Observational Study
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World J Gastroenterol. Dec 14, 2014; 20(46): 17507-17515
Published online Dec 14, 2014. doi: 10.3748/wjg.v20.i46.17507
Endoscopic non-technical skills team training: The next step in quality assurance of endoscopy training
Manmeet Matharoo, Adam Haycock, Nick Sevdalis, Siwan Thomas-Gibson
Manmeet Matharoo, Adam Haycock, Siwan Thomas-Gibson, the Wolfson Unit for Endoscopy, St. Mark’s Hospital, Harrow HA1 3UJ, United Kingdom
Manmeet Matharoo, Adam Haycock, Nick Sevdalis, Siwan Thomas-Gibson, Department of Surgery and Cancer, Imperial College, St. Mary’s campus, Norfolk Place, London W2 1NY, United Kingdom
Author contributions: Matharoo M, Haycock A, Sevdalis N and Thomas-Gibson S contributed to study conception and design; Matharoo M contributed to data acquisition, data analysis and interpretation, and writing of article; Matharoo M, Haycock A, Sevdalis N and Thomas-Gibson S contributed to editing, reviewing and final approval of article.
Supported by NHS Bowel Cancer Screening Programme; and Drs. Matharoo and Sevdalis are affiliated with the Imperial Centre for Patient Safety and Service Quality (www.cpssq.org), affiliated with the Imperial Patient Safety Translational Research Centre, which is funded by the National Institute for Health Research
Correspondence to: Manmeet Matharoo, MRCP, MBBS, the Wolfson Unit for Endoscopy, St. Mark’s Hospital, Watford Rd, Harrow, Middlesex HA1 3UJ, United Kingdom. m.matharoo@imperial.ac.uk
Telephone: +44-20-82354225 Fax: +44-20-84233588
Received: December 20, 2013
Revised: January 24, 2014
Accepted: May 28, 2014
Published online: December 14, 2014

AIM: To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes.

METHODS: A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day’s training utilising real clinical examples. Pre and post-course evaluation comprised participants’ patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected.

RESULTS: Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training.

CONCLUSION: A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams’ knowledge and safety attitudes.

Keywords: Patient safety, Bowel cancer screening, Teamwork, Endoscopy Training, Adverse events

Core tip: Medical error is common and patient safety is increasingly a priority. Teamwork and communication are often implicated and hence training to improve these aspects is gaining recognition. A novel patient safety focussed training intervention was successfully targeted to multidisciplinary endoscopy teams. By delivering a single days training to experienced endoscopy teams, there was significant improvement in patient safety knowledge and some aspects of patient safety attitudes. Global course evaluation was positive with recommendations that such training should be extended more widely in endoscopy. Patient safety focused endoscopy team training should be developed to cover diagnostic, therapeutic, screening and emergency endoscopy.