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Measuring teamwork performance: Validity testing of the Team Emergency Assessment Measure (TEAM) with clinical resuscitation teams

      Abstract

      Aim

      To test the resuscitation non-technical Team Emergency Assessment Measure (TEAM) for feasibility, validity and reliability, in two Australian Emergency Departments (ED).

      Background

      Non-technical (teamwork) skills have been identified as inadequate and as such have a significant impact on patient safety. Valid and reliable teamwork assessment tools are an important element of performance assessment and debriefing processes.

      Methods

      A quasi experimental design based on observational ratings of resuscitation non-technical skills in two metropolitan ED. Senior nursing staff rated 106 adult resuscitation team events over a ten month period where three or more resuscitation team members attended. Resuscitation events, team performance and validity and reliability data was collected for the TEAM.

      Results

      Most rated events were for full cardiac resuscitation (43%) with 3–15 team members present for an average of 45 min. The TEAM was found to be feasible and quickly completed with minimal or no training. Discriminant validity was good as was internal consistency with a Cronbach alpha of 0.94. Uni-dimensional and concurrent validity also reached acceptable standards, 0.94 and >0.63 (p = < 0.001), respectively, and a single ‘teamwork’ construct was identified. Non-technical skills overall were good but leadership was rated notably lower than task and teamwork performance indicating a need for leadership training.

      Conclusion

      The TEAM is a feasible, valid and reliable non-technical assessment measure in simulated and real clinical settings. Emergency teams need to develop leadership skills through training and reflective debriefing.

      Keywords

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      References

        • Weaver S.J.
        • Lubomksi L.H.
        • Wilson R.F.
        • Pfoh E.R.
        • Martinez K.A.
        • Dy S.M.
        Promoting a culture of safety as a patient safety strategy: a systematic review.
        Ann Intern Med. 2013; 158: 369-374
        • de Vries E.N.
        • Ramrattan M.A.
        • Smorenburg S.M.
        • Gouma D.J.
        • Boermeester M.A.
        The incidence and nature of in-hospital adverse events: a systematic review.
        Qual Saf Health Care. 2008; 17: 216-223
        • Leonard M.
        • Graham S.
        • Bonacum D.
        The human factor: the critical importance of effective teamwork and communication in providing safe care.
        Qual Saf Health Care. 2004; 13: i85-i90
        • Neily J.
        • Mills P.D.
        • Young-Xu Y.
        • et al.
        Association between implementation of a medical team training program and surgical mortality.
        JAMA. 2010; 304: 1693-1700
        • Havyer R.D.
        • Wingo M.T.
        • Comfere N.I.
        • et al.
        Teamwork assessment in internal medicine: a systematic review of validity evidence and outcomes.
        J Gen Intern Med. 2014; 29: 894-910
        • O’Leary K.J.
        • Sehgal N.L.
        • Terrell G.
        • Williams M.V.
        Interdisciplinary teamwork in hospitals: a review and practical recommendations for improvement.
        J Hosp Med. 2012; 7: 48-54
        • Cooper S.
        • Porter J.
        • Peach L.
        Measuring situation awareness in emergency setting: a systematic review of tools and outcomes.
        Open Access Emerg Med. 2014; 6: 1-7
        • Valentine M.A.
        • Nembhard I.M.
        • Edmondson A.C.
        Measuring teamwork in health care settings: a review of survey instruments.
        Med Care. 2015; 53 (2015): e16-e30
        • Kim J.
        • Neilipovitz D.
        • Cardinal P.
        • Chiu M.
        • Clinch J.
        A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: the University of Ottawa critical care medicine, high-fidelity simulation, and crisis resource management study.
        Crit Care Med. 2006; 34: 2167-2174
        • Yule S.
        • Flin R.
        • Paterson-Brown S.
        • Maran N.
        Non-technical skills for surgeons in the operating room: a review of the literature.
        Surgery. 2006; 139: 140-149
        • Malec J.
        • Torsher L.
        • Dunn W.
        • et al.
        The Mayo high performance teamwork scale: reliability and validity for evaluating key crew resource management skills.
        Simul Health. 2007; 2: 4-10
        • Cooper S.
        • Cant R.
        • Sellick K.
        • et al.
        Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM).
        Resuscitation. 2010; 81: 446-452
        • Cooper S.J.
        • Cant R.P.
        Measuring non-technical skills of medical emergency teams: an update on the validity and reliability of the Team Emergency Assessment Measure.
        Resuscitation. 2014; 85: 31-33
        • McKay A.
        • Walker S.T.
        • Brett S.J.
        • Vincent C.
        • Sevdalis N.
        Team performance in resuscitation teams: comparison and critique of two recently developed scoring tools.
        Resuscitation. 2012; 83: 1478-1483
      1. IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. http://www-01.ibm.com/support/docview.wss?uid=swg21476197

