Team performance during postsurgical patient handovers in paediatric care
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ORIGINAL ARTICLE
Team performance during postsurgical patient handovers in paediatric care Matthias Weigl 1 & Maria Heinrich 1 & Julia Keil 2 & Julius Z. Wermelt 3 & Florian Bergmann 4 & Jochen Hubertus 4 & Florian Hoffmann 2 Received: 3 April 2019 / Revised: 20 November 2019 / Accepted: 5 December 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019
Abstract Postsurgical handover of paediatric patients from operating rooms to intensive care units is a critical moment. This process is susceptible to errors and inefficiencies particularly if poor teamwork in this multidisciplinary and ad hoc collaboration occurs. Through combining provider- and observer-rated team performance, we aimed to determine agreement levels on team performance and associations with mental demands, disruptions, and stress. An observational and multisource study of provider and concomitant expert-observer ratings was established. In an Academic Paediatric Hospital, we conducted standardized observations of postsurgical handovers to PICU. We applied established observational and self-reported teamwork tools. Nested fixed and mixed models were established to estimate agreement within teams, between providers’ and observer’s ratings, as well as for estimations between team performance and mental demands, disruptions, and stress outcomes. Thirty-one postsurgical patient handovers were included with overall 109 ratings of involved providers. Provider-perceived team performance was rated high. Within the receiving sub-team, situation awareness was perceived lower compared to the handoff sub-team [F(df = 1) = 4.41, p = .04]. Inter-provider agreement on handover team performance was low for the overall team yet higher within handover subteams. We observed that high level of distractions during the handover was associated with inferior team performance rated by observers (B = − 0.72, 95% CI = − 1.44, − 0.01). Conclusion: We observed substantial disagreements on how involved professionals as well as observers rated teamwork during patient transfers. Investigations into paediatric teamwork and particular team-based handovers should carefully consider if concurrent provider and observer assessments are a valid and reliable way to evaluate teamwork in paediatric care. Common handover language should be established and mandatory before jointly evaluating this process. Our findings advocate also that handovers should be performed under low levels of distractions.
Communicated by Piet Leroy Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00431-019-03547-w) contains supplementary material, which is available to authorized users. * Matthias Weigl [email protected] Maria Heinrich [email protected]
Florian Hoffmann [email protected] 1
Julia Keil [email protected]
Institute and Outpatient Clinic for Occupational, Social, and Environmental Medicine, Ludwig-Maximilians-University Munich, Ziemssenstrasse 1, D-80336 Munich, Germany
2
Julius Z. Wermelt julius.wermelt@me
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