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Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review
Abstract Number: T-40
Abstract Type: Original Research
Introduction: The management of obstetric emergencies requires a multidisciplinary team. Lack of communication and inadequate care are frequent factors in poor maternal and fetal outcomes . The Institute of Medicine identifies team-based training and simulation as methods to improve patient safety . Many teamwork assessment tools exist to try to quantify the adequacy of teamworking in various scenarios, but whether or not a specific tool is better adapted to teamwork assessment in obstetric emergencies is unclear, and no general consensus exists. The purpose of this systematic review was to determine the best teamwork assessment tool, in terms of ease of use, reliability and validity, for use in obstetric emergencies.
Methods: Prospective studies evaluating multidisciplinary team non-technical skills in obstetric emergencies, using a specific tool, were included. The search was conducted in Embase, Medline, Pubmed, Web of Science, PsycINFO, CINAHL and Google Scholar using the search string: ‘group processes’, ‘team’, ‘non-technical skills’, ‘nontechnical skills’, ‘obstetrics’ and ‘pregnancy’. The search was conducted from 1944 to January 11, 2016. Abstracts and non-English studies were excluded. Data on study intervention, outcomes assessed, reliability and validity were collected and a descriptive analysis performed.
Results: A total of 15,333 records were identified, 6,168 were screened after removal of duplicates and non-English studies. Seventy full text articles were assessed for eligibility with 57 excluded for not meeting the inclusion criteria. Thirteen studies were included in the qualitative synthesis and assessed simulation scenarios. Nine looked at team training and scenario implementation and one looked at patient safety. One evaluated teamwork scales using validity measures, six using reliability measures and one used both (Table 1). Only 6 of the 13 studies included anesthetists in the simulations.
Discussion: Five scales had the greatest reliability with the CTS also displaying construct validity. Only the GAOTP and GRS were evaluated with anesthetist involvement in the team scenario. More work needs to be done to establish the validity of teamwork scales for non-technical skills. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these scales.
References: 1) MBRRACE-UK 2011-13 2) Institute of Medicine 2000