Author(s): Berwick C.; Morton S.; Lown N.
Source: Anaesthesia; Jan 2018; vol. 73 ; p. 72
Publication Date: Jan 2018
Publication Type(s): Conference Abstract
Available at Anaesthesia – from Wiley Online Library Full Collection
Abstract:The concept of the laparotomy team is beginning to develop in our region. To provide the best care for emergency laparotomy patients, a multidisciplinary team is required. This team is distributed across time, location and specialty, which can lead to team members feeling disparate. Team work processes of communication, leadership, and membership have recognised impacts on clinical performance and focused interventions on team work can enhance team effectiveness . Merseyside Emergency Laparotomy Collaboration (MEL-C), a group of anaesthetic and surgical trainees in the region, developed a tool to assess perceptions of the laparotomy team in order to focus future quality improvement in this area. Methods A 24 item, Likert scale-based, teamwork self-report tool was developed, based upon themes from validated teamwork tools including the Royal College of Surgeons guide to the High Performing Surgical Team  and the TeamSTEPPS Teamwork Perceptions Questionnaire . Our tool aimed to assess team membership, leadership, communication, coordination of tasks, safe working environment and reflective learning. We tested our tool in a large teaching hospital and undertook face to face feedback with members of staff including consultant and trainee anaesthetists and surgeons, ODPs, scrub staff and porters. Results Forty-four members of staff completed the Teamwork Evaluation Tool. Participants grasped the underlying concept of a ‘distributed’ team and questions were well understood. Notable findings from the results were only 36% of participants agreed that there is a no-blame culture, 43% agreed that patient plans are communicated effectively across specialities, and 36% felt aware of emergency laparotomy patient outcomes. Only 75% of staff involved in emergency laparotomy care agreed that they felt important to patient outcomes. Discussion The MEL-C Teamwork Evaluation Tool is a brief assessment to determine the perceptions staff of the emergency laparotomy team. The tool identified areas of concern that ought to be addressed alongside standard quality improvement process mapping techniques. To address the perceived lack of insight into the outcomes of emergency laparotomies we have created an app that utilises NELA data with the purpose of real-time feedback to departments on specific measures as determined by each hospital. We are also developing a comparative tool for the better established trauma team.