A. J. Johnson Escauriza1, B. Ramirez Leal1, B. Medina Vega2, M. M. Garcia2, W. M. Santiesteban Herrera2, G. Costa Ortiz2, A. L. Guelmes Lavandero2, N. Montero Laffita2, K. Iverson1, Y. Valdés González2, J. McLarren1, A. Sende Odoardo2, M. A. De Moya1 1Medical College Of Wisconsin & Froedert Hospital, Critical Care, Acute And Trauma Surgery, Milwaukee, WI, USA 2General Calixto-Garcia University Hospital, Critical Care, Acute And Trauma Surgery/General Surgery, Emergency Medicine And ICU, Havana, HAVANA, Cuba
Introduction: The General Calixto-Garcia University Hospital has been one of the largest trauma centers in Havana, Cuba, with a yearly admission of approximately 3,000 trauma patients. As in other Latin American countries, Cuba has experienced a rise in surgical interventions. Culture of patient safety and team communication have been marked as critical for the safety and prevention of poor surgical outcomes. Therefore, simulation-based interventions such as TeamSTEPPS, a teamwork system designed to improve institutional collaboration and communication, can improve teamwork and communication. Currently, there are no available programs validated in Latin America. As a result, this study aims to analyze the Cuban culture of patient safety and communication among the operating room teams in the General Calixto-Garcia Hospital. We hypothesized that the design, translation, and implementation of TeamSTEPPS will enhance team communication and functioning in the operating room (OR), thus increasing and strengthening the culture of patient safety.
Methods: A multi-disciplinary operating room of the General Calixto-Garcia University Hospital in Cuba identified challenges via focus-groups in June 2022. The utilization of TeamSTEPPS to target these issues was proposed and implemented. Four of its original eight modules were employed. These were: Module 1 – Introduction, Module 6 – Communication, Module 7 – Mutual Support, and Module 8 – Summary/Putting it All Together. They were translated and combined for use with the operating room teams.
Results: The focus-groups identified significant gaps between the discussion about holistic surgical team communication satisfaction and quality of patient safety culture. The gaps in communication within the OR team provided an opportunity to focus the future training. Hence, there is a need of initiating a culture of patient safety that includes all operating room staff. Four multidisciplinary simulation-based teaching modules were selected for implementation.
Conclusion: Multidisciplinary communication plays an important role in the causation and prevention of poor surgical outcomes leading to more efficient patient care. Hence, simulation-based interventions focusing on communication and leadership can enhance performance and culture of safety. TeamSTEPPS has been employed by the General Calixto-Garcia University Hospital in collaboration with the Medical College of Wisconsin to develop superior interdisciplinary communication and improve the culture of safety. The four simulation-based education modules will be validated for hospital-wide implementation. Additionally, use of standardized pre-operative, intra-operative and post-operative checklists and protocols were designed for the surgeons, anesthesiologists, and operating nurses. Our goal is to promote a collective culture of safety and communication to reduce individualism and foster teamwork in the General Calixto-Garcia University Hospital.