Improving Ad Hoc Medical Team Performance with an Innovative "I START-END" Communication Tool.

To study the effect of a communication tool entitled: "I START-END" (I-Identify; S-Story; T-Task; A-Accomplish/Adjust; R-Resources; T-Timely Updates; E-Exit; N-Next; D-Document and Debrief) in simulated urgent scenarios in non-operating room settings (referred to as "Ad Hoc") with anesthesia residents. The "I START-END" tool was created by incorporating Crisis Resource Management (CRM) principles into a practical and user-friendly format. This was a mixed methods pre/post observational study with 47 anesthesia resident volunteers participating from July 2014 to June 2016. Each resident served as their own control, and participated in three simulated Ad Hoc scenarios. The first simulation served as a baseline. The second simulation occurred 1-2 weeks after 80-90% of residents stated the tool provided an organized approach to Ad Hoc scenarios - specifically, information helpful to care of the patient was obtained more readily and better resource planning occurred as communication with the team improved. Residents stated they would continue to use the tool and apply it to other clinical settings. Resident video performance scores of technical skills showed significant improvement at the "late" session (3-6 months post exposure to the Non-operating room settings are fraught with unfamiliarity that create many challenges. The

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© 2022 McGhee et al.

Déclaration de conflit d'intérêts

Mrs Susan DeSousa reports personal fees from Sunnybrook Health Sciences Centre, grants from Alternative Funding Plan (AFP) Innovation Fund: Sunnybrook Health Sciences Centre, during the conduct of the study. The authors report no other conflicts of interest in this work.