The ART (Airway Response Team) of Interprofessional Communication and Collaboration

Abstract

Background:

Emergency response teams such as an airway response team (ART) have been shown to improve patient outcomes and decrease unexpected mortality. These teams are comprised of interprofessional clinicians with the aim to address escalating airway needs efficiently to avoid untoward events such as cardiopulmonary arrest. ARTs require strong interprofessional communication and collaboration and an understanding of team role and responsibilities to ensure a safe procedure. We aimed to address opportunities for effective team dynamics and improve communication and collaboration by developing an ART simulation for team members within our 766-bed adult level 1 trauma center.

Methods:

The ART simulation was first conducted in March 2024. The annual 10-item ART interprofessional questionnaire was sent to all ART members adding 4 questions specific to simulation participants (SP) to assess opinions of collaboration and communication post-simulation. The SP questionnaire results were cross compared with the non-simulation participant (N-SP) questionnaire results.

Results:

A total of 69 ART members responded (36 N-SP, 33 SP, P = .46). The question seeking suggestions for further improvement exhibited a statistically significant (P < .05) difference with a 69% increase in respondent engagement (13.9% N-SP, 45.5% SP, P = .03). The question assessing respondents’ perception of ART training showed 97.2% N-SP and 94% SP positive responses (P = .92). The SP specific questions showed a mean increase of 64.7% in at confidence/agreement.

Conclusions:

Initially, comparing N-SP respondents to SP respondents, it appears that the simulation may have had a negative impact on the respondents’ confidence level. However, deeper assessment actually shows a significantly higher engagement in open-ended responses for suggestions on further process improvements. There was also significant increase in confidence following the simulation. One consideration for these findings is that many of the RT and resident SPs were newer to ART. These findings could suggest that SP had increased understanding of roles, responsibilities, expectations and workflow. This increased understanding could have led to enhanced recognition of further opportunities to improve the quality of the ART response. Interprofessional simulation could lead to improved understanding of team dynamics and serve as a beneficial educational supplement. Further study is needed to assess this.

Fig 1: ART Interprofessional Questionnaire Result Comparison of Simulation vs. No-Simulation Participation Respondents

 	Non-Simulation Respondents	Simulation Participation Respondents	P Value
Interprofessional Response (n, %)	36RTs: 14 (38.9%)Rapid RN: 5 (13.9%)Transplant ICU RN: 1 (2.8%)Pharmacist: 11 (30.6%)Anesthesia Resident CA-2: 0 Anesthesia Resident CA-3: 2 (5.6%)Anesthesia Faculty: 3 (8.2%)	33RTs: 9 (27.3%)Rapid RN: 9 (27.3%)Transplant ICU RN: 1 (3%)Pharmacist: 2 (6.1%)Anesthesia Resident CA-2: 3 (9.1%)Anesthesia Resident CA-3: 8 (24.2%)Anesthesia Faculty: 1 (3%)	P=.46
Key Questionnaire Items:	 	 	 
I feel I have received adequate training on my role in the Airway Response Team. (n, %)	Well trained: 28 (77.8%)Somewhat trained: 7 (19.4%)Neutral: 0 Not well trained: 1 (2.8%)No training: 0	Well trained: 28 (84.9%)Somewhat trained: 3 (9.1%)Neutral: 2 (6%)Not well trained: 0No training: 0	Somewhat or Well Trained97.2% vs 94%P=.92
In general, are you comfortable with Airway Response Team members asking questions about the plan of care? (n, %)	Yes: 33 (94.3%)No: 2 (5.71%)	Yes: 32 (96.7%)No: 1 (3.03%)	P=.87
In general, my role on the Airway Response Team is valued by my fellow team members. (n, %)	Strongly agree: 19 (52.8%)Agree: 12 (33.3%)Neutral: 3 (8.3%)Disagree: 2 (5.6%)Strongly Disagree: 0	Strongly agree: 19 (57.6%)Agree: 10 (30.3%)Neutral: 3 (9.1%)Disagree: 0 Strongly disagree: 1 (3%)	Agree or Strongly Agree86.1% vs 87.9%P=.95
We are hoping to continue to improve collaboration between all members of the Airway Response Team. Do you have any suggestions on ways you feel we can improve this collaboration? (n = unique respondent suggestions, %)	5 (13.9%)	15 (45.5%)	P=0.03
I feel more confident in my own role since the simulation-based learning experience. (n, %)	N/A	Strongly agree: 11 (34.4%)Agree: 8 (25%)Neither agree/disagree: 11 (34.4%)Disagree: 0Strongly disagree: 2 (6.2%)	Agree or Strongly Agree57.6%
My knowledge of the roles of other members of the Airway Response Team increased after training. (n, %)	N/A	Significant increase: 8 (25%)Some increase: 15 (46.9%)Little increase: 3 (9.4%)No increase: 6 (18.7%)	Some Increase or Significant Increase69.7%
Following participation in the ART simulation, my confidence to bring up a suggestion or concern with the patient plan of care has increased. (n, %)	N/A	Strongly agree: 10 (31.3%)Agree: 12 (37.5%)Neither agree/disagree: 8 (25%)Disagree: 0Strongly disagree: 2 (6.2%)	Agree or Strongly Agree66.7%