نوع مقاله: مقاله مروری

نویسنده

استادیار، دکترای پرستاری، دانشکده پرستاری و مامایی حضرت فاطمه (س)، دانشگاه علوم پزشکی شیراز، شیراز، ایران

چکیده

مقدمه: آموزش کار تیمی رایج‌ترین روش تقویت کار تیمی در محیط‌های درمانی است. بنابراین مطالعه حاضر با هدف مرور مطالعات در زمینه آموزش کار تیمی در سیستم ارائه مراقبت بهداشتی انجام شد.مواد و روش: در این مطالعه مروری، متون علمی با واژه‌های کلیدی کار تیمی، عملکرد بین حرفه‌ای، آموزش کار تیمی و دانش، مهارت و نگرش در سایت‌های  Google scholar،Pubmed، بانک اطلاعات جهاد دانشگاهی (SID) و بانک اطلاعات نشریات کشور (Magiran ) جستجو شدند.نتایج: روش‌های مختلف مبتنی بر کلاس درس، نمایش و شبیه‌سازی برای آموزش کار تیمی استفاده می‌شود. نتایج مطالعات نشان می‌دهد دوره‌هایی از جمله مهارت‌هایی قاطعیت، مدیریت خطا، هماهنگی و دانش، مهارت و نگرش‌های کار تیمی به افراد آموزش داده شده است. " استراتژی‌ها و ابزارهای تیمی برای افزایش عملکرد و ایمنی بیمار" یک رویکرد سیستماتیک مبتنی بر شواهد است که تکنیک‌های کاربردی را برای اجرا در محیط‌های بالینی آموزش می‌دهد. برای ارزشیابی آموزش نیز از بررسی دانش و نگرش افراد، رفتار و فرآیندهای تیمی آنان و برآیندهای بیماران با کمک ابزارهای خود گزارش دهی، مشاهده‌ای و غیره استفاده شده است.بحث و نتیجه‌گیری: روش‌های آموزشی مختلف می‌تواند روی فرآیندهای تیم و برآیندهای بیماران اثربخش باشد. اما روش‌هایی که کارتیمی را در فعالیت‌های روزانه تیم ادغام می‌کند مؤثرترند. با توجه به تفاوت در ماهیت کار در بخش‌های مختلف لازم است برنامه‌های آموزشی متناسب با شرایط آن‌ها طراحی شود.

کلیدواژه‌ها

عنوان مقاله [English]

Teamwork Training in Healthcare Delivery System: A Review of the Literature

نویسنده [English]

  • Z Khademian

Assistant Professor, PhD, MSN, School of Nursing and Midwifery, Shiraz University Of Medical Sciences, Shiraz, Iran

چکیده [English]

Background: Teamwork training is the most common method of strengthening teamwork in healthcare delivery system. Therefore, the current study aimed to review the studies in the field of teamwork education in the healthcare delivery system.
Method: In this review study, scientific texts with the key-words of teamwork, inter-professional practice, teamwork training, knowledge, skills, and attitudes were searched in Google scholar, PubMed, Scientific Information Database (SID) and Magiran.
Results: A variety of classroom-based, demonstration- and simulation-based methods are used for teamwork training. Various studies indicated that skills such as assertiveness, error management, and coordination as well as the knowledge of teamwork skills and attitudes towards teamwork are taught in healthcare delivery system. Specifically, "Team strategies and tools to enhance performance and patient safety" is an evidence-based systematic approach that teaches applicable techniques that can be implemented in clinical settings. Furthermore, for the purpose of educational evaluation, the following tools have been used: assessment of individuals’ knowledge and attitudes, their team behaviors and processes and evaluation of patients’ outcomes through self-report, and observation.
Conclusion: Different training methods can be effective on team processes and patients’ outcomes. However, methods that integrate teamwork into team’s daily activities are more effective. Considering the differences in the nature of work in different wards, it is necessary to design training programs tailored to their requirements.

