Abstract
BACKGROUND: Ward resuscitation requires both technical and teamwork skills, however conventional drills rarely address teamwork. We evaluated whether a brief Team Resource Management (TRM) curriculum combined with in-situ simulations could improve the quality of resuscitation and safety culture. METHODS: This retrospective study analyzed data from a hospital-wide quality-improvement project at a 250-bed regional hospital. Ward teams (physicians, nursing specialists, and nurses) completed three training cycles at baseline, 6 months, and 12 months. Each cycle included 30-min online modules plus two in-situ simulations with TRM-focused debriefs. The primary outcome was resuscitation protocol adherence (RPA) using a 28-item checklist based on the 2020 ILCOR recommendations. The secondary outcomes were Safety Attitudes Questionnaire (SAQ) and Teamwork Perception Questionnaire (TPQ) scores. RESULTS: Fifty-three of 94 eligible staff (56%) provided complete responses. The mean RPA rate increased from 76.5 ± 16.5% at baseline to 92.6 ± 9.7% after cycle three (p = 0.030), primarily driven by improvements in the "Transmission of Rescue Information" domain (62.5% vs. 90.6%, p = 0.028). No significant changes occurred in composite SAQ/TPQ scores. CONCLUSIONS: Three low-fidelity TRM in-situ simulations significantly increased the rate of RPA, particularly team communication, without immediate changes in the overall safety culture. Short, recurring TRM drills rapidly enhanced process reliability; sustained coaching may be needed for broader cultural transformation.