Daniel Fein

392: NUMBERED JERSEYS IMPROVE TEAMWORK DURING SIMULATED EMERGENCIES

Critical Care Medicine • Volume 46 • Number 1 (Supplement) www.ccmjournal.org Learning Objectives: Teamwork and leadership skills in Cardiac Arrest/Rapid Response (CA/RR) scenarios have been shown to correlate with clinical outcomes such as mortality. During these high stress and high acuity events, leaders must be able to rapidly assign roles and tasks, as well as give effective commands to each team member to optimize teamwork. We hypothesize that the use of individual numbered jerseys for each code team member improves overall teamwork performance during simulated CA/ RR scenarios. Methods: Internal Medicine Residents PGY-1 (n = 48) were randomized into two groups. In the experimental group, the team leader received a yellow jersey with the number 1 printed on it and each team member received white numbered jerseys (2 through 8). The control team leader and members wore their regular work clothes. Each group participated in 8 simulated CA/RR cases using high-fidelity simulation, and participants alternated between team leader and team member roles for each case. The 16-item validated Mayo High Performance Teamwork Scale (MHPTS) was independently completed by an experienced faculty member observer. Results: A total of 64 simulated cases and 64 Mayo scales were completed. In the experimental jersey group, the overall teamwork score was significantly higher as compared to the control group (24.8 vs 18.2, p < 0.01). In addition, team leaders in the experimental group were better recognized by the other team members (2.0 vs 1.8, p < 0.01) and were better at finding balance between command authority and team member participation (1.7 vs 1.2, p < 0.01). Furthermore, team members in the experimental group had a clearer understanding of their assigned team role (1.6 vs 1.1, p < 0.01) and had improved team communication and recognition of errors (1.4 vs 0.8, p < 0.01). Conclusions: The use of numbered jerseys to identify each member of the CA/RR team is an effective method of improving overall teamwork as well as many specific critical team components during CA/RR scenarios. Further research is needed to evaluate the feasibility of using these jerseys during real in-hospital events 392