Patient SafetyTEAM-AMBNCT05244928
Team Training and Medication Administration in an Ambulance Service
A study testing The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®" in people with Patient Safety and Medication Administration, run by Sykehuset Innlandet HF at 1 site in Norway.
Trial summary
Medication administration events have the potential to cause patient harm. Frequency of medication administration events in the ambulance services is less known. Effective teamwork has been described as paramount for providing safe and effective patient care in the high-risk ambulance environment. Read more about this study
- Who is it for?
- Any age
- Conditions the study is for
- Patient Safety, Medication Administration
- What is being tested?
- The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®"
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 131 participants
- Where
- 1 siteNorway
- Study dates
- 24 Jan 2022to 31 Jan 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages Any age
- All sexes
- No healthy volunteers
- Child, Adult, Older adult
Who may be able to join
- Ambulance professionals employed in the ambulance services
- EPJs for patients who are transported or treated within the assigned areas
- Patient which receives medication (Oxygen, or clear fluid intravenously, by inhalation, intramuscularly, intraosseous, per os, sublingually, or intranasally)
- Ambulance professionals employed in the ambulance services
- Ambulance professionals and apprentices participating in the "Team Strategies and Tools to Enhance Performance and Patient Safety®" intervention
Who cannot join
- Under 18 years of age
- Missing and/or incomplete data.
- Under 18 years of age
- Student and apprentices
- Ambulance professionals on long-term leave
- Under 18 years of age
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Team Training and Medication Administration in an Ambulance Service. A Study of a Team Training Interventions' Impact on Medication Administration, Teamwork, and Patient Safety Culture.
Medication administration events have the potential to cause patient harm. Frequency of medication administration events in the ambulance services is less known. Effective teamwork has been described as paramount for providing safe and effective patient care in the high-risk ambulance environment. "Team Strategies and Tools to Enhance Performance and Patient Safety®" is an evidence-based team training program released from the Agency for Healthcare Research and Quality.
The aims of the study are: (1) to advance the knowledge of medication administration process in the ambulance services, and (2) to study the impact of a team training program on medication administration events, teamwork, and patient safety culture.
Read more
To address the overall aims, the following research objectives will guide the study:
Pre-study: To analyse and validate the psychometric properties of the Norwegian version of the Teamwork Perception Questionnaire for use in an ambulance service.
Studies:
- To determine the frequency of medication administration events in an ambulance service.
- To describe the medication administration process in an ambulance service according to the "Systems Engineering Initiative for Patient Safety model".
- To identify the impact of a team training program on the frequency of medication administration events in an ambulance service.
- To explore ambulance professionals' experiences of teamwork before and after the implementation of a team training program and their experiences with the program.
- To compare ambulance professionals' perceptions of teamwork and patient safety culture before and after implementation of a team training program.
Post-study: To study the association between medication administration events and team training and patient safety culture in an ambulance service.
A quasi-experimental, pre- and post-design, provides the framework for the intervention of the team training program in two clusters including seven ambulance stations, in total.
- Conditions
- Patient Safety, Medication Administration
- Being tested
- The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®"
- Keywords
- Patient safety, Team training, Medication administration, Ambulance services, Human factors
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®"Other
"Team Strategies and Tools to Enhance Performance and Patient Safety®" is a team training program consisting of an evidence-based set of tools designed to develop teamwork skills with the goal of improving quality in healthcare services and providing safer patient care. In this study, selected tools from the "Team Strategies and Tools to Enhance Performance and Patient Safety®" curriculum have been chosen for implementation over a 4-month period together with a general emphasis on the key principles: communication, leadership, situation monitoring and mutual support. A full day introduction will be held to mark the start of the intervention and each successive month will have a focus on a single key principle with associated tools.
A quasi-experimental, pre- post design, provides the framework for the intervention of the team training program in two clusters including seven ambulance stations, in total.
| Study group | Role | What they receive |
|---|---|---|
| Cluster 1. | Experimental | The clusters will be formed from two ambulance stations (Approximately 50 participants). Receives: Other: The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®" |
| Cluster 2. | Experimental | The clusters will be formed from five ambulance stations (Approximately 70 participants). Receives: Other: The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®" |
What is being measured
The primary outcome is the main question the study is designed to answer.
