Teamwork as a Tool for Patient Safety

Facilitator's Guide and Outline

Rationale

Teamwork failures can have serious impact on patient safety.

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Grabber

  • RMF-sponsored study of impact of team factors on patient safety in the operating room
  • Alternate example from ambulatory setting

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Key Message #1

Health care is better when delivered by individuals committed to a team approach

  • What makes a good team?
  • Creating a culture for teamwork

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Key Message #2

A successful team practices good team communication. Team communication is challenged by:

  • Professional complexity
  • Personal complexity
  • Patient complexity

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Key Message #3

Communication breakdowns among team members are at the root of many errors and adverse events. Three types of team communication breakdowns are at the root of most errors that impact patient safety

  • Different interactive styles
  • Role conflict or confusion
  • Chain of command unclear

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Key Message #4

Leaders have a wide impact on team effectiveness. It is the leader's role to:

  • Ensure the completion of team activity
  • Serve as model for teamwork
  • Structure and regulate team processes
  • Provide motivation and supportive climate for team cohesion
  • Lead planning of future contingencies

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Key Message #5

Health care can learn much about successful team communication from other industries.

  1. Learning about team communication from the air transportation industry
    • Two-thirds of air crashes involve human error, especially failures in teamwork communication
    • Professional training focuses on technical not interpersonal skills
    • To address these communication failures, a crew resource management training system was put in place
  2. Crew Resource Management
    • Using all available sources-information, equipment, and people-to achieve safe patient care
  3. Two important techniques developed in this model were deemed very important and transferable to health care teams:
    • Briefings
    • Assertiveness

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Key Message #6

Briefings are essential to effective patient care team communication

  • Overview
  • What to Brief
  • How to Brief

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Key Message #7

Assertiveness is essential to effective patient care team communication

  • An overview
  • What it is
  • What it's not
  • How to be assertive

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Summary

  • Teams are complex groupings of people from different professions, skill, knowledge levels, backgrounds
  • Teams communicate better with training and practice