Team strategies and tools to enhance performance and patient safety training: The effect of training on both nursing staff perceptions regarding physician behaviors and patient satisfaction scores in the ED

Abstract

Introduction: Background: Program used to enhance teamwork and communication among health professionals to improve patient safety and employee satisfaction. Objective: We hypothesized that Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) training would improve communication between physicians and nurses and between physicians and their patients and family members, and that it would improve patient perceptions of emergency department teamwork.Methods: Design: Before and after prospective observational study. Setting: Tertiary Care Hospital Emergency Department. Participants/Subjects: Twelve core physicians and 43 nurses underwent two, 4-hour TeamSTEPPS training sessions in July 2011 and July 2012. The first session consisted of didactic instruction using the TeamSTEPPS material. The second session was comprised of simulations focusing on the content of the initial training course. Nurses were asked to rate individual physicians on five distinct aspects of communication, both before and after the training sessions. Statistical Methods: Survey results were compared using theWilcoxon signed rank test. Patient satisfaction survey questions regarding teamwork (4th Quarters 2010 and 2011) were analyzed using two-sample t-tests.Results: TeamSTEPPS improved nurse’s perception regarding physician communication with patients and their families (post: 4.28 ± 0.37 vs. pre: 4.16 ± 0.42, p = .0479), with a trend towards improvement in nurse’s perception of physician’s communication with nursing staff regarding changes in patient care plans (post: 3.94 ± 0.38 vs. pre: 3.81 ± 0.5, p = .0942). TeamSTEPPS was also associated with a significant improvement in patient’s rating of teamwork between doctors and nurses as “excellent” (post: 62.9% vs. pre: 48.3%, p = .0132).Conclusions: Team training with the TeamSTEPPS program improved selected aspects of nursing and patient perceptions of teamwork and communication between emergency department physicians and nurses.