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Team training: implications for emergency and critical care pediatrics

Eppich, Walter Ja; Brannen, Melissab; Hunt, Elizabeth Ac

Current Opinion in Pediatrics: June 2008 - Volume 20 - Issue 3 - p 255–260
doi: 10.1097/MOP.0b013e3282ffb3f3
Emergency and critical care medicine: Edited by Jean Klig

Purpose of review The field of team training is quickly evolving and data are emerging to support the close relationship between effective teamwork and patient safety in medicine. This paper provides a review of the literature on team training with specific emphasis on the perspectives of emergency and critical care pediatricians.

Recent findings Errors in medicine are most frequently due to an interaction of human factors like poor teamwork and poor communication rather than individual mistakes. Critical care settings and those in which patients are at the extremes of age are particularly high-risk, making emergency and critical care pediatrics a special area of concern. Team training is one approach for reducing error and enhancing patient safety. Currently, there is no single standard for team training in medicine, but multiple disciplines, including anesthesiology, emergency medicine and neonatology, have adapted key principles from other high-reliability industries such as aviation into crisis resource management training.

Summary Team training holds promise to improve patient safety in pediatric emergency departments and critical care settings. We must carefully delineate the optimal instructional strategies to improve team behaviors and combine these with rigorous outcomes assessment to diagnose team problems and prescribe targeted solutions, and determine their long-term impact on patient safety.

aDivision of Emergency Medicine, USA

bDivision of Critical Care, Department of Pediatrics, Children's Memorial Hospital, Chicago, Illinois, USA

cJohns Hopkins School of Medicine, Division of Pediatric Critical Care, Department of Anesthesiology, Baltimore, Maryland, USA

Correspondence to Walter J. Eppich, MD, Division of Emergency Medicine, Department of Pediatrics, Children's Memorial Hospital, Chicago, IL, USA Tel: +1-773-975-8617; e-mail:

© 2008 Lippincott Williams & Wilkins, Inc.