Periodic Reporting for period 1 - Tools4Teams (Tools4Teams: Research Training to Design and Implement Tools Supporting Safe Teamwork in Healthcare)
Reporting period: 2023-03-01 to 2025-02-28
Teamwork is crucial to maintain safe and effective care
There is ample evidence that effective teamwork is crucial to the provision of safe and effective patient care. In the last decade significant progress has been made to describe cognitive, affective, and behavioral team interactions that determine safe and effective care. These team interactions are supported by healthcare professionals’ non-technical skills: a combination of cognitive (e.g. decision making), social (e.g. leadership) and self-regulation skills (e.g. stress and fatigue).
Current challenges to effective team performance
The complexity of healthcare is rapidly increasing due to technological innovations, increasing healthcare specialization, and decentralization of care delivery. These changes pose emerging challenges to the performance of health care teams, such as the need for collaboration between multiple teams, including patients and families as team members. The Tools4Teams network will study emerging tools and training for improving teamwork, as well as developing new approaches to address emerging teamwork challenges in healthcare.
Training program
The primary goal of the Tools4Teams project is to train 12 highly skilled Doctoral Candidates with in-depth knowledge and cross-disciplinary expertise in methods for research on teamwork and healthcare services, design and system thinking, and ethics, complemented with transferable and networking skills, an entrepreneurial mind-set and experience of industrial application.
Tools4Teams aims to establish a European training network to prepare the next generation of teamwork experts to contribute to the next step in safe and effective care. Tools4Teams brings together expertise from social and technical sciences, human centered design, education, and clinical specialties alongside non-academic partners from technological business, healthcare, and education to reach both scientific and societal impact.
There is ample evidence that effective teamwork is crucial to the provision of safe and effective patient care. In the last decade significant progress has been made to describe cognitive, affective, and behavioral team interactions that determine safe and effective care. These team interactions are supported by healthcare professionals’ non-technical skills: a combination of cognitive (e.g. decision making), social (e.g. leadership) and self-regulation skills (e.g. stress and fatigue).
Current challenges to effective team performance
The complexity of healthcare is rapidly increasing due to technological innovations, increasing healthcare specialization, and decentralization of care delivery. These changes pose emerging challenges to the performance of health care teams, such as the need for collaboration between multiple teams, including patients and families as team members. The Tools4Teams network will study emerging tools and training for improving teamwork, as well as developing new approaches to address emerging teamwork challenges in healthcare.
Training program
The primary goal of the Tools4Teams project is to train 12 highly skilled Doctoral Candidates with in-depth knowledge and cross-disciplinary expertise in methods for research on teamwork and healthcare services, design and system thinking, and ethics, complemented with transferable and networking skills, an entrepreneurial mind-set and experience of industrial application.
Tools4Teams aims to establish a European training network to prepare the next generation of teamwork experts to contribute to the next step in safe and effective care. Tools4Teams brings together expertise from social and technical sciences, human centered design, education, and clinical specialties alongside non-academic partners from technological business, healthcare, and education to reach both scientific and societal impact.
The doctoral candidates have completed four training events, covering diverse scientific areas, such as qualitative and quantitative research methods and simulation-based team training; as well as in transferable skills, including extensive research ethics and leadership workshops. DCs have updated their Career Development Plans at the start of their second year and have provided a report on their future training needs, which is always considered.
Furthermore, DCs learn on the job, by working to achieve the objectives set out within each Work Package. The progress of each WP towards its objectives is outlined below. Although many findings are preliminary and pending further research, these efforts have already informed training curricula, tool development, and clinical practices.
WP4 – Teamwork tools applied in centralized acute care settings
The objectives of WP4 are to obtain insights, develop, and test novel methods, instruments, tools and programs for assessing and supporting team functioning and performance in acute health care, thereby considering the complex and dynamic context in which acute care teams operate nowadays. Specifically, WP4 aims to:
1. Scrutinize measures to assess and train non-technical skills.
2. Identify effective strategies for assessment and training of non-technical skills in clinical practice.
3. Establishing a deeper understanding of team dynamics underlying effective team functioning in an unstable, taxing acute care setting.
4. Developing and testing support systems that can be used either during or after action to facilitate effective team functioning and performance in dynamic and taxing acute care environments.
5. Determine key factors and formulate guidelines for effective implementation of instruments, tools, and programs in clinical practice.
WP4 has made substantial progress towards its scientific objectives. Key milestones include DC1’s identification of conflict management training needs in operating rooms, DC2’s development of insights and tools for testing biofeedback effects in acute care teams, and DC3’s advancements in evaluating acoustic markers of stress and emotions in surgical settings. Additionally, DC4’s work on CRM training impact and team reflexivity measures, DC5’s meta-review of SA assessment tools, DC10’s immersive platforms for clinical training, and DC12’s focus on person-centered practice in the stroke patient trajectory collectively contributes to a comprehensive understanding of teamwork and communication in healthcare.
