Evaluation of aviation-based safety team training in a hospital in The Netherlands. Issue 6 (11th November 2014)

• Record Type: Journal Article
• Authors: F. de Korne, Dirk; D.H. van Wijngaarden, Jeroen; van Dyck, Cathy; Francis Hiddema, U.; S. Klazinga, Niek
• Is Part Of: Journal of health organisation and management. Volume 28:Issue 6(2014)
• Page Start: 731
• Page End: 753
• Publication Date: 2014-11-11
• Subjects: Health services administration -- Periodicals; Health services administration -- Great Britain -- Periodicals; Health services administration -- Europe -- Periodicals; 362.106805
• DOI: 10.1108/JHOM-01-2013-0008
• Languages: English
• ISSNs: 1477-7266

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title content-type="abstract-heading">Purpose</title> <p> – The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture. </p> </sec> <sec> <title content-type="abstract-heading">Design/methodology/approach</title> <p> – Pre- and post-assessments of the hospitals' safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice. </p> </sec> <sec> <title content-type="abstract-heading">Findings</title> <p> – The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction. </p> </sec> <sec> <title content-type="abstract-heading">Research limitations/implications</title> <p> – The study was observational and the hospital's variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention. </p> </sec> <sec> <title content-type="abstract-heading">Originality/value</title> <p> – Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on "team" instead of "profession" seems both necessary and difficult in hospital care.</p> </sec> </abstract>