Integration of TeamSTEPPS Framework and Escape Room to Improve Teamwork and Collaboration.

BACKGROUND: As the need for healthcare professionals continues to grow, different learning environments have been assessed to optimize knowledge while keeping the student engaged. Escape rooms, live action, team-based exercises, supplemented with TeamSTEPPS tools can assist in overall team performance, while keeping the participant engaged in a new learning environment. OBJECTIVE: The goal of this quality improvement project was to enhance teamwork and collaboration through the integration of TeamSTEPPS concepts and escape room active learning. This concept was explored through the integration of TeamSTEPPS tools and strategies in an escape room setting. The purpose was to improve team dynamics and cohesiveness in a new dynamic way with a small cohort of nurse leaders in a large urban academic medical center, while exploring the engagement and depth of learning experience for the participant. METHODS: Twelve nurse leaders completed two different escape rooms while observers completed the TeamSTEPPS observation tool assessing team dynamics and performance and participants assessed their perceptions before and after intervention. These nurses also were observed at staff meetings and completed a perceptions tool on teamwork pre- and postintervention. A postescape room survey was completed by participants to assess learning and interest in this interactive learning exercise. RESULTS: There was a significant statistical difference after TeamSTEPPS and escape room intervention (Mean 17.3 and p = 0.004 SD 5.9) when compared to before intervention as well as has a more positive sense of teamwork was noted. In addition, 75% of the nurses strongly agreed that the escape room was engaging and fun with 25% agreeing. Ninety-one percent agreed or strongly agreed that the escape room was an effective team-building exercise with 100% agreeing or strongly agreeing to recommend the escape room experience to others. CONCLUSIONS: This cohort validated the integration of TeamSTEPPS tools and strategies in an escape room setting as an enjoyable and engaging way to learn while providing an effective team-building activity. This small cohort demonstrates that new methods of learning such as an escape room should be explored further for engaging participants and improving communication and teamwork skills. IMPLICATIONS FOR NURSING: Integrating TeamSTEPPS into an escape room offers this institution a way to continue this project while providing valuable team-building skills to its participants. While this was just a small sample in one intercity hospital, new methods for learning should be reviewed for successful teamwork in nursing and in healthcare as a whole, as there was some data to suggest that utilizing an escape room could have a positive impact on team cohesiveness as well as leadership skills for the individual.

Polymorphous low-grade adenocarcinoma: a 17 patient case series.

Polymorphous low-grade adenocarcinoma (PLGA) is a rare malignancy most commonly seen in the minor salivary glands. First described in 1983, this entity has been recognized to have an indolent course with rare metastases or deaths. We describe our experience with 17 patients treated at our institution for PLGA from 1984 to 2012. All tumors were located in the oral cavity or soft palate. All patients were treated surgically, with the exception of one patient who declined therapy. No deaths or metastases have been identified in subsequent follow-up. Three patients in this series had undergone prior surgery up to 20 years previously and were treated for recurrences at our institution; no other recurrences have been noted. In summary, PLGA is best treated with wide excision to negative margins with excellent prognosis, but long-term follow-up is recommended given the propensity for late recurrences.