6) 團隊合作

1. 6) 團隊合作 員工 的Mindset --組織效能的發揮 組織效能 員工 的治理 員工 的勝任 會不會做願不願意做有沒有機會做

2. 組員發揮CRM的精神挽救了多數旅客的生命 The aircraft crashed while attempting an emergency landing with no hydraulics after an uncontained engine failure severed all hydraulic fluid lines. Date: 19 July 1989Airline: United Air LinesFlight No.: 232Aircraft: DC-10-10Location: Sioux City, IAFatalities: 112:296

3. 領導風格 高 對人的關心 低 高 對生產力的關心 低

4. The MedTeams approach is based on avoiding errors, trapping them as they occur, and mitigating the consequences of actual errors. Principles underlying the MedTeams approach include: • Team responsibility for patients. • A belief in clinician fallibility. • Peer monitoring. • Team member awareness of patient status, team member status and institutional resources.

5. 7) 疏失管理 • 疏失的定義：不慎的動作或該做而未做，進而偏離作業的要求及規範 • 疏失的種類： “蓄意的疏失” 、“決策的疏失” 、“溝通的疏失” 、“熟練度的疏失” 、“程序的疏失” • Rule base、Knowledge base、skill base • 深思熟慮的掌握威脅；當機立斷的疏失處置 • 確實檢討“疏失的肇因”：教訓必須記取，歷史不能遺忘

6. “意外雖出於一時的疏忽， 但疏忽卻源自習慣！” －證嚴法師「靜思語」

7. Accidents Don’t Happen by Accident ! “To err is human” “Human factors are just an excuse for incompetence.”

8. “When you make a mistake, there are only three things you should ever do about it, -- admit it, learn from it, and don’t repeat it.”

10. Medical Crew Resource Management醫療團隊資源管理

11. The following fundamental skills have been transferred to staff members and deployed in hospitals and care facilities throughout the world: • Standardized Communication • Team Briefings • Team Debriefings • Situational Awareness • Decision Making • Leadership Strategies • Effective Teamwork • Critical Language Vocabulary and Usage

12. CRM training encompasses a wide range of knowledge, skills and behavioral attitudes including communications, situational awareness, problem solving, decision making, and teamwork. CRM can be defined as a management system which makes optimum use of all available resources: people, process and technology. The blending of three areas within one standardized system promotes safety and enhances the efficiency of operations. • CRM is concerned not so much with the technical knowledge and skills required to operate equipment but rather with the cognitive and interpersonal skills needed to effective manage a team-based, high-risk activity. In this context, cognitive skills are defined as the mental processes used for gaining and maintaining situational awareness, for solving problems and making decisions. Interpersonal skills are regarded as communications and a range of behavioral activities associated with teamwork.

13. CRM fosters a climate or culture where the freedom to respectfully question authority is encouraged. It recognizes that a discrepancy between what is happening and what should be happening is often the first indicator that an error is occurring. This is a delicate subject for many organizations, especially ones with traditional hierarchies, so appropriate communication techniques must be taught to supervisors and their subordinates, so that supervisors understand that the questioning of authority need not be threatening, and subordinates understand the correct way to question orders. • CRM skills, while seeming like common sense, are difficult skills to master, as they require a change in interpersonal dynamics and organizational culture. Through a blended and systematized approach, including education, practical skill development and inter-disciplinary simulation, research has shown that CRM skills can be successfully embedded within a high risk department or organization.

15. Human Factors in Healthcare • In the healthcare industry, system and process flaws are the source of many errors. However, a human dimension is cited as a contributing factor in 60 to 80 percent of all medical errors. Fatigue, a lack of situational awareness, suboptimal teamwork and poor communication are among the leading factors and human elements known to be associated with accidental injury to patients. • Today, many healthcare providers are recognizing the value of using human factors training and skill development – including situational awareness – to improve operational excellence, increase team efficiencies and, most importantly, create a culture of patient safety. 

16. Medical Safety Management/醫療安全管理 • 病人安全/Patient Safety • 病情的掌握 • 醫療行為 • 避免感染 • 醫療環境安全/Medical Environment Safety • 內外在感染源的控制 • 作業環境威脅的掌握 • 人為因素之應用/Application of Human Factor • 情境認知 • 自我認知 • 團隊合作 • 威脅與疏失管理 • 優質醫療文化的塑造/Cultivating Positive Medical Culture • 快樂的員工、滿意的顧客

17. 政策、程序與控制 程序文件化 法規政策化 政策程序化 一切的政策、程序、行動均須以法規為依據 文件標準化 標準行動化 行動精確化 結果預期化

18. 摸索管理 經驗管理 人文需求 & 人文自覺 要我安全 我要安全 法規管理 人文內涵式管理

19. 變革的思維 從現狀中發掘問題 從歷史的脈絡中尋覓方向 從理論中尋找解答 結語

20. 思維的改變 觀念改變現狀 認知決定一切 態度決定高度 氣度決定寬度

21. 用心至極，完美勝出

22. 簡報完畢敬請指教