Abstract
Objective
The objective of this study was to develop a new interdisciplinary teamwork scale,
the Perinatal Emergency: Team Response Assessment (PETRA), for the management of obstetric
crises, through consensus agreement of obstetric caregivers.
Methods
This prospective study was performed using expert consensus, based on a Delphi method.
The study investigators developed a new PETRA tool, specifically related to obstetric
crisis management, based on the existing literature and discussions among themselves.
The scale was distributed to a selected panel of experts in the field for the Delphi
process. After each round of Delphi, every component of the scale was analyzed quantitatively
by the percentage of agreement ratings and each comment reviewed by the blinded investigators.
The assessment scale was then modified, with components of less than 80% agreement
removed from the scale. The process was repeated on three occasions to reach a consensus
and final PETRA scale.
Results
Fourteen of 24 invited experts participated in the Delphi process. The original PETRA
scale included six categories and 48 items, one global scale item, and a 3-point rubric
for rating. The overall percentage agreement by experts in the first, second, and
third rounds was 95.0%, 93.2%, and 98.5%, respectively. The final scale after the
third round of Delphi consisted of the following seven categories: shared mental model,
communication, situational awareness, leadership, followership, workload management,
and positive/effective behaviours and attitudes. There were 34 individual items within
these categories, each with a 5-point rating rubric (1 = unacceptable to 5 = perfect).
Conclusion
Using a structured Delphi method, we established the face and content validity of
this assessment scale that focuses on important aspects of interdisciplinary teamwork
in the management of obstetric crises.
Résumé
Objectif
Cette étude visait à élaborer, par consensus de fournisseurs de soins obstétricaux,
une nouvelle échelle d'évaluation du travail d'équipe interdisciplinaire applicable
à la prise en charge des situations d'urgence en obstétrique, la Perinatal Emergency
Team Response Assessment [Évaluation d'une équipe d'intervention en cas d'urgence
périnatale], ou PETRA.
Méthodologie
Cette étude prospective repose sur un consensus d'experts établi selon une méthode
Delphi. Les chercheurs ont mis au point l'échelle PETRA, qui s'applique précisément
à la prise en charge des urgences obstétricales, en utilisant la littérature existante
et les résultats des discussions entre membres. Pour l'enquête Delphi, l'échelle a
été distribuée à un groupe d'experts choisis du domaine. Après chaque tour d'enquête,
les chercheurs analysaient quantitativement chaque élément de l'échelle, selon les
pourcentages d'accord reçus, et passaient en revue chaque commentaire. Cet examen
en aveugle menait ensuite à la modification de l'échelle : les éléments ayant moins
de 80 % d'accord étaient retirés. Répété trois fois, le processus a mené à l'établissement
d'un consensus et d'une version définitive de l'échelle PETRA.
Résultats
Sur les 24 experts invités, 14 ont participé à l'enquête Delphi. L'échelle initiale
comprenait 48 éléments regroupés en six catégories, un élément général et un système
de notation sur trois points. Le pourcentage d'accord global aux premier, deuxième
et troisième tours était de 95,0 %, 93,2 % et 98,5 %, respectivement. Après le troisième
tour, l'échelle comptait sept catégories : modèle mental commun, communication, conscience
de la situation, direction, respect de la hiérarchie, gestion de la charge de travail,
et attitudes et comportements positifs et efficaces. Ces catégories rassemblaient
34 éléments, notés sur une échelle de cinq points (1 = inacceptable; 5 = parfait).
Conclusion
Nous avons suivi une méthode Delphi, un processus structuré, pour établir la validité
de l'organisation et du contenu de l'échelle d'évaluation PETRA, qui porte sur des
aspects importants de la collaboration interdisciplinaire dans la prise en charge
des situations d'urgence en obstétrique.
Key Words
Abbreviation:
GAOTP (Global Assessment of Obstetric Team Performance), GRS (Global Rating Scale), NICU (Neonatal Intensive Care Unit), PETRA (Perinatal Emergency Team Response Assessment)To read this article in full you will need to make a payment
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References
- Saving mothers' lives. Reviewing maternal deaths to make motherhood safer: 2006-2008.BJOG. 2011; 118 (discussion 3–4): 1402-1403
- Saving mothers' lives: the 2006-8 anaesthesia perspective.Br J Anaesth. 2011; 107: 119-122
The Joint Commission: Sentinal Event Data Root Causes by Event Type 2004-2014. Oakbrook Terrace, IL: The Joint Commission. Available at: http://www.tsigconsulting.com/tolcam/wp-content/uploads/2015/04/TJC-Sentinel-Event-Root_Causes_by_Event_Type_2004-2014.pdf. Accessed on May 15, 2015.