Testing the psychometric properties of the Teamwork Perception Questionnaire
The questionnaire will be digitally distributed to approximately 500 ambulance personnel in a hospital trust. Each items are scored on a five-point scale. The survey will be carried out for 14 days in February, and 14 days in August 2022.
Measured: 4 weeks
The perception of patient safety culture and teamwork.
To measure the ambulance personnel's perception of patient safety culture and teamwork, the Prehospital Survey on Patient Safety Culture (five point-scale) and the Teamwork Perception Questionnaire (five point-scale), will be carried out at three times in each cluster (one time before and two times after the intervention)
In cluster 1, the survey will be carried out for 14 days in January/February 2022, 14 days in June 2022 and 14 days in January 2023.
In cluster 2, the survey will be carried out for 14 days in August 2022, 14 days in January 2023 and 14 days in August 2023.
Measured: 3 month
The frequency of medication administration in ambulance service
The frequency of medication administration will be assed by a retrospective review of approximately 500 electronic patient journals before the intervention. An interim analysis will be conducted after the this review to determine the final number of necessary review of electronic patient journals after the intervention. The journals will be collected for a 6-month period prior to the intervention and a 12-month period after the end of the intervention in both clusters.
Measured: 18 month
Description of the medication administration process.
Qualitative data from partly participants observations, approximately 10 individual interviews of ambulance professionals and supplemented by local guidelines.
Measured: 3 month
The experiences of teamwork and the team training program before and after the intervention.
Qualitative data from from four focus group interviews before and after the intervention in each cluster.
Measured: 4 days
Secondary outcomes (1)
Association between medication administration, team training and patient safety culture
The study include data from the primary outcome measures 2 and 3.
Measured: 21 month
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted17 Feb 2022
- Study start24 Jan 2022
- Primary completion31 Jan 2024
- Study completion31 Jan 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (3)Papers the sponsor has linked to this study.
- Other trials for Patient SafetyStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Factorial
- Model description
- A quasi-experimental, pre- post design, imply the framework for how the "Team Strategies and Tools to Enhance Performance and Patient Safety®" intervention will be introduced in the two clusters. To ease the logistics need for training and the implementation, two clusters will be formed from seven ambulance stations within the same organization. The order in which the two clusters will undergo the intervention will be randomized. The intervention will be introduced for one cluster in February 2022, and for the other cluster in September 2022.
- Masking
- None (open label)
- Enrolment
- 131 participants (actual)
Sponsor and investigators
- Lead sponsor
- Sykehuset Innlandet HF
- Sponsor type
- University, hospital or other
- Collaborators
- Norwegian University of Science and Technology
- Responsible party
- Sponsor
- Investigators
- Ingeborg Hartz, PhD, Study director, Sykehuset Innlandet HF
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05244928
- Sponsor's protocol ID
- 16797830
- Acronym
- TEAM-AMB
- Status last verified
- Mar 2024
- First submitted
- 19 Jan 2022
- Last updated
- 6 Oct 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Myhr K, Ballangrud R, Porthun J, Sollid SJM, Vifladt A. Medication administration errors in a Norwegian ambulance service: a quasi-experimental study on the impact of a team training program. Scand J Trauma Resusc Emerg Med. 2026 Jan 24;34(1):41. doi: 10.1186/s13049-026-01560-1.
PubMed 41580728Myhr K, Ballangrud R, Aase K, Vifladt A. Ambulance professionals' experiences of teamwork in the context of a team training programme - a qualitative study. BMC Emerg Med. 2024 Jul 2;24(1):108. doi: 10.1186/s12873-024-01018-6.
PubMed 38956498Vifladt A, Ballangrud R, Myhr K, Grusd E, Porthun J, Maehlum PA, Aase K, Sollid SJM, Odberg KR. Team training program's impact on medication administration, teamwork and patient safety culture in an ambulance service (TEAM-AMB): a longitudinal multimethod study protocol. BMJ Open. 2023 Jan 20;13(1):e067006. doi: 10.1136/bmjopen-2022-067006.
PubMed 36669839
Study at a glance
From the registry record, last updated by the sponsor on 6 Oct 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Team Training and Medication Administration in an Ambulance Service. A Study of a Team Training Interventions' Impact on Medication Administration, Teamwork, and Patient Safety Culture.