        • Pallant J.
        SPSS survival manual: a step by step guide to data analysis using SPSS.
        4th ed. Allen and Unwin, Sydney2011
        • Baker V.
        • Cuzzola R.
        • Knox C.
        • Liotta C.
        • Cornfield S.S.
        Teamwork education improves trauma team performance in undergraduate health professional students.
        J Educ Eval Health Prof. 2015; 12: 36
        • Yeung J.H.
        • Ong G.J.
        • Davies R.P.
        • Gao F.
        • Perkins G1.
        Factors affecting team leadership skills and their relationship with quality of cardiopulmonary resuscitation.
        Crit Care Med. 2012; 40: 2617-2621
        • The 2010 American Heart Association guidelines (2,3)
        • Bhanji F.
        • Mancini F.
        • Sinz M.E.E.
        • et al.
        • Part 16: Education, Implementation, and Teams
        2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.
        Circulation. 2010; 122: 920-933
        • Greif R.
        • Lockey A.
        • Conaghan P.
        • Lippert A.
        • De Vries W.
        • Monsieurs K.G.
        European Resuscitation Council Guidelines for Resuscitation 2015, Section 10. Education and implementation of resuscitation.
        Resuscitation. 2015; 95: 288-301
        • Endacott R.
        • Cooper S.
        • Scholes J.
        • Kinsman L.
        • McConnell-Henry T.
        Final-year nursing students’ ability to assess, detect and act on clinical cues of deterioration in a simulated environment.
        J Adv Nurs. 2010; 66: 2722-2731
        • Jones D.
        • Hicks B.
        • Currey J.
        • et al.
        Findings of the first ANZICS conference on the role of intensive care in Rapid Response Teams.
        Anaesth Intensive Care. 2015; 43: 369-379
      2. Liaw SY, Wong LF, Ang SBL, et al. BMJ Qual Saf Published Online First: [21 August 2015], doi:10.1136/bmjqs-2015- 004073.

        • O’Toole Baker V.
        • Cuzzola R.
        • Liota C.
        • et al.
        Teamwork education improves trauma team performance in undergraduate health professional students.
        J Educ Eval Health Prof. 2015; 12 (http://dx.doi.org/10.3352/jeehp.2015.12.36): 36
        • Kilday D.
        • Spiva L.
        • Barnett J.
        • et al.
        The effectiveness of combined training modalities on neonatal rapid response teams.
        Clin Simul Nurs. 2013; 9: pe249-pe256
        • Yeung J.
        • Perkins G.
        • Davies R.
        • et al.
        Introducing non-technical skills teaching to the resuscitation council (UK) advanced life support course.
        Resuscitation. 2014; (http://dx.doi.org/10.1016/j.resuscitation.2014.03.178)
        • Yeung J.
        • Husselbee N.
        • Davies R.
        • et al.
        Effect of non-technical skills teaching on performance—an evaluation of additional non-technical skills teaching in Resuscitation Council ALS course.
        Resuscitation. 2015; (http://dx.doi.org/10.1016/j.resuscitation.2015.09.056)
        • Jelovsek J.
        • Kow N.
        • Diwadkar G.B.
        Tools for the direct observation and assessment of psychomotor skills in medical trainees: a systematic review.
        Med Educ. 2013; 47: 650-673
        • Ricker K.
        Setting cut scores: a critical review of the Angoff and modified Angoff methods.
        Alberta J Educ Res. 2006; 52: 53-63
        • Cooper S.
        • Bradbury M.
        • Blakely G.
        Expert clinical examiner's decision processes in Objective Structured Clinical Examinations (OSCEs); is intuition a valid and reliable decision strategy?.
        Int J Clin Skills. 2009; 3: 140-146
        • Cant R.
        • Cooper S.J.
        The benefits of debriefing as formative feedback in nurse education.
        Aust J Adv Nurs. 2011; 29: 37-47