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Published (Version of record)CC BY V4.0, Open Access
Published (Version of record)CC BY V4.0, Open
Journal article
Do cognitive aids reduce error rates in resuscitation team performance? Trial of emergency medicine protocols in simulation training (TEMPIST) in Australia
Human resources for health, Vol.18(1), pp.1-13
08/01/2020
PMID: 31915029
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Abstract
Background: Resuscitation of patients with time-critical and life-threatening illness represents a cognitive challenge for emergency room (ER) clinicians. We designed a cognitive aid, the Emergency Protocols Handbook, to simplify clinical management and team processes. Resuscitation guidelines were reformatted into simple, single step-by-step pathways. This Australian randomised controlled trial tested the effectiveness of this cognitive aid in a simulated ER environment by observing team error rates when current resuscitation guidelines were followed, with and without the handbook.
Methods: Resuscitation teams were randomised to manage two scenarios with the handbook and two without in a high-fidelity simulation centre. Each scenario was video-recorded. The primary outcome measure was error rates (the number of errors made out of 15 key tasks per scenario). Key tasks varied by scenario. Each team completed four scenarios and was measured on 60 key tasks. Participants were surveyed regarding their perception of the usefulness of the handbook.
Results: Twenty-one groups performed 84 ER crisis simulations. The unadjusted error rate in the handbook group was 18.8% (121/645) versus 38.9% (239/615) in the non-handbook group. There was a statistically significant reduction of 54.0% (95% CI 49.9-57.9) in the estimated percentage error rate when the handbook was available across all scenarios 17.9% (95% CI 14.4-22.0%) versus 38.9% (95% CI 34.2-43.9%). Almost all (97%) participants said they would want to use this cognitive aid during a real medical crisis situation.
Conclusion: This trial showed that by following the step-by-step, linear pathways in the handbook, clinicians more than halved their teams' rate of error, across four simulated medical crises. The handbook improves team performance and enables healthcare teams to reduce clinical error rates and thus reduce harm for patients.
Details
- Title
- Do cognitive aids reduce error rates in resuscitation team performance? Trial of emergency medicine protocols in simulation training (TEMPIST) in Australia
- Creators
- Charlotte Hall - Western Sydney UniversityDean Robertson - Maclean District HospitalMargaret Rolfe - The University of SydneySharene Pascoe - The University of SydneyMegan E Passey - The University of SydneySabrina Winona Pit - Western Sydney University
- Publication Details
- Human resources for health, Vol.18(1), pp.1-13
- Publisher
- Springer Nature
- Grant note
- Funding was received by the Agency for Clinical Innovation, New South Wales, and Laerdal Company Australia.
- Identifiers
- 991013344084702368
- Copyright
- © The Author(s). 2020.
- Academic Unit
- Faculty of Health
- Language
- English
- Resource Type
- Journal article