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Association Between Implementation of a Medical Team Training Program and Surgical Mortality Neily J, et al, JAMA 2010;304:1693-1700. VA Study: 3 yrs, 100 facilities, >100,000 proc Focus on CRM with training similar to previous study
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Association Between Implementation of a Medical Team Training Program and Surgical MortalityNeily J, et al, JAMA 2010;304:1693-1700 • VA Study: 3 yrs, 100 facilities, >100,000 proc • Focus on CRM with training similar to previous study • VASQIP (formerly Nat’l Surg Qual Impr Prgm) Data were main outcome measures. Also captured briefing/de-briefing
Improvements Reported by Medical Team Training Facilities From Structured Interviews • Communication among OR staff 35% • Staff awareness 34% • Overall efficiency 49% • Equipment use during surgery 44% • Reduced length of procedures 15% • Improved first-case start times 30% No. of Facilities
Results • At trained facilities: 18% decrease in mortality (P=.01) vs 7% in non-trained facilities (P=.59) • Dose-response relationship for increased training quarters • For every increase in briefing/debriefing, mortality was reduced by 0.6/1000 procedures