WP5 – Teamwork tools applied in decentralized chronic care
The objectives of WP5 are to examine how emerging technologies can be effectively integrated in the care of patients in the community from the perspective of the potential end-users of these technologies in order to improve the teamwork of community healthcare teams and to identify effective ways of integrating support tools for coordinating tasks and information transfer (i.e. checklists, protocols and Health IT) with patient involvement in transmural care, by multiple care providers and services, in single and multi-team processes. Specifically, the projects in WP5 aims to:
1. Improve the understanding of how to integrate emerging technologies to foster improved teamwork in community care settings.
2. Identify the barriers and enablers to emerging technologies both from the perspective of the community healthcare team and the patients for which they care.
3. Identify how these emerging technologies can assist, as well as potentially inhibit, patient safety and quality of care for patients in the community.
4. Deeper understanding of the working mechanism of system integrating tools on interaction patterns and outcomes along the patient’s journey.
5. Develop and test tools using human centered design principles to integrate transmural care by multiple healthcare providers and teams.
6. Develop and test e-learning to improve team skills of a wider population of formal and informal team members.
All DCs in WP5 have made considerable progress towards meeting the early objectives of their projects. Key milestones include DC6’s identification of the issues with remote monitoring of patients in the community, DC7’s mapping of the patient journey of patients undergoing hand- and wrist surgery, DC8's identification of barriers enablers to emerging technologies from the perspective of the community healthcare team, their patients and the company perspective. Additionally, DC9 developed an inventory of essential multiteam system competencies, including measures to assess and train multi-team competencies and training of these multi-team complexities in stroke care.
Furthermore, DCs learn on the job, by working to achieve the objectives set out within each Work Package. The progress of each WP towards its objectives is outlined below. Although many findings are preliminary and pending further research, these efforts have already informed training curricula, tool development, and clinical practices.
WP4 – Teamwork tools applied in centralized acute care settings
The objectives of WP4 are to obtain insights, develop, and test novel methods, instruments, tools and programs for assessing and supporting team functioning and performance in acute health care, thereby considering the complex and dynamic context in which acute care teams operate nowadays. Specifically, WP4 aims to:
1. Scrutinize measures to assess and train non-technical skills.
2. Identify effective strategies for assessment and training of non-technical skills in clinical practice.
3. Establishing a deeper understanding of team dynamics underlying effective team functioning in an unstable, taxing acute care setting.
4. Developing and testing support systems that can be used either during or after action to facilitate effective team functioning and performance in dynamic and taxing acute care environments.
5. Determine key factors and formulate guidelines for effective implementation of instruments, tools, and programs in clinical practice.
WP4 has made substantial progress towards its scientific objectives. Key milestones include DC1’s identification of conflict management training needs in operating rooms, DC2’s development of insights and tools for testing biofeedback effects in acute care teams, and DC3’s advancements in evaluating acoustic markers of stress and emotions in surgical settings. Additionally, DC4’s work on CRM training impact and team reflexivity measures, DC5’s meta-review of SA assessment tools, DC10’s immersive platforms for clinical training, and DC12’s focus on person-centered practice in the stroke patient trajectory collectively contributes to a comprehensive understanding of teamwork and communication in healthcare.
WP5 – Teamwork tools applied in decentralized chronic care
The objectives of WP5 are to examine how emerging technologies can be effectively integrated in the care of patients in the community from the perspective of the potential end-users of these technologies in order to improve the teamwork of community healthcare teams and to identify effective ways of integrating support tools for coordinating tasks and information transfer (i.e. checklists, protocols and Health IT) with patient involvement in transmural care, by multiple care providers and services, in single and multi-team processes. Specifically, the projects in WP5 aims to:
1. Improve the understanding of how to integrate emerging technologies to foster improved teamwork in community care settings.
2. Identify the barriers and enablers to emerging technologies both from the perspective of the community healthcare team and the patients for which they care.
3. Identify how these emerging technologies can assist, as well as potentially inhibit, patient safety and quality of care for patients in the community.
4. Deeper understanding of the working mechanism of system integrating tools on interaction patterns and outcomes along the patient’s journey.
5. Develop and test tools using human centered design principles to integrate transmural care by multiple healthcare providers and teams.
6. Develop and test e-learning to improve team skills of a wider population of formal and informal team members.
All DCs in WP5 have made considerable progress towards meeting the early objectives of their projects. Key milestones include DC6’s identification of the issues with remote monitoring of patients in the community, DC7’s mapping of the patient journey of patients undergoing hand- and wrist surgery, DC8's identification of barriers enablers to emerging technologies from the perspective of the community healthcare team, their patients and the company perspective. Additionally, DC9 developed an inventory of essential multiteam system competencies, including measures to assess and train multi-team competencies and training of these multi-team complexities in stroke care.
Each DC has made meaningful progress, contributing valuable insights to their fields and disseminating findings through presentations at international conferences. Forthcoming research outputs, including systematic reviews, empirical research, and technological innovations, will foster greater understanding, practical applications, and the potential for future advancements in healthcare practices.