On the front lines of patient safety: Implementation and evaluation of team training in Iraq

Shad Deering, Michael A. Rosen, Vivian Ludi, Michelle Munroe, Amber Pocrnich, Christine Laky, Peter G. Napolitano

Research output: Contribution to journalArticle

Abstract

Background: Team training has been identified as a key strategy for reducing medical errors and building a culture of safety in health care. Communication and coordination skills can serve as barriers to potential errors, as in the modern deployed U.S. Military Healthcare System (MHS), which emphasizes rapid movement of critically injured patients to facilities capable of providing definitive care. A team training intervention-TeamSTEPPS®-was implemented on a large scale during one of the most intense phases of the conflict in Iraq. This evaluation of the program constituted the first undertaken in a combat theater of operations. Implementing TeamSTEPPS in Iraq: The Baghdad combat support hospital (CSH) conducted continuous operations from a fixed facility for a 13-month deployment-between November 2007 and December 2008. The TeamSTEPPS implementation in Iraq began at this facility and spread throughout the combat theater of operations. Teamwork training was implemented in two primary training sessions, followed up with reinforcement of team behaviors on the unit by hospital leadership. Results: A total of 153 patient safety reports were submitted during the 13 months reviewed, 94 before TeamSTEPPS implementation and 59 afterwards. After training, there were significant decreases in the rates of communication-related errors, medication and transfusion errors, and needlestick incidents. There was a significant decrease in the rate of incidents coded communication as the primary teamwork skill that could have potentially prevented the event. Conclusions: Process improvement programs such as TeamSTEPPS implementation can be conducted under the extremely austere conditions of a CSH in a combat zone. Teamwork training decreased medical errors in the CSH while deployed in the combat theater in Iraq. Copyright 2011

Original languageEnglish (US)
Pages (from-to)350-356
Number of pages7
JournalJoint Commission Journal on Quality and Patient Safety
Volume37
Issue number8
StatePublished - Aug 2011

ASJC Scopus subject areas

  • Leadership and Management

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    Deering, S., Rosen, M. A., Ludi, V., Munroe, M., Pocrnich, A., Laky, C., & Napolitano, P. G. (2011). On the front lines of patient safety: Implementation and evaluation of team training in Iraq. Joint Commission Journal on Quality and Patient Safety, 37(8), 350-356.