Using Simulation as an Investigational Methodology to Explore the Impact of Technology on Team Communication and Patient Management: A Pilot Evaluation of the Effect of an Automated Compression Device

Simul Healthc. 2017 Jun;12(3):139-147. doi: 10.1097/SIH.0000000000000205.

Abstract

Introduction: This pilot study used a simulation-based platform to evaluate the effect of an automated mechanical chest compression device on team communication and patient management.

Methods: Four-member emergency department interprofessional teams were randomly assigned to perform manual chest compressions (control, n = 6) or automated chest compressions (intervention, n = 6) during a simulated cardiac arrest with 2 phases: phase 1 baseline (ventricular tachycardia), followed by phase 2 (ventricular fibrillation). Patient management was coded using an Advanced Cardiovascular Life Support-based checklist. Team communication was categorized in the following 4 areas: (1) teamwork focus; (2) huddle events, defined as statements focused on re-establishing situation awareness, reinforcing existing plans, and assessing the need to adjust the plan; (3) clinical focus; and (4) profession of team member. Statements were aggregated for each team.

Results: At baseline, groups were similar with respect to total communication statements and patient management. During cardiac arrest, the total number of communication statements was greater in teams performing manual compressions (median, 152.3; interquartile range [IQR], 127.6-181.0) as compared with teams using an automated compression device (median, 105; IQR, 99.5-123.9). Huddle events were more frequent in teams performing automated chest compressions (median, 4.0; IQR, 3.1-4.3 vs. 2.0; IQR, 1.4-2.6). Teams randomized to the automated compression intervention had a delay to initial defibrillation (median, 208.3 seconds; IQR, 153.3-222.1 seconds) as compared with control teams (median, 63.2 seconds; IQR, 30.1-397.2 seconds).

Conclusions: Use of an automated compression device may impact both team communication and patient management. Simulation-based assessments offer important insights into the effect of technology on healthcare teams.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Cardiopulmonary Resuscitation / methods*
  • Communication*
  • Emergency Service, Hospital / organization & administration*
  • Group Processes
  • Heart Arrest / complications
  • Heart Arrest / therapy*
  • Models, Anatomic
  • Patient Care Team / organization & administration*
  • Pilot Projects
  • Simulation Training / methods*
  • Tachycardia, Ventricular / etiology
  • Tachycardia, Ventricular / therapy
  • Time Factors
  • Ventricular Fibrillation / etiology
  • Ventricular Fibrillation / therapy