کلیدواژه‌ها [English]

  • Attitudes
  • education
  • Interpersonal relations
  • Patient Safety
  • Teamwork

  1.      Merriam-Webster, https://www.merriam-webster.com/dictionary/teamwork  [Accessed: January 20, 2017].
  2.      Zeltser MV, Nash DB. Approaching the evidence basis for aviation-derived teamwork training in medicine. American Journal of Medical Quality 2010;25(1):13-23.
  3.      Baker DP, Day R, Salas E. Teamwork as an essential component of high‐reliability organizations. Health Services Research 2006;41(4p2):1576-98.
  4.      King HB, Battles J, Baker DP, et al. TeamSTEPPS™: Team Strategies and Tools to Enhance Performance and Patient Safety. In: Henriksen K, Battles JB, Keyes MA, et al., editors. Advances in Patient Safety: New Directions and Alternative Approaches (Vol. 3: Performance and Tools). Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Aug. Available from: https://www.ncbi.nlm.nih.gov/books/NBK43686/
  5.      O'leary KJ, Sehgal NL, Terrell G, Williams MV. Interdisciplinary teamwork in hospitals: a review and practical recommendations for improvement. Journal of Hospital Medicine 2012; 7(1):48-54.
  6.      Hull L, Sevdalis N. Teamwork and safety in surgery. Colombian Journal of Anesthesiology 2015; 43(1):3-6.
  7.      O’Leary KJ, Buck R, Fligiel HM, Haviley C, Slade ME, Landler MP, et al. Structured interdisciplinary rounds in a medical teaching unit: improving patient safety. Archives of Internal Medicine 2011; 171(7):678-84.
  8.      Mayer CM, Cluff L, Lin W-T, Willis TS, Stafford RE, Williams C, et al. Evaluating efforts to optimize TeamSTEPPS implementation in surgical and pediatric intensive care units. The Joint Commission Journal on Quality and Patient Safety 2011;37(8):365-AP3.
  9.      Khademian Z, Sharif F, Tabei SZ, Bolandparvaz S, Abbaszadeh A, Abbasi HR. Teamwork improvement in emergency trauma departments. Iranian Journal of Nursing and Midwifery Research 2013;18(4):333-339.
  10.     Reader TW, Cuthbertson BH. Teamwork and team training in the ICU: Where do the similarities with aviation end? Critical Care 2011; 15(6):313.
  11.     Suter E, Arndt J, Arthur N, Parboosingh J, Taylor E, Deutschlander S. Role understanding and effective communication as core competencies for collaborative practice. Journal of Interprofessional Care 2009;23(1):41-51.
  12.     Khademian Z, Moattari M, Khademian F. Iranian Nursing Students’ Perceptions of Nursing and The Ideal Career: A Descriptive Comparative Study. Nursing and Midwifery Studies 2016; 5(3):e33113.
  13.     Martin GP, Finn R. Patients as team members: opportunities, challenges and paradoxes of including patients in multi-professional healthcare teams. Sociology of Health & Illness. 2011;33(7):1050-65.
  14.     Khademian Z, Vizeshfar F. Nursing students’ perceptions of the importance of caring behaviors. Journal of Advanced Nursing 2008;61(4):456-62.
  15.     Nguyen N, Watson WD, Dominguez E. An event-based approach to design a teamwork training scenario and assessment tool in surgery. Journal of Surgical Education 2016; 73(2):197-207.
  16.      Hall P. Interprofessional teamwork: Professional cultures as barriers. Journal of Interprofessional Care 2005;19:188-96.
  17.     Clancy CM, Tornberg DN. TeamSTEPPS: assuring optimal teamwork in clinical settings. American Journal of Medical Quality 2007; 22(3):214-7.
  18.     Baker VOT, Cuzzola R, Knox C, Liotta C, Cornfield CS, Tarkowski RD, et al. Teamwork education improves trauma team performance in undergraduate health professional students. Journal of Educational Evaluation for Health Professions 2015;12 36.
  19.     Robertson B, Kaplan B, Atallah H, Higgins M, Lewitt MJ, Ander DS. The use of simulation and a modified TeamSTEPPS curriculum for medical and nursing student team training. Simulation in Healthcare 2010;5(6):332-7.
