Positive communication behaviour during handover and team-based clinical performance in critical situations: a simulation randomised controlled trial

Barthélémy Bertrand; Jean-Noël Evain; Juliette Piot; Rémi Wolf; Pierre-Marie Bertrand; Vincent Louys; Hugo Terrisse; Jean-Luc Bosson; Pierre Albaladejo; Julien Picard

doi:10.1016/j.bja.2020.12.011

Positive communication behaviour during handover and team-based clinical performance in critical situations: a simulation randomised controlled trial

Br J Anaesth. 2021 Apr;126(4):854-861. doi: 10.1016/j.bja.2020.12.011. Epub 2021 Jan 7.

Authors

Affiliations

¹ Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France; Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France; TIMC-IMAG Laboratory, UMR, CNRS 5525, Grenoble Alpes University, Grenoble, France.
² Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France; Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France; TIMC-IMAG Laboratory, UMR, CNRS 5525, Grenoble Alpes University, Grenoble, France. Electronic address: jnevain@chu-grenoble.fr.
³ Department of Anaesthesia and Intensive Care, Grenoble Alpes University Hospital, Grenoble, France; Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France.
⁴ Department of Intensive Care, Cannes Hospital, Cannes, France.
⁵ Alps Research Assessment and Simulation Centre, Grenoble Alpes University Hospital, Grenoble, France.
⁶ TIMC-IMAG Laboratory, UMR, CNRS 5525, Grenoble Alpes University, Grenoble, France; Department of Biostatistics, Grenoble Alpes University Hospital, Grenoble, France.

Abstract

Background: Positive communication behaviour within anaesthesia teams may decrease stress response and improve clinical performance. We aimed to evaluate the effect of positive communication during medical handover on the subsequent team-based clinical performance in a simulated critical situation. We also assessed the effect of positive communication behaviour on stress response.

Methods: This single-centre RCT involved anaesthesia teams composed of a resident and a nurse in a high-fidelity scenario of anaesthesia-related paediatric laryngospasm after a standardised handover. During the handover, similar information was provided to all teams, but positive communication behaviour was adopted only for teams in the intervention group. Primary outcome was team-based clinical performance, assessed by an independent blinded observer, using video recordings and a 0-to 100-point scenario-specific scoring tool. Three categories of tasks were considered: safety checks before the incision, diagnosis/treatment of laryngospasm, and crisis resource management/non-technical skills. Individual stress response was monitored by perceived level of stress and HR variability.

Results: The clinical performance of 64 anaesthesia professionals (grouped into 32 teams) was analysed. The mean (standard deviation) team-based performance score in the intervention group was 44 (10) points vs 35 (12) in the control group (difference: +8.4; CI_95% [0.4-16.4]; P=0.04). The effects were homogeneous over the three categories of tasks. Perceived level of stress and HR variability were not significantly different between groups.

Conclusions: Positive communication behaviour between healthcare professionals during medical handover improved team-based performance in a simulation-based critical situation.

Clinical trial registration: NCT03375073.

Keywords: clinical performance; communication behaviour; high-fidelity simulation; positive communication; stress response; teamwork.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Clinical Competence / standards*
Communication*
Critical Care / methods
Critical Care / standards*
Female
Health Personnel / standards*
Humans
Male
Patient Care Team / standards*
Patient Handoff / standards*
Prospective Studies
Simulation Training / methods
Simulation Training / standards*

Associated data

ClinicalTrials.gov/NCT03375073