- Non-technical skills in the intensive care unit.Br J Anaesth. 2006; 96: 551-559
- Rating non-technical skills: developing a behavioural marker system for use in anaesthesia.Cogn Tech Work. 2004; 6: 165-171
- The mayo high performance teamwork scale: reliability and validity for evaluating key crew resource management skills.Simul Healthc. 2007; 2: 4-10
- Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system.Br J Anaesth. 2003; 90: 580-588
- Surgeons' non-technical skills in the operating room: reliability testing of the NOTSS behavior rating system.World J Surg. 2008; 32: 548-556
- A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: the University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management I Study.Crit Care Med. 2006; 34: 2167-2174
- Observational Skill-based Clinical Assessment tool for Resuscitation (OSCAR): development and validation.Resuscitation. 2011; 82: 835-844
- Rating medical emergency teamwork performance: development of the Team Emergency Assessment Measure (TEAM).Resuscitation. 2010; 81: 446-452
- Using the Communication and Teamwork Skills (CATS) Assessment to measure health care team performance.Jt Comm J Qual Patient Saf. 2007; 33: 549-558
- Multidisciplinary team training in a simulation setting for acute obstetric emergencies: a systematic review.Obstet Gynecol. 2010; 115: 1021-1031
Onwochei D, Halpern S, Balki M. Teamwork assessment tools in obstetric emergencies: A systematic review [e-pub ahead of print]. Simul Healthc http://dx.doi.org/10.1097/SIH.0000000000000210. Accessed on December 22, 2016.
- Measuring teamwork and conflict among emergency medical technician personnel.Prehosp Emerg Care. 2012; 16: 98-108
- Does teamwork improve performance in the operating room? A multilevel evaluation.Jt Comm J Qual Patient Saf. 2010; 36: 133-142
- An experimental study of group opinion: the Delphi method.Futures. 1969; 1: 408-426
- The Delphi technique: myths and realities.J Adv Nurs. 2003; 41: 376-382
- Group techniques for program planning: a guide to nominal groups and Delphi process.Scott Foresman Company, Glenview, IL1975
- The Delphi technique: making sense of consensus.Pract Assess Res Eval. 2007; 12 (Available at http://pareonline.net/pdf/v12n10.pdf. Accessed on September 15, 2013): 1-8
- Validation of a tool to measure and promote clinical teamwork.Simul Healthc J Soc Med Simul. 2008; 3: 217-223
- Determination of the psychometric properties of a behavioural marking system for obstetrical team training using high-fidelity simulation.BMJ Qual Saf. 2012; 21: 78-82
- Evaluating teamwork in a simulated obstetric environment.Anesthesiology. 2007; 106: 907-915
- An exploration of the use of simple statistics to measure consensus and stability in Delphi studies.BMC Med Res Methodol. 2007; 7: 52
- Consensus conference.in: Kirch W. Encyclopedia of public health. Springer, The Netherlands2008: 156
- The consensus group technique in social research.Field Methods. 2001; 13: 277-290
- Consensus-oriented decision-Making: the CODM model for facilitating groups to widespread agreement.New Society Publishing, Gabriola Island, BC2010
- Nominal group technique: an effective method for obtaining group consensus.Int J Nurs Pract. 2012; 18: 188-194
- Multidisciplinary teamwork and communication training.Semin Perinatol. 2011; 35: 89-96
- Impact of the Liaison Committee on medical education requirements for emergency medicine education at U.S. Schools of Medicine.Acad Emerg Med. 2005; 12: 1003-1009
- Toward a theory of situation awareness in dynamic systems.Hum Factors Ergon Soc. 1995; 37: 32-64
- Decision making, situation awareness, and communication skills in the operating room.Int Anesthesiol Clin. 2013; 51: 105-127
Balki M, Hoppe D, Monks D, et al. The PETRA (Perinatal Emergency Team Response Assessment) scale: A high-fidelity simulation validation study. J Obstet Gynaecol Can. In press.
Article info
Publication history
Accepted:
January 30,
2017
Received:
October 27,
2016
Footnotes
Competing interests: See Acknowledgements
Identification
Copyright
© 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.
