Pediatric emergency medicine trisk 0106 0106
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performance through coordination and receipt of feedback from other
members. Hierarchy is flattened; the common goal is more important than
any individual’s contribution or performance.
Facilitating Teamwork
There are three mechanisms that facilitate teamwork: shared mental models,
closed-loop communication, and mutual trust. Salas notes that teams which
employ the five competencies of teamwork, while making sure to utilize the
three coordinating mechanisms, should outperform those teams that do not.
TABLE 4.1
ACHIEVING A SHARED MENTAL MODEL a
Individual
Group
Environment
Know the patient care
plan
Active listening
Closed-loop
communication
Read back
Verify
Mutual performance
monitoring
Self-monitoring
Brief (before)
Debrief (after)
Huddle (during)
Documentation
Hand-overs
Call out
Visual management
tools
Checklists
Distraction control
Technology aids
Communication boards
a Team
members, patient and family are on the same page.
Shared Mental Models
Structures must be put into place to support team work. SBAR (S ituation,
B ackground, A ssessment, R ecommendation) and I-PASS (Illness severity,
P atient summary, A ction list, S ituational awareness and contingency plan,
S ynthesis by receiver) are examples of structured communication tools to
standardize hand-offs and reduce error. Clinical standards can guide care for
chief complaints, specific diseases, procedures, or care processes.
Communication boards can assure the patient/family understands the
current care plan. Table 4.1 lists some other strategies for team guidance.