- ClinicalTrials.gov ID
- NCT05244928
- Acronym / sponsor ID
- TEAM-AMB / 16797830
- Conditions
- Patient Safety, Medication Administration
- Keywords
- Patient safety, Team training, Medication administration, Ambulance services, Human factors
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 131 participants (actual)
- Lead sponsor
- Sykehuset Innlandet HFUniversity, hospital or other
- Collaborators
- Norwegian University of Science and Technology
- Study start
- 24 Jan 2022 (actual)
- Primary completion
- 31 Jan 2024 (actual)
- Study completion
- 31 Jan 2024 (actual)
- First posted
- 17 Feb 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Medication administration events have the potential to cause patient harm. Frequency of medication administration events in the ambulance services is less known. Effective teamwork has been described as paramount for providing safe and effective patient care in the high-risk ambulance environment. "Team Strategies and Tools to Enhance Performance and Patient Safety®" is an evidence-based team training program released from the Agency for Healthcare Research and Quality.
The aims of the study are: (1) to advance the knowledge of medication administration process in the ambulance services, and (2) to study the impact of a team training program on medication administration events, teamwork, and patient safety culture.
To address the overall aims, the following research objectives will guide the study:
Pre-study: To analyse and validate the psychometric properties of the Norwegian version of the Teamwork Perception Questionnaire for use in an ambulance service.
Studies:
- To determine the frequency of medication administration events in an ambulance service.
- To describe the medication administration process in an ambulance service according to the "Systems Engineering Initiative for Patient Safety model".
- To identify the impact of a team training program on the frequency of medication administration events in an ambulance service.
- To explore ambulance professionals' experiences of teamwork before and after the implementation of a team training program and their experiences with the program.
- To compare ambulance professionals' perceptions of teamwork and patient safety culture before and after implementation of a team training program.
Post-study: To study the association between medication administration events and team training and patient safety culture in an ambulance service.
A quasi-experimental, pre- and post-design, provides the framework for the intervention of the team training program in two clusters including seven ambulance stations, in total.
Study design
- Primary purpose
- Health services research
- Allocation
- Randomised
- Intervention model
- Factorial
- Masking
- None (open label)
- Number of arms
- 2
- Model description
- A quasi-experimental, pre- post design, imply the framework for how the "Team Strategies and Tools to Enhance Performance and Patient Safety®" intervention will be introduced in the two clusters. To ease the logistics need for training and the implementation, two clusters will be formed from seven ambulance stations within the same organization. The order in which the two clusters will undergo the intervention will be randomized. The intervention will be introduced for one cluster in February 2022, and for the other cluster in September 2022.
| Arm | Type | Receives |
|---|---|---|
| Cluster 1. | Experimental | Other: The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®"The clusters will be formed from two ambulance stations (Approximately 50 participants). |
| Cluster 2. | Experimental | Other: The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®"The clusters will be formed from five ambulance stations (Approximately 70 participants). |
Who may qualify
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult, Older adult
Key inclusion criteria (5 listed)
- Ambulance professionals employed in the ambulance services
- EPJs for patients who are transported or treated within the assigned areas
- Patient which receives medication (Oxygen, or clear fluid intravenously, by inhalation, intramuscularly, intraosseous, per os, sublingually, or intranasally)
- Ambulance professionals employed in the ambulance services
- Ambulance professionals and apprentices participating in the "Team Strategies and Tools to Enhance Performance and Patient Safety®" intervention
Key exclusion criteria (6 listed)
- Under 18 years of age
- Missing and/or incomplete data.
- Under 18 years of age
- Student and apprentices
- Ambulance professionals on long-term leave
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®""Team Strategies and Tools to Enhance Performance and Patient Safety®" is a team training program consisting of an evidence-based set of tools designed to develop teamwork skills with the goal of improving quality in healthcare services and providing safer patient care. In this study, selected tools from the "Team Strategies and Tools to Enhance Performance and Patient Safety®" curriculum have been chosen for implementation over a 4-month period together with a general emphasis on the key principles: communication, leadership, situation monitoring and mutual support. A full day introduction will be held to mark the start of the intervention and each successive month will have a focus on a single key principle with associated tools. A quasi-experimental, pre- post design, provides the framework for the intervention of the team training program in two clusters including seven ambulance stations, in total. | Other | Cluster 1., Cluster 2. |
Primary outcome
Testing the psychometric properties of the Teamwork Perception Questionnaire
Time frame: 4 weeks
The questionnaire will be digitally distributed to approximately 500 ambulance personnel in a hospital trust. Each items are scored on a five-point scale. The survey will be carried out for 14 days in February, and 14 days in August 2022.
