1153 / Staff training on Non-Technical Skills (NTS) and team activities observation with OTAS methodology

ITALY
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Education in Patient Safety
Simulation in Patient Safety There is no specified text here
Topic of the reported practice
Professional learning program on quality and safety
Aim and the benefit of the Patient Safety Practice
 
The project was launched with the aim of training operating teams professionals on non-technical skills, specifically: • Make the participants aware of the cognitive aspects of their own activity and the related non-technical skills, encouraging the development of individual and group behavior reading skills and of the surrounding reality. • Increase self-awareness and behavior in complex clinical scenarios, helping to strengthen useful and positive resources for the achievement of the objective, restraining inadequate attitudes. • Facilitate discussion on the applicability in the clinical practice of monitoring tools to improve team performance and to reduce adverse events.
Description of the Patient Safety Practice
 
Literature shows that the majority (80%) of the accidents that occur in the operating room are mainly related to shortcomings in individual and group non-technical skills, rather than to gaps in professional technical skills. To learn more and create awareness of these non-technical aspects and their importance in 2012 and 2013 the Hospital of the Province of Lecco organized a course of advanced simulation in the operating theater, involving surgeons, anesthesiologists, nurses, midwives and perfusionists. The operators were able to simulate surgery scenarios with risk situations in a familiar environment, with the use of mannequins and with a technology that allows you to perform the surgery in a very realistic way. Afterwards there was a debriefing during which the teachers of the course led the group in the analysis of behavior. Prior to the course, and after about two months, a SAQ (Safety Attitudes Questionnaire)was given to learners, aimed at assessing the perception of risk by operators (evaluated in 6 areas: safety climate, team climate, job satisfaction , quality management, working conditions, recognition of stress). The analysis of the results showed a significant difference between the results of pre- and post-course. This has been attributed to the fact that a single training event cannot be considered enough to change the perception of risk. The use of the observation method OTAS (Observational teamwork assessemnt for surgery - developed by the Imperial College of London) was therefore identified as the natural continuation of the project. In 2014 a group of professionals has been trained to the use the OTAS checklist and on the ways to facilitate the debriefing. This group has begun to make observations during surgery sessions and to organize, with the team that has been observed, the debriefing. Key words: simulations, non-technical skills, operating room, team, debriefing.
Prior to the course, and about two months after, a SAQ (Safety Attitudes Questionnaire) was given to learners, aimed at assessing the perception of risk by operators (evaluated in 6 areas: safety climate, team climate, job satisfaction , quality management, working conditions, recognition of stress).
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Quality manager
Other or not relevant
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/questionnaire.aspx?id=4666
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
No
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
There is no specified text here
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
Staff and management recognised the need for change
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Paola Goretti
Country: ITALY
Organisation: OSPEDALE DI LECCO
E-mail: p.goretti@ospedale.lecco.it
Phone: There is no specified text here
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