gms | German Medical Science

Introduction: Healthcare organisations have been trying to learn how to make systems safer from aviation. Interest has been increasing on the prevention of human error, teamwork and communication in medical teams. The question remains to what extent methods for so called Crew Resource Management need adaptation when transferred from aviation to medicine. FOR-DEC is an example of such a scheme used by cockpit crews in case of an emergency. It is an acronym for the steps of a rational decision-making process: Facts, Options, Risks & Benefits are to be considered before a Decision is made and Execution and Control phases follow. This might work well for a (rare) critical incident on board of a plane, but may be too time consuming and formal for medical teams facing critical decision-making situations on a regular basis. Emergencies are recurring situations during a regular shift for many healthcare professionals.

Objectives: The objective of the study is to transfer the benefits of a structured call-out procedure like FOR-DEC into the fast-paced reality of medical teams. This procedure should support information sharing and decision-making whilst being lean, easy to remember and to apply. Moreover, it should consider aspects of situational awareness, decision-making, leadership, and efficient communication.

Material & Methods: We developed a communication method called "TeamCheck", with expertise from psychology, medical education, medicine and management. It comprises only three steps: "What?" (situation statement), "How?" (steps to problem solution) and "Who?" (assignment of tasks and responsibilities). Each step is followed by a query to confirm the whole team's approval. Subsequently, a video clip was produced to demonstrate and train the TeamCheck procedure with a good practice example of how a TeamCheck can be applied in a healthcare team. To validate the TeamCheck procedure and the video intervention a pilot study concept was designed which is currently being rolled out.

Results: So far a pocket card for the TeamCheck procedure was designed (see figure 1 [Fig. 1]), a training video was produced and a pilot study concept for validation of both received ethics commission approval. Recently the University of Munich additionally granted research funds for the project and a following series of similar video interventions. On the RIME conference in March 2017 first results of the study will be presented.

Conclusion: Professionalisation of teamwork in medicine is an emerging topic. We are working on means to support this by transferring and adapting proven procedures from aviation to medicine. The TeamCheck is a procedure that is simple and easy to implement. It contributes to Patient Safety by improving communication and decision making in medical teams. With an empirical evaluation that is currently being performed, we strive to find optimal ways to bring it to medical education and practice.