Manser, Tanja
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Manser, Tanja
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- PublikationDeveloping the TeamOBS-vacuum-assisted delivery checklist to assess clinical performance in a vacuum-assisted delivery: a Delphi study with initial validation(Frontiers Research Foundation, 2024) Brogaard, Lise; Hinshaw, Kim; Kierkegaard, Ole; Manser, Tanja; Uldbjerg, Niels; Hvidman, Lone [in: Frontiers in Medicine]In Northern Europe, vacuum-assisted delivery (VAD) accounts for 6–15% of all deliveries; VAD is considered safe when conducted by adequately trained personnel. However, failed vacuum extraction can be harmful to both the mother and child. Therefore, the clinical performance in VAD must be assessed to guide learning, determine a performance benchmark, and evaluate the quality to achieve an overall high performance. We were unable to identify a pre-existing tool for evaluating the clinical performance in real-life vacuum-assisted births. We aimed to develop and validate a checklist for assessing the clinical performance in VAD. We conducted a Delphi process, described as an interactive process where experts answer questions until answers converge toward a “joint opinion” (consensus). We invited international experts as Delphi panelists and reached a consensus after four Delphi rounds, described as follows: (1) the panelists were asked to add, remove, or suggest corrections to the preliminary list of items essential for evaluating clinical performance in VAD; (2) the panelists applied weights of clinical importance on a Likert scale of 1–5 for each item; (3) each panelist revised their original scores after reviewing a summary of the other panelists’ scores and arguments; and (4) the TeamOBS-VAD was tested using videos of real-life VADs, and the Delphi panel made final adjustments and approved the checklist. Twelve Delphi panelists from the UK (n = 3), Norway (n = 2), Sweden (n = 3), Denmark (n = 3), and Iceland (n = 1) were included. After four Delphi rounds, the Delphi panel reached a consensus on the checklist items and scores. The TeamOBS-VAD checklist was tested using 60 videos of real-life vacuum extractions. The inter-rater agreement had an intraclass correlation coefficient (ICC) of 0.73; 95% confidence interval (95% CI) of [0.58, 0.83], and that for the average of two raters was ICC 0.84 95% CI [0.73, 0.91]. The TeamOBS-VAD score was not associated with difficulties in delivery, such as the number of contractions during vacuum extraction delivery, cephalic level, rotation, and position. Failed vacuum extraction occurred in 6% of the video deliveries, but none were associated with the teams with low clinical performance scores. The TeamOBS-VAD checklist provides a valid and reliable evaluation of the clinical performance of vaginal-assisted vacuum extraction.01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationTeam performance during vacuum-assisted vaginal delivery: video review of obstetric multidisciplinary teams(Frontiers Research Foundation, 2024) Brogaard, Lise; Rosvig, Lena Have; Hjorth-Hansen, Kristiane Roed; Hvidman, Lone; Hinshaw, Kim; Kierkegaard, Ole; Uldbjerg, Niels; Manser, Tanja [in: Frontiers in Medicine]Introduction Vacuum extraction is generally considered an operator-dependent task, with most attention directed toward the obstetrician’s technical abilities. Little is known about the effect of the team and non-technical skills on clinical outcomes in vacuum-assisted delivery. This study aimed to investigate whether the non-technical skills of obstetricians were correlated with their level of clinical performance via the analysis of video recordings of teams conducting actual vacuum extractions. Methods We installed between two or three video cameras in each delivery room at Aarhus University Hospital and Horsens Regional Hospital and obtained 60 videos of teams managing vacuum extraction. Appropriate consent was obtained. Two raters carefully reviewed the videos and assessed the teams’ non-technical skills using the Assessment of Obstetric Team Performance (AOTP) checklist, rating all items on a Likert scale score from 1 to 5 (1 = poor; 3 = average; and 5 = excellent). This resulted in a total score ranging from 18 to 90. Two different raters independently assessed the teams’ clinical performance (adherence to clinical guidelines) using the TeamOBS-Vacuum-Assisted Delivery (VAD) checklist, rating each item (0 = not done, 1 = done incorrectly; and 2 = done correctly). This resulted in a total score with the following ranges (low clinical performance: 0–59; average: 60–84; and high: 85–100). Interrater agreement was analyzed using intraclass correlation (ICC), and the risk of high or low clinical performance was analyzed on a logit scale to meet the assumption of normality. Results Teams that received excellent non-technical scores had an 81% probability of achieving high clinical performance, whereas this probability was only 12% among teams with average non-technical scores (p < 0.001). Teams with a high clinical performance often had excellent behavior in the non-technical items of “team interaction,” “anticipation,” “avoidance fixation,” and “focused communication.” Teams