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Multidisciplinary Teamwork Education

Draft 2 October 29 1400. Multidisciplinary Teamwork Education. Improving Patient Safety Through Simulation. Scenario #3 Conflict Resolution and Mutual Support. Reinforce Briefs for planning Role clarity Mutual Support and Conflict Management Task-related support

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Multidisciplinary Teamwork Education

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  1. Draft 2 October 29 1400 Multidisciplinary Teamwork Education Improving Patient Safety Through Simulation

  2. Scenario #3 Conflict Resolution and Mutual Support • Reinforce Briefs for planning • Role clarity • Mutual Support and Conflict Management • Task-related support • Effectively advocate for the patient • Two Challenge Rule • CUS • Advocacy/Assertion • Awareness of impact of conflict on the team • Provide timely and constructive feedback • Creating Psychological Safety

  3. Advocacy and Assertion • Demonstrate advocacy and assertion when encountering viewpoints that don’t coincide with own. • CUS words • Discuss use of the “two-challenge rule” when initial assertion is ignored. • Review constructive strategies for reaching conflict resolution • Advocacy/Assertion approach: • Opening (eg. CUS) • State concern • Offer solution • Obtain agreement • “I need clarity” • “I can only take direction from one consultant. Dr. “In Charge”, what would you like the team priorities to be?” SBAR communication to surgery consultant when he arrives late

  4. Scenario #2 Communication and Situational Awareness • Reinforce Role Clarity • Role of briefing • Communication • Call outs and Checkbacks • TV voice • SBAR for report • Situational Awareness • Characteristics of highly functional teams • Creating shared mental model • Avoiding Task Fixation Errors • Checklists • Cross monitoring

  5. Role Clarity – Have a Plan x Trauma Cons. X Airway Provider X RTX EM Res X Recorder X Team Leader X Assisting Provider X Assessing Provider X Left Arm Nurse X Right Arm Nurse

  6. Scenario #1 Leadership and Role Clarity Skills/Strategies for leader and the team: • Role Clarity and team structure agreement (constant for every trauma team) • Brief: critical to organize the team • 4 key team skills for leader to focus and create shared mental model • Articulate Goals (Know the plan; Share the plan) • Organize the team (delegation is key) • Seek Input (Empower team to speak up) • Resolve questions/conflict • Mutual support of team for leader • Closed loop communication

  7. Scenario #1 Patient arrives with little warning, so team must organize on arrival. • S – 33 yo male; high speed MVA; GCS 13 • VS: BP 80/40; HR 125; RR 26; Sats 96% on 15L • B – Scene call, Unrestrained driver, hit on driver side by car • No known past medical history • A – Responds to painful stimuli only; deformity to L ankle; tender abdomen (fluid on US RUQ) • R – IV 500 cc bolus, O2 at high flow, splint L ankle, spinal precautions

  8. Trauma Experience • Identified 6 key behaviors to reinforce • Briefs for pre-arrival planning • Role clarity • PPE with names on front • Plan based on EMS info • Equipment set-up; where to find equipment that might be needed • 4 key leadership behaviors • Check –backs (closed-loop communication) • “TV” voice (audible communication) • Crowd / Noise control • Primary surveyor accountability for “Positives”

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