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Effect of crew resource management training in a multidisciplinary obstetrical setting

Haller, Guy ; Garnerin, Philippe ; Morales, Michel-Ange ; Pfister, Ricardo ; Berner, Michel ; Irion, Olivier ; Clergue, François ; Kern, Christian

In: International Journal for Quality in Health Care, 2008, vol. 20, no. 4, p. 254-263

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    Titre
    • Effect of crew resource management training in a multidisciplinary obstetrical setting
    Auteur
    • Haller, Guy. Department of Anaesthesia and Intensive Care, Geneva University Hospital, Geneva, Switzerland
    • Garnerin, Philippe. Department of Anaesthesia and Intensive Care, Geneva University Hospital, Geneva, Switzerland
    • Morales, Michel-Ange. Department of Gynaecology and Obstetrics, Geneva University Hospital, Geneva, Switzerland
    • Pfister, Ricardo. Department of Paediatrics, Geneva University Hospital, Geneva, Switzerland
    • Berner, Michel. Department of Paediatrics, Geneva University Hospital, Geneva, Switzerland
    • Irion, Olivier. Department of Gynaecology and Obstetrics, Geneva University Hospital, Geneva, Switzerland
    • Clergue, François. Department of Anaesthesia and Intensive Care, Geneva University Hospital, Geneva, Switzerland
    • Kern, Christian. Department of Anaesthesia and Intensive Care, Geneva University Hospital, Geneva, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • International Journal for Quality in Health Care, 2008, vol. 20, no. 4, p. 254-263. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:302826
    Summary
    Objective To assess the effect of a Crew Resource Management (CRM) intervention specifically designed to improve teamwork and communication skills in a multidisciplinary obstetrical setting. Method Design-A before-and-after cross-sectional study designed to assess participants' satisfaction, learning and change in behaviour, according to Kirkpatrick's evaluation framework for training programmes. Setting-Labour and delivery units of a large university-affiliated hospital. Participants-Two hundred and thirty nine midwives, nurses, physicians and technicians from the department of anaesthesia, obstetrics and paediatrics. Intervention-All participants took part in a CRM-based training programme specifically designed to improve teamwork and communication skills. Principal measures of outcome-We assessed participants' satisfaction by means of a 10-item standardized questionnaire. A 36-item survey was administered before and after the course to assess participants' learning. Behavioural change was assessed by a 57-item safety attitude questionnaire measuring staff's change in attitude to safety over 1 year of programme implementation. Results Most participants valued the experience highly and 63-90% rated their level of satisfaction as being very high. Except for seven items, the 36-item survey testing participants' learning demonstrated a significant change (P < 0.05) towards better knowledge of teamwork and shared decision making after the training programme. Over the year of observation, there was a positive change in the team and safety climate in the hospital [odds ratio (OR) 2.9, 95% confidence interval (CI) (1.3-6.3) to OR 4.7, 95% CI (1.2-17.2)]. **There was also improved stress recognition [OR 2.4, 95% CI (1.2-4.8) to OR 3.0, 95% CI (1.0-8.8)]. Conclusion The implementation of a training programme based on CRM in a multidisciplinary obstetrical setting is well accepted and contributes to a significant improvement in interprofessional teamwork