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A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience

  • Innovations in Education
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ABSTRACT

INTRODUCTION

Communication and teamwork failures are a common cause of adverse events. Residency programs, with a mandate to teach systems-based practice, are particularly challenged to address these important skills.

AIM

To develop a multidisciplinary teamwork training program focused on teaching teamwork behaviors and communication skills.

SETTING

Internal medicine residents, hospitalists, nurses, pharmacists, and all other staff on a designated inpatient medical unit at an academic medical center.

PROGRAM DESCRIPTION

We developed a 4-h teamwork training program as part of the Triad for Optimal Patient Safety (TOPS) project. Teaching strategies combined didactic presentation, facilitated discussion using a safety trigger video, and small-group scenario-based exercises to practice effective communication skills and team behaviors. Development, planning, implementation, delivery, and evaluation of TOPS Training was conducted by a multidisciplinary team.

PROGRAM EVALUATION

We received 203 evaluations with a mean overall rating for the training of 4.49 ± 0.79 on a 1–5 scale. Participants rated the multidisciplinary educational setting highly at 4.59 ± 0.68.

DISCUSSION

We developed a multidisciplinary teamwork training program that was highly rated by all participating disciplines. The key was creating a shared forum to learn about and discuss interdisciplinary communication and teamwork.

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Acknowledgements

We thank the Gordon and Betty Moore Foundation for their active support and funding of the TOPS project. We also thank our wonderful collaborators at El Camino Hospital in Mountain View, CA (including Suann Schutt, Michael Podlone, Phil Strong, and Sara Mills) and Kaiser Permanente in San Francisco, CA (including Rachel Mueller, Clarissa Johnson, Paul Preston, and Lynn Paulsen) for their contributions to the TOPS Training Program and implementing local versions on their respective medical units. We’re grateful for the support we received to conduct TOPS Training from UCSF Medical Center and the UCSF Internal Medicine Residency Program leadership. Finally, we thank Terrie Evans for her role as TOPS Project Coordinator in orchestrating the successful delivery of the TOPS Training Program sessions. The TOPS Training program was presented as a poster presentation (2006) and workshop (2007) at the Society of General Internal Medicine Annual Meeting.

Conflict of Interest

Jack Barker was employed as a consultant from Mach One Leadership, Inc., to contribute experience and expertise in developing and teaching teamwork training. There are no other conflicts of interest to report for the remaining authors.

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Authors and Affiliations

  1. Division of Hospital Medicine, University of California, San Francisco, CA, USA

    Niraj L. Sehgal MD, MPH, Arpana R. Vidyarthi MD, Bradley A. Sharpe MD & Robert M. Wachter MD

  2. School of Nursing, University of California, San Francisco, CA, USA

    Michael Fox RN, Susan Gearhart RN & Mary A. Blegen PhD, RN

  3. School of Pharmacy, University of California, San Francisco, CA, USA

    Thomas Bookwalter PharmD & Brian K. Alldredge PharmD

  4. Mach One Leadership, Inc., Miami, FL, USA

    Jack Barker PhD

Authors
  1. Niraj L. Sehgal MD, MPH
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  2. Michael Fox RN
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  3. Arpana R. Vidyarthi MD
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  4. Bradley A. Sharpe MD
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  5. Susan Gearhart RN
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  6. Thomas Bookwalter PharmD
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  7. Jack Barker PhD
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  8. Brian K. Alldredge PharmD
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  9. Mary A. Blegen PhD, RN
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  10. Robert M. Wachter MD
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Consortia

The Triad for Optimal Patient Safety (TOPS) Project

Corresponding author

Correspondence to Niraj L. Sehgal MD, MPH.

Electronic supplementary material

Below is the link to the electronic supplementary material.

ESM 1

Training guide (PDF 3.12 MB)

ESM 2

Training scenario (DOC 144 KB)

ESM 3

Course evaluation (DOC 60 KB)

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Sehgal, N.L., Fox, M., Vidyarthi, A.R. et al. A Multidisciplinary Teamwork Training Program: The Triad for Optimal Patient Safety (TOPS) Experience. J GEN INTERN MED 23, 2053–2057 (2008). https://doi.org/10.1007/s11606-008-0793-8

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  • DOI: https://doi.org/10.1007/s11606-008-0793-8

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