Communication failure is a leading source of adverse events in healthcare. Collaborative teamwork may bridge communication gaps in the process of healthcare delivery. In order to address the need for interdisciplinary collaborative teams in the clinical environment, the VA National Center for Patient Safety is offering the Medical Team Training (MTT) program. This program is designed to improve outcomes of patient care and staff job satisfaction by implementing Crew Resource Management (CRM) communication tools from aviation with briefings and debriefings in the clinical workplace.
 Pre-operative briefing by surgical team in OR suite. |  CPR performed by care team. |  Interdisciplinary briefing (rounds) at patient bedside. |
We are involved in the entire process of the MTT program - from preparation and planning to the Learning Session hosted by the participating VA Medical Center (VAMC) to the implementation and follow-up in the VA facility. Our program is unique in that we require a commitment to behavioral change from the participating VAMC and offer long term follow-up, coaching, support, and feedback of data analysis for all of our participants.
As of March 2009, 124 VAMCs are participating in our program, representing various clinical units such as Operating Rooms, Intensive Care Units, Medical-Surgical unit, Ambulatory Clinics, Long Term Care Unit, and ED. Since 2003, our facilities have:
- Improved surgeon-anesthesiologist communication
- Enhanced staff job satisfaction and staff morale
- Streamlined the utility and management of surgical instruments
- Improved staff planning for surgical procedures
- Improved ICU staff understanding of daily patient goals
- Prevented wrong site/side surgical procedures
- Improved DVT prophylaxis and SIP performance measures
The Medical Team Training program is offered to VAMCs to improve patient care by enhancing communication in the delivery of care by healthcare professionals. The highlight of the program is a full day Learning Session that introduces aviation-based CRM communication tools applied in the healthcare setting. Program participation includes two months of preparation and planning and a minimum of 12 months follow-up with quarterly interviews, coaching, data collection, and follow-up questionnaire administration with MTT support and feedback of data analysis.
In order to participate in a MTT Learning Session, a VAMC must make a commitment to the following:
- Host a full day Learning Session facilitated by MTT Faculty
- Close OR to elective procedures on the day of the Learning Session
- Plan and prepare for the Learning Session
- Ensure maximum VAMC staff attendance at the Learning Session
- Organize a interdisciplinary Implementation Team
- Implement MTT project involving briefings and debriefings for a minimum of one year following the Learning Session
- Participate in follow-up quarterly interviews and data collection with NCPS support for a minimum of one year
- Administer the Safety Attitudes Questionnaire in staff meetings to Learning Session attendees nine months following the Learning Session
If you are interested in learning more about our program, check out our Learning Materials and Publications:
Note: All documents are in Portable Document Format (PDF) and require Adobe Acrobat or Adobe Reader. To get Adobe Reader, follow the link at the bottom of the page.
- Learning Materials
Publications referencing or regarding Medical Team Training:
- TIPS November/December 2004 - "Medical Team Training: An Overview"
- TIPS March/April 2006 - "Medical Team Training Program: Coming to a local VAMC near you"
- MTT White Paper
- MTT Executive Summary
- Paull DE, Mazzia LM, Izu BS, Neily J, Mills PD, Bagian JP. Predictors of Successful Implementation of Preoperative Briefings and Postoperative Debriefings Following Medical Team Training. Am J Surg. 2009; 198(5):675-678
For more information, contact Douglas Paull, Physician Educator, or Lisa Mazzia, Physician Educator at (734) 930-5890.