The perception of patient safety culture and teamwork.
Time frame: 3 month
To measure the ambulance personnel's perception of patient safety culture and teamwork, the Prehospital Survey on Patient Safety Culture (five point-scale) and the Teamwork Perception Questionnaire (five point-scale), will be carried out at three times in each cluster (one time before and two times after the intervention) In cluster 1, the survey will be carried out for 14 days in January/February 2022, 14 days in June 2022 and 14 days in January 2023. In cluster 2, the survey will be carried out for 14 days in August 2022, 14 days in January 2023 and 14 days in August 2023.
The frequency of medication administration in ambulance service
Time frame: 18 month
The frequency of medication administration will be assed by a retrospective review of approximately 500 electronic patient journals before the intervention. An interim analysis will be conducted after the this review to determine the final number of necessary review of electronic patient journals after the intervention. The journals will be collected for a 6-month period prior to the intervention and a 12-month period after the end of the intervention in both clusters.
Description of the medication administration process.
Time frame: 3 month
Qualitative data from partly participants observations, approximately 10 individual interviews of ambulance professionals and supplemented by local guidelines.
The experiences of teamwork and the team training program before and after the intervention.
Time frame: 4 days
Qualitative data from from four focus group interviews before and after the intervention in each cluster.
1 secondary outcome
Association between medication administration, team training and patient safety culture
Time frame: 21 month
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Oct 2025.
- Derived from this study: PubMed 41580728Myhr K, Ballangrud R, Porthun J, Sollid SJM, Vifladt A. Medication administration errors in a Norwegian ambulance service: a quasi-experimental study on the impact of a team training program. Scand J Trauma Resusc Emerg Med. 2026 Jan 24;34(1):41. doi: 10.1186/s13049-026-01560-1.
- Derived from this study: PubMed 38956498Myhr K, Ballangrud R, Aase K, Vifladt A. Ambulance professionals' experiences of teamwork in the context of a team training programme - a qualitative study. BMC Emerg Med. 2024 Jul 2;24(1):108. doi: 10.1186/s12873-024-01018-6.
- Derived from this study: PubMed 36669839Vifladt A, Ballangrud R, Myhr K, Grusd E, Porthun J, Maehlum PA, Aase K, Sollid SJM, Odberg KR. Team training program's impact on medication administration, teamwork and patient safety culture in an ambulance service (TEAM-AMB): a longitudinal multimethod study protocol. BMJ Open. 2023 Jan 20;13(1):e067006. doi: 10.1136/bmjopen-2022-067006.
- Individual participant dataSharing planned: No
Related trials for Patient Safety
RecruitingObservational study
A Study in Children and, Adults With Congenital Thrombotic Thrombocytopenic Purpura (cTTP) Treated With Adzynma
Thrombotic Thrombocytopenic Purpura (TTP)
RecruitingPhase 1/2
The Safety and Efficacy of Daratumumab in Patients With Refractory Aplastic Anemia
Aplastic Anemia, Refractory
Active, not recruitingPhase 2
Safety and Efficacy of Empagliflozin in Hemodialysis
End Stage Renal Disease
RecruitingPhase 3
Study to Assess the Efficacy, Pharmacokinetics, Safety and Tolerability of Atrasentan in Pediatric Patients With Primary IgAN
Berger Disease, Bergers Disease
Active, not recruitingPhase 4
A Study Evaluating the Effectiveness and Safety of Risdiplam Administered as an Early Intervention in Pediatric Participants With Spinal Muscular Atrophy After Gene Therapy
Muscular Atrophy, Spinal
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Ingeborg Hartz, PhD study director
Sykehuset Innlandet HF
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing The team training program "Team Strategies and Tools to Enhance Performance and Patient Safety®" in people with Patient Safety and Medication Administration, run by Sykehuset Innlandet HF at 1 site in Norway.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 6 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Norway. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Testing the psychometric properties of the Teamwork Perception Questionnaire (time frame: 4 weeks). The study lists 5 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05244928, which also lists 3 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Oct 2025.