Wednesday, July 1, 2015

The Use of Leadership Training for Pediatric Fellows to Improve Code Team Performance

Melissa Brannen, MD, MEd
Northwestern University

The resuscitation of a child in extremis or cardiac arrest requires the coordinated effort of an effective code team. The team leader orchestrates this team. His or her performance and style can have deleterious effects on the team’s performance. Despite this pivotal role, code team leaders often do not receive additional training in how to be an effective leader. The purpose of this study was to determine if specific leadership behaviors could be taught to the code team leaders and improve the code team’s performance as measured by team member perceptions and adherence to established guidelines. An educational intervention using simulation was designed using literature from current team training in medicine and other fields. To determine if there was a noticeable effect on team leader behavior and code team performance in situ, mock codes were conducted using actual code teams. These mock codes were reviewed for team leader behaviors in the areas of communication, monitoring, and feedback, as well as adherence to established guidelines. Finally, all team members completed a survey at the end of the study to assess perceptions of the team leader and the team’s performance. Team leaders adopted specific communication, monitoring and feedback behaviors following the educational intervention that were noticed by team members. However, there was no improvement in the team’s performance as related to adherence to established guidelines or in the team member’s perceptions of the performance. In conclusion, educational interventions designed at improving team leader behavior’s can work; however, it is not enough to improve team adherence to established guidelines.