Proposed Topic (Most preferred): :
Staff Engagement and Empowerment (motivating staff / teamwork / work revamp tackling manpower issue / staff wellness / OSH / retention)
Authors (including presenting author) :
So EHK(1)(2), Cheung VKL(1), So SS(1), Hung JLK(1), Yau TML(3), Chia NH(1)(4), Ng GWY(1)(5)
Affiliation :
(1) Multi-Disciplinary Simulation and Skills Centre (MDSSC), Queen Elizabeth Hospital, (2) Department of Anaesthesiology and Operating Theatre Services, Queen Elizabeth Hospital, (3) Central Nursing Division, Kowloon Central Cluster, (4) Department of Surgery, Queen Elizabeth Hospital, (5) Intensive Care Unit, Queen Elizabeth Hospital.
Introduction :
As a scientifically backed approach for high-risk industries, Crew Resource Management (CRM) has been incorporated into regular HA training programme to strengthen teamwork of frontline healthcare professionals and patient safety for more than a decade. Our CRM programme keeps up with trends of clinical service transformation, in terms of mode of education (from classroom teaching to scenario-based simulation) and precision (from generic to specialty-based training). Following the capacity enhancement strategy of HAHO, our team embarked on investigating how applicable our CRM programme is for non-locally trained healthcare professionals from the Greater Bay Area (GBA), at which relevant academic literature or hospital sharing record was completely lacking.
Objectives :
Except enhancement in “clinical teamwork and cultural adaptation among inter-disciplinary professionals from diverse training backgrounds”, this project aims to fill the knowledge gap by i) tailoring a GBA-specific CRM programme with practical tips to share with HAHO CRM Committee members and devoted CRM programme directors; and ii) examining training effectiveness of the modified curriculum of CRM on overall satisfaction, knowledge acquisition of local healthcare service and concept of CRM elements, and change of attitude towards CRM-related behaviours.
Methodology :
This is an evaluation of “深化醫療團隊協作”, a 4-hour sharing group session covered i) introduction of HA organisation structure and training centre development, and ii) key CRM concepts in “ACLS”, namely Assertiveness, Communication, Leadership and Followership (Interpersonal Skills) and Situational Awareness (Cognitive Skills) with interactive activities and clinical scenarios for memory consolidation. With intellectual support from Central Nursing Division (CND), QEH Multi-Disciplinary Simulation and Skills Centre (MDSSC) initiated modification for GBA-specific curriculum using “TUFER” approach:
1) Translated all materials from English to Chinese with attention to cultural differences
2) Utilised full spelling of terminologies in English and Chinese supplementary with Abbreviations in English
3) Fine-tuned medical scenario relevant and coherent with areas of their clinical practice
4) Enhanced peer interactivity by cutting down proportion of theoretical content but adding games/ reflective questions
5) Received KCC hospital management buy-in in advance
Following rounds of internal review and beta test, the first pilot GBA-specific session was conducted in the QEH MDSSC by a team of experienced CRM instructors in early September 2023. To quantify overall satisfaction, acquisition of knowledge (in service overview and CRM), and attitudinal change in CRM-related behaviour (Assertiveness, Communication, Leadership and followership, and Situational awareness), a set of pre-test and post-test with up to 38 items in format of 5-point Likert scales (1 = Strongly Disagree; 5 = Strongly Agree) was distributed to all participants before and after the programme. Post-activity comments regarding perceived benefits of CRM in cultural adaptation process would be consolidated for continuous sustainable service enhancement.
Result & Outcome :
[Results] Of 14 participants in the programme, 4 and 10 were non-locally trained doctors and nurses from KCC, respectively. In programme evaluation, participants appraised all components as interesting and useful in clinical practice (e.g., Concept of CRM: M = 4.93, SD = 0.27). Regarding knowledge acquisition, participants showed remarkable knowledge gain in healthcare service (Mpre = 3.79, Mpost = 4.90; Difference(Post-pre) = +29.6%) and elements of local CRM training (Mpre= 4.19, Mpost = 5; Difference(Post-pre) = +19.5%) after the programme. Participants reported increase in post-activity attitudinal change in overall CRM-related behaviours by 10%, where “Situational awareness” stood out by 14%, and showed high agreement (93%) on effectiveness in applying CRM to mitigate challenges related to communication, inter-disciplinary team co-operation, and cultural diversity in healthcare acculturation process.
[Conclusion] CRM programme specialised for non-locally trained healthcare professionals from GBA was organized expeditiously to show its potential in strengthening service integration. Precious feedback from participants provided valuable reference for our future training and research development to build resilient expert teams for seamless collaboration in HA.
