A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

Journal of General Internal Medicine (Impact Factor: 3.45). 01/2008; 23(12):2053-2057. DOI: 10.1007/s11606-008-0793-8


INTRODUCTIONCommunication and teamwork failures are a common cause of adverse events. Residency programs, with a mandate to teach systems-based
practice, are particularly challenged to address these important skills.

AIMTo develop a multidisciplinary teamwork training program focused on teaching teamwork behaviors and communication skills.

SETTINGInternal medicine residents, hospitalists, nurses, pharmacists, and all other staff on a designated inpatient medical unit
at an academic medical center.

PROGRAM DESCRIPTIONWe developed a 4-h teamwork training program as part of the Triad for Optimal Patient Safety (TOPS) project. Teaching strategies
combined didactic presentation, facilitated discussion using a safety trigger video, and small-group scenario-based exercises
to practice effective communication skills and team behaviors. Development, planning, implementation, delivery, and evaluation
of TOPS Training was conducted by a multidisciplinary team.

PROGRAM EVALUATIONWe received 203 evaluations with a mean overall rating for the training of 4.49 ± 0.79 on a 1–5 scale. Participants rated
the multidisciplinary educational setting highly at 4.59 ± 0.68.

DISCUSSIONWe developed a multidisciplinary teamwork training program that was highly rated by all participating disciplines. The key
was creating a shared forum to learn about and discuss interdisciplinary communication and teamwork.

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    • "They include Situation-Background-Assessment-Recommendation (SBAR) communication skills (Wacogne and Diwakar, 2010), the Concerned-Uncomfortable-Safety Issue (CUS) communication strategy (Simons, 2008), Crew Resource Management (Sculli et al., 2011), and the Triad for Optimal Patient Safety (Seghal et al., 2008). The Canadian Patient Safety Institute (CPSI) describes teamwork and communication as essential for creating a culture of safety and supporting the safe delivery of patient care and provides a framework for teamwork and communication that includes collaboration , leadership, transparency, open honest disclosure, and commitment to continuous learning and process improvement (Teamwork and Communication Working Group, 2011; pp. "
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