validation of the TeamSTEPPS Teamwork Perceptions Questionnaire-Spanish in Colombia

BACKGROUND

Teamwork influences health care quality and patient safety. Yet, validated instruments for assessing teamwork in Colombia are lacking.

PURPOSE

The purpose of this study was to validate the Spanish version of the TeamSTEPPS-Teamwork Perceptions Questionnaire (T-TPQ-S) for the Colombian health care context.

METHODS

The T-TPQ-S underwent translation, cultural adaptation, and comprehensive psychometric testing, including reliability and confirmatory factor analyses and item difficulty and discrimination analyses.

RESULTS

The T-TPQ-S demonstrated high internal consistency and excellent fit to the theoretical model. Item discrimination was within expected ranges, with response thresholds displaying an ascending order. The tool better differentiated subjects with low and high teamwork perceptions.

CONCLUSIONS

The T-TPQ-S is an effective, reliable, and valid instrument for assessing teamwork perception among Colombian health care workers.

Application effect study of a combination of TeamSTEPPS with modularization teaching in the context of clinical instruction in trauma care

To explore the effect of a combination of Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) with modularization teaching in the context of clinical instruction in trauma care. A total of 244 nursing students who participated in clinical practice in orthopaedic wards from March 2020 to April 2022 were divided into two groups that received the same trauma care teaching content. The control group (n = 119) used the traditional teaching approach, and the experimental group (n = 125) utilized a combination of TeamSTEPPS with a modularization teaching model. A questionnaire was used to assess students' theoretical knowledge, practical skills, self-concepts and professional benefits after one month with the goal of determining their end-of-course performance. The theoretical knowledge scores obtained by the control group and the experimental group were 89.56 ± 4.06 and 91.62 ± 2.84, respectively, and these results were statistically significant (P < 0.05). Students preferred the combination of TeamSTEPPS with the modularization teaching model to the traditional instructional method in terms of practical skills, professional self-concepts and professional benefits (P < 0.05). The application of the combination of TeamSTEPPS with modularization teaching in the context of clinical instruction in trauma care made significant contributions to nursing students' mastery of theoretical knowledge and practical skills, enhanced their sense level of professional identity, instilled a correct occupational ideology in such students, and enhanced the professional benefits they were able to obtain.

A Qualitative Study of Racial, Ethnic, and Cultural Experiences of Minority Clinicians During Agitation Care in the Emergency Department

STUDY OBJECTIVE

Racial and ethnic bias in health care has been documented at structural, organizational, and clinical levels, impacting emergency care, including agitation management in the emergency department (ED). Little is known about the experiences of racial and ethnic minority ED clinicians caring for racial and ethnic minority groups, especially during their agitated state. The objective of this study was to explore the lived experiences of racial and ethnic minority ED clinicians who have treated patients with agitation in the ED.

METHODS

We performed semistructured individual interviews of Black, Latino, and multiracial clinicians who worked at 1 of 3 EDs from an urban quaternary care medical center in the Northeast United States between August 2020 and June 2022. We performed thematic analysis through open coding of initial transcripts and identifying additional codes through sequential iterative rounds of group discussion. Once the codebook was finalized and applied to all transcripts, the team identified key themes and subthemes.

RESULTS

Of the 27 participants interviewed, 14 (52%) identified as Black, 9 (33%) identified as Hispanic/Latino, and 4 (15%) identified as multiracial and/or other race and ethnicity. Three primary themes emerged from racial and ethnic minority clinician experiences of managing agitation: witness of perceived bias during clinical interactions with patients of color who bear racialized presumptions of agitation, moral injury and added workload to address perceived biased agitation management practices while facing discrimination in the workplace, and natural advocacy and allyship for agitated patients of color based on a shared identity and life experience.

CONCLUSIONS

Our study found that through their shared minority status, racial and ethnic minority clinicians had a unique vantage point to observe perceived bias in the management of agitation in minority patients. Although they faced added challenges as racial and ethnic minority clinicians, their allyship offered potential mitigation strategies for addressing disparities in caring for an underserved and historically marginalized patient population.