Teamwork and Safety Climate of Perinatal Caregivers

Purpose:
To describe variations in perinatal caregiver perceptions of teamwork and safety climate prior to a 6-month Crew Resource Management (CRM) training program at a large urban academic medical center and to compare responses between nurses and physicians.

Background/Significance:
As a result of the Institute of Medicine's landmark findings on patient safety problems in U.S. hospitals, many organizations have implemented strategies to improve teamwork to ultimately improve patient safety. Patient safety climate which encompasses staffing, team respect, comfort with reporting errors, and other important factors such as fostering appropriate feedback and open receptive communication, is one important factor in improving the care that women receive in perinatal units.

Methods:
A descriptive survey design was used. Sample: Registered nurses (n=70) and physicians (n=88) that work a minimum of 50% of full time hours in the perinatal units at a large urban academic medical center in the north-east were invited to participate. Prior to the initiation of the CRM training program, the Teamwork and Safety Climate Survey (Sexton, et al., 2006) was administered to eligible perinatal care providers. This 27-item tool allows participants to respond to statements using a 5- point Likert scale. A higher score reflects more positive assessment of teamwork and safety climate. Demographic information was also assessed.

Results:
Results indicate that physicians perceived teamwork climate to be significantly more positive (63.1, SD=21.4) than nurses (52.38, SD = 15.02) (t = -2.01, p = .05) however there were no significant differences in perceptions of safety climate.

Conclusions and Implications for Practice:
Findings support the need for training to enhance perinatal caregivers' attitudes towards team work and safety. We plan to resurvey upon completion of training and implementation of Crew Resource Management behaviors to see if these strategies enhanced teamwork and safety climate.