The Efficacy of a Team Resource Management Program on the Safety of Transferring ICU Patients

Background: Intra-hospital transfer poses substantial risks to critically ill patients. Multidisciplinary team work is required for ensuring the safety of the transferring process. To prevent error during the process, teamwork education and training might play an important role. The purpose of the study is to test the efficacy of a Team Resource Management (TRM) program on the safety of transferring critically ill patients.

Methods: The study was based on one group pre and post design. A convenient sample of 126 healthcare providers was recruited from intensive care units of a medical center in Taipei. After pre-test, the participants received a 12-month TRM training program, which include group skill training, video demonstration, and case reviews with feedback. The self-report TRM questionnaire was used to measure the participants’ perceived degrees of TRM during the intra-hospital transferring processes. The 16-item questionnaire measures the following four dimensions of TRM: leadership, situational awareness, team work, and communication. The actual performance of applying TRM skills as well as mistakes or accidences occurred during the transferring processes were also observed and recorded by a member of the research team.

Results: 126 healthcare providers, including 92 nurses, 16 respiratory therapists, 12 nurse practitioners, and 6 physicians participated in the study. 188 ICU patient intra-hospital transfers were observed. Results of paired t-tests showed significant improvements in leadership (5.39 ± 0.93, p = 0.04), situational awareness (5.44± 0.83, p = 0.02), team work (5.02 ± 0.92, p = 0.05), and communication (5.63 ± 0.81, p = 0.04) dimension of TRM. The participants showed a variety of teamwork behaviors during the transferring processes. The rate of actual performance TRM skills among the healthcare providers increased from 55.2% to 91.8%. Neither accidence nor error in communication or patient’s identification occurred during the processes.

Conclusion: The TRM training program significantly improved health care providers’ teamwork skills and behaviors during intra-hospital patient transferring processes and thereafter ensured the safety of transferred ICU patients.