Emergency Care and Transportation of the Sick and Injured: Chapter 9 - The Team Approach to Healthcare

Overview

• Understanding the team approach to healthcare.
• Impact on positive patient outcomes.
• Steps an EMT should follow to assist with advanced life support skills.

Key Concepts

EMS Agenda 2050

• Goal: Design EMS systems to be inherently safe.
  • Minimize exposure to injury, infections, illness, and stress.
• Components:
  • Data collection, coordinated support, and resources.
  • EMS education initiatives and safety standards.
  • Reporting and investigating errors and near misses.
  • "Just Culture" - Fairness, accountability, risk management.

Continuum of Care

• Uniform teamwork from first patient contact to discharge.
• Community paramedicine and mobile integrated health care (MIH) emphasized.

Types of Teams

• Regular Teams:
  • EMTs who consistently work and train with the same partners.
  • Smoother transition between steps in procedures.
• Temporary Teams:
  • EMTs working with providers they don't regularly interact with.
  • Need a collaborative environment.
• Special Teams:
  • Fire, rescue, hazmat, tactical, special event EMS, EMS bike teams, etc.

Groups vs. Teams

• Groups:
  • Individuals working independently.
  • Divided by function (triage, transport, treatment).
• Teams:
  • Healthcare providers with assigned roles working interdependently.
  • Essential Elements: Common goal, group identity, shared values, different roles.

Effective Team Performance

• Shared Goal:
  • Commitment from all team members.
• Clear Roles and Responsibilities:
  • Clear understanding of tasks and expectations.
• Diverse and Competent Skill Set:
  • Familiarity with each other's tools and techniques.
• Effective Collaboration and Communication:
  • Clear messages, closed-loop communication, courtesy, constructive intervention.
• Supportive and Coordinated Leadership:
  • Role assignments, oversight, decision making.

Crew Resource Management (CRM)

• Develop shared understanding of emergencies.
• P.A.C.E. Mnemonic: Probe, Alert, Challenge, Emergency.

Transferring Patient Care

• Minimize transfer errors along continuum.
• Ensure uninterrupted critical care, minimal interference, respectful interaction.

Working with Basic and Advanced Life Support

• Responsibilities:
  • Understand scope of practice, standards, and local protocols.

Assisting with Advanced Life Support Skills

• Four-step Process:
  • Patient preparation, equipment setup, procedure performance, continuing care.

Decision Making and Critical Thinking

• Stages: Pre-arrival, arrival, during the call, after the call.
• Decision Traps: Bias, anchoring, overconfidence.

Conflict Resolution

• Techniques:
  • Patient first, maintain composure, separate person from issue, choose battles wisely.

Review Questions

• Characteristics of a regular team: Consistent interaction with the same partner.
• Essential elements of a group: Shared goals.
• Interdependent group members: Shared responsibilities and common goal.
• Closed-loop communication: Repeating messages back.
• Team leader's role: Assignments, coordination, oversight.
• Verbal transfer of care: Ensure respectful interactions.
• Handling partner disagreements: Communicate post-resolution.

These notes summarize the main points from the lecture on the team approach to healthcare, focusing on team dynamics, effective communication, and collaboration within emergency medical services.