PhD defence A. (Aartje) Boon

Below is a brief summary of the dissertation: 

This dissertation examines how teamwork in healthcare can be strengthened and sustained to improve patient safety. Chapter 2 explores the long-term effects of Crew Resource Management (CRM) training in a children’s hospital, showing that leadership support, open communication, and continuous reinforcement are essential for sustainability. Chapter 3 presents the development and validation of the Professional Assessment Tool for Team Improvement (PATTI©), designed to measure both technical and non-technical skills of pediatric intensive care nurses. Chapter 4 applies the Safety Attitudes Questionnaire (SAQ) to identify strengths and areas for improvement in safety culture, highlighting the importance of translating survey results into concrete actions.

Chapter 5 evaluates simulation-based “proficiency checks” of resuscitation skills, demonstrating improvements in both technical and non-technical skills while also revealing that stress during testing could hinder learning. Chapter 6 reflects on teamwork training during the COVID-19 pandemic across Dutch hospitals, showing how flexibility, resilience, and structured communication supported team functioning, while underscoring the need to prepare healthcare teams for future crises.

The general discussion (Chapter 7) situates the findings within the broader literature and policy context, emphasizing the role of leadership in embedding teamwork in healthcare systems. CRM principles, structured reflection (briefings and debriefings), and tools like PATTI© and the SAQ are highlighted as valuable mechanisms for monitoring and improving teamwork. Overall, the dissertation argues that resilient, sustainable teamwork and a proactive learning culture are crucial foundations for delivering safe, high-quality healthcare.