  20.     Capella J, Smith S, Philp A, Putnam T, Gilbert C, Fry W, et al. Teamwork training improves the clinical care of trauma patients. Journal of Surgical Education. 2010;67(6):439-43.
  21.     Xyrichis A, Ream E. Teamwork: a concept analysis. Journal of advanced nursing. 2008;61(2):232-41.
  22.     Weaver SJ, Dy SM, Rosen MA. Team-training in healthcare: a narrative synthesis of the literature. BMJ Qual Saf 2014;23(5):359-72.
  23.     McEwan D, Ruissen GR, Eys MA, Zumbo BD, Beauchamp MR. The Effectiveness of Teamwork Training on Teamwork Behaviors and Team Performance: A Systematic Review and Meta-Analysis of Controlled Interventions. PloS one 2017;12(1):0169604.
  24.     Sorensen A, Poehlman J, Bollenbacher J, Riggan S, Davis S, Miller K, et al. Training for teamwork through in situ simulations. BMJ Innovations 2015;1(3):144.
  25.     Ferguson SL. TeamSTEPPS: integrating teamwork principles into adult health/medical-surgical practice. Medsurg Nursing 2008;17(2):122-5.
  26.     Agency for Healthcare Research and Quality (AHRQ). Pocket guide TeamSTEPPS. Team Strategies and Tools to Enhance Performance and Patient Safety . Accessed from: https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/essentials/pocketguide.pdf.
  27.     Hekmat SN, Dehnavieh R, Rahimisadegh R, Kohpeima V, Jahromi JK. Team Attitude Evaluation: An Evaluation in Hospital Committees. Mater Sociomed 2015; 27(6): 429–433.
  28.     Khademian Z, Tehrani Neshat B. The relationship between interpersonal communication skills and attitude toward teamwork in nursing students. Sadra Medical Journal 2017;5 (2):99-110.
  29.     Clapper TC, Kong M. TeamSTEPPS®: The patient safety tool that needs to be implemented. Clinical Simulation in Nursing 2012;8(8):e367-e73.
  30.     Weller J. Assessing Teamwork and Communication in the Health Professions 2015. Available from: www.sccm.org/Communications/Critical-Connections/Archives/Pages/Assessing-Teamwork-and-Communication-in-the-Health-Professions.aspx.
  31.     Whittaker G, Abboudi H, Khan MS, Dasgupta P, Ahmed K. Teamwork assessment tools in modern surgical practice: a systematic review. Surg Res Pract 2015:494827. doi: 10.1155/2015/494827.
  32.     Cooper S, Cant R, Porter J, Sellick K, Somers G, Kinsman L, et al. Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM). Resuscitation 2010;81(4):446-52.
  33.     Battles J, King H. TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) Manual [Internet]. Washington, DC: American Institutes for Research; 2010 [Accessed 2016 Sep].
  34.     Baker DP, Amodeo AM, Krokos KJ, Slonim A, Herrera H. Assessing teamwork attitudes in healthcare: development of the TeamSTEPPS teamwork attitudes questionnaire. Qual Saf Health Care 2010; 19(6): 49.
  35.     Forse RA, Bramble J, McQuillan R. Team training can improve operating room performance. Surgery 2011;150(4):771-8.
  36.     Zhang C, Miller C, Volkman K, Meza J, Jones K. Evaluation of the team performance observation tool with targeted behavioral markers in simulation-based interprofessional education. Journal of Interprofessional Care 2015;29(3):202-8.
  37.     Moyer AR. Empowering patients, engaging teams: an interprofessional continuing education pilot. The Journal of Continuing Education in Nursing 2016; 1;47(9):421-6.
  38.     Keshtkaran Z, Sharif F, Rambod M. Students' readiness for and perception of inter-professional learning: a cross-sectional study. Nurse Education Today 2014;34(6):991-8.
  39.     Heinrichs WL, Youngblood P, Harter PM, Dev P. Simulation for team training and assessment: case studies of online training with virtual worlds. World journal of surgery. 2008;32(2):161-70.
  40.     Guise J-M, Lowe NK, Deering S, Lewis PO, O’Haire C, Irwin LK, et al. Mobile in situ obstetric emergency simulation and teamwork training to improve maternal-fetal safety in hospitals. The Joint Commission Journal on Quality and Patient Safety 2010;36(10):443.