with a low or average clinical performance often neglected to consider analgesia, had delayed abandonment of the attempted vaginal delivery and insufficient use of appropriate fetal monitoring. Interrater reliability was high for both rater-teams, with an ICC for the non-technical skills of 0.83 (95% confidence interval [CI]: 0.71–0.88) and 0.84 for the clinical performance (95% CI: 0.74–0.90). Conclusion Although assisted vaginal delivery by vacuum extraction is generally considered to be an operator-dependent task, our findings suggest that teamwork and effective team interaction play crucial roles in achieving high clinical performance. Teamwork helped the consultant anticipate the next step, avoid fixation, ensure adequate analgesia, and maintain thorough fetal monitoring during delivery.01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationExploring objective measures for assessing team performance in healthcare: an interview study(Frontiers Research Foundation, 10/2023) Wespi, Rafael; Birrenbach, Tanja; Schauber, Stefan K.; Manser, Tanja; Sauter, Thomas C.; Kämmer, Juliane E. [in: Frontiers in Psychology]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationBehavioural observation tool for patient involvement and collaboration in emergency care teams (PIC‑ET‑tool)(BioMed Central, 01.07.2023) Dubois, Hanna; Creutzfeldt, Johan; Manser, Tanja [in: BMC Emergency Medicine]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationStOP? II trial: cluster randomized clinical trial to test the implementation of a toolbox for structured communication in the operating room—study protocol(BioMed Central, 18.10.2022) Keller, Sandra; Tschan, Franziska; Semmer, Norbert K; Trelle, Sven; Manser, Tanja; Beldi, Guido [in: Trials]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationUsing the Global Trigger Tool in surgical and neurosurgical patients: A feasibility study(Public Library of Science, 16.08.2022) Brösterhaus, Mareen; Hammer, Antje; Gruber, Rosalie; Kalina, Steffen; Grau, Stefan; Roeth, Anjali A.; Ashmawy, Hany; Gross, Thomas; Binnebösel, Marcel; Knoefel, Wolfram Trudo; Manser, Tanja [in: PLOS ONE]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationTeamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams(Frontiers, 21.02.2022) Brogaard, Lise; Hvidman, Lone; Esberg, Gitte; Finer, Neil; Hjorth-Hansen, Kristiane R.; Manser, Tanja; Kierkegaard, Ole; Uldbjerg, Niels; Henriksen, Tine B. [in: Frontiers in Pediatrics]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationSimulation‐based training improves process times in acute stroke care (STREAM)(Wiley, 21.10.2021) Bohmann, Ferdinand O.; Gruber, Katharina; Kurka, Natalia; Willems, Laurent M.; Herrmann, Eva; du Mesnil de Rochemont, Richard; Scholz, Peter; Rai, Heike; Zickler, Philipp; Ertl, Michael; Berlis, Ansgar; Poli, Sven; Mengel, Annerose; Ringleb, Peter; Nagel, Simon; Pfaff, Johannes; Wollenweber, Frank A.; Kellert, Lars; Herzberg, Moriz; Koehler, Luzie; Haeusler, Karl Georg; Alegiani, Anna; Schubert, Charlotte; Brekenfeld, Caspar; Doppler, Christopher E. J.; Onur, Özgür A.; Kabbasch, Christoph; Manser, Tanja; Steinmetz, Helmuth; Pfeilschifter, Waltraud [in: European Journal of Neurology]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationStructure and concept of ICU rounds: the VIS-ITS survey(Springer, 14.06.2021) Hillmann, Bastian; Schwarzkopf, Daniel; Manser, Tanja; Waydhas, Christian; Riessen, Reimer [in: Medizinische Klinik - Intensivmedizin und Notfallmedizin]01A - Beitrag in wissenschaftlicher Zeitschrift
- PublikationCoordination and communication in healthcare action teams(Hogrefe, 10/2020) Burtscher, Michael J.; Nussbeck, Fridtjof W.; Sevdalis, Nick; Gisin, Stefan; Manser, Tanja [in: Swiss Journal of Psychology]Communication and coordination represent central processes in healthcare action teams. However, we have a limited understanding of how expertise affects these processes and to what extent these effects are shaped by interprofessional differences. The current study addresses these questions by jointly investigating the influence of different aspects of expertise – individual expertise, team familiarity, and expertise asymmetry – on coordination quality and communication openness. We tested our propositions in two hospitals: one in Switzerland (CH, Sample 1) and one in the United Kingdom (UK, Sample 2). Both samples included two-person anesthesia action teams consisting of a physician and a nurse ( NCH = 47 teams, NUK = 48 teams). We used a correlational design with two measurement points (i.e., pre- and postoperation). To consider potential interprofessional differences, we analyzed our data with actor-partner interdependence models. Moreover, we explored differences in the effects of expertise between both hospitals. Our findings suggest that nurses’ expertise is the most important predictor of coordination quality and communication openness. Overall, differences between the two hospitals were more prevalent than interprofessional differences between physicians and nurses. The current study provides a nuanced picture of the effects of expertise, and thereby extends our understanding of interprofessional teamwork.01A - Beitrag in wissenschaftlicher Zeitschrift