Study of Team Leadership Training Effect on Patient Care

NCT03155490 | Completed

• 1 other identifier: STUDY00000748
• Study Type: interventional
• Target: 79
• Locations: 1 country
• Sites: 1

Brief Summary

Brief Summary: Trauma is a major public health burden; it is the fifth most common cause of mortality overall in the US and accounts for the majority of deaths in patients younger than 45. Trauma resuscitations present unique patient care challenges due to the need to perform complex tasks under uncertain and time-pressured conditions. It is not entirely surprising that one-third to one-half of trauma patient-related errors occurred in emergency departments during the initial resuscitation period. Effective team leadership can enhance teamwork and team adaptability, thus improving teams' ability to handle unexpected and rapidly changing situations. Simulation-based training provides a clinically relevant practice environment that has been recommended for team and team leader training. The purpose of this research is to evaluate the impact of simulation-based leadership training on clinical teamwork, team leadership and patient care. The investigators hypothesize that team leadership training will improve team leadership, teamwork, and critical patient care events during actual trauma resuscitations.

Conditions

Wounds and Injuries; Trauma

Keywords

Hospital medical emergency team; Leadership; Simulation training

Outcome Measures

Primary Outcomes (1)

• Team leadership

  Subject performance during trauma resuscitations is video recorded and assessed using team leadership measure (behaviorally anchored rating scale). Final outcome will be reported as an average score.

  Data will be collected pre- and post-intervention for approximately 5 weeks total.

Secondary Outcomes (1)

• Patient care

  Data will be collected pre- and post-intervention for approximately 5 weeks total.

Other Outcomes (3)

• Survival to discharge

  Data will be collected up to 4 months after admission

• Total hospital length of stay

  Data will be collected up to 4 months after admission

• Total intensive care length of stay

  Data will be collected up to 4 months after admission

Study Arms (2)

Leadership Training

EXPERIMENTAL

Subjects are resident trainees with a role in the emergency department evaluation and management of trauma patients.

Behavioral: Leadership training

Control

NO INTERVENTION

Subjects are resident trainees with a role in the emergency department evaluation and management of trauma patients.

Interventions

Leadership training BEHAVIORAL

Subjects randomized to the experimental arm of the study will receive an additional 4 hours of simulation-based trauma team leadership training. This training is in addition to the baseline 2 hours of trauma leader training and orientation all subjects receive.

Leadership Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Second or third year emergency medicine or general surgical resident in good standing with the Office of Graduate Medical Education
• Up-to-date ATLS-certification
• \>6 weeks prior experience in trauma care at Harborview Medical Center
• Scheduled for a trauma team leader month during the data collection period of the study

You may not qualify if:

• a) Unavailable for intervention or assessment
• \*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*\*
• Age \> 21
• Patients with one or more of the following clinical presentations:
• i. Witnessed trauma with intubation in the pre-hospital setting ii. Witnessed trauma with hypotensive (SBP\< 90 mmHg for two consecutive readings) in the pre-hospital setting iii. Stab wound or impalement to the neck, chest, abdomen, pelvis, or groin iv. MVC with ejection from the vehicle v. Fall \> 20ft vi. Pedestrian struck by a motorized vehicle vii. Motorcycle crash \> 20 mph viii. Gunshot wounds to the head, neck, chest, abdomen, pelvis, or groin ix. Two or more obvious long bone/ extremity injuries
• Prisoners
• Obstetric patient
• Patient status downgraded based on first 5 min. of evaluation
• Patient dead on arrival to ED or pronounced dead within 5 min of arrival
• Patient removed from ED within 5 minutes of arrival
• Patients arriving to the ED with do not resuscitate or comfort care orders
• Patients on whom resuscitative efforts ceased within 5 minutes of arrival to the ED

Sponsors & Collaborators

• University of Washington: lead
• Michigan State University: collaborator
• University of Maryland: collaborator

Study Sites (1)

Harborview Medical Center

Seattle, Washington, 98104, United States

Location

MeSH Terms

Conditions

Wounds and Injuries

Study Officials

• Rosemarie Fernandez, MD

  University of Washington

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor, Emergency Medicine

Study Record Dates

• First Submitted: May 11, 2017
• First Posted: May 16, 2017
• Study Start: April 1, 2016
• Primary Completion: December 1, 2017
• Study Completion: August 1, 2018
• Last Updated: October 18, 2018

Record last verified: 2018-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)