Emergency Care and Transportation of Sick and Injured: Chapter 9
The Team Approach to Healthcare
Key Goals of the Chapter
- Understand the significance and characteristics of a team approach to healthcare.
- Impact of team approach on positive patient outcomes.
- Steps an EMT should follow to assist with advanced life support skills.
Emergency Health Care Team
- Includes first responders, paramedics, physicians, nurses, and other personnel.
- Goal: Improve patient outcomes through teamwork.
EMS Agenda 2050
- Design EMS systems to be inherently safe.
- Minimize exposure to injury, infection, illness, and stress.
- Elements include:
- Data collection culture
- Coordinated support and resources
- EMS education initiatives
- EMS safety standards
- Reporting and investigating errors and near misses
- Just culture: Balances fairness and accountability
Continuum of Care
- Previous models were sequential and isolated.
- New models emphasize teamwork from initial contact to discharge.
- Community paramedicine and mobile integrated healthcare (MIH) as examples.
Types of Teams
-
Regular Teams:
- Consist of EMTs who frequently interact and train together.
- Smooth transitions between procedure steps.
-
Temporary Teams:
- EMTs work with new or unfamiliar partners.
- Environment promotes collaboration over competition.
- Understanding roles and responsibilities is crucial.
-
Special Teams:
- Include fire, rescue, hazmat, tactical, EMS bike teams, etc.
Groups vs. Teams
- Groups:
- Defined by NIMS as functional level organizations.
- Perform special functions, often across geographic boundaries.
- Teams:
- Healthcare providers with specific roles, working interdependently.
- Essential elements:
- Common goal
- Image of themselves as a group
- Sense of community
- Shared values
- Differentiated roles
Effective Team Performance
- Essential Elements:
- Shared goal: Commitment from all team members.
- Clear roles and responsibilities.
- Diverse and competent skill set.
- Effective collaboration and communication:
- Clear message
- Close-loop communication
- Courtesy
- Constructive intervention
- Supportive and coordinated leadership.
Transferring of Patient Care
- Minimize transfers to reduce critical errors.
- Ensure:
- Uninterrupted critical care
- Minimal interference
- Respectable interaction
- Common priorities and language systems
Coordination with ALS Providers
- Maintain basic life support throughout the continuum of care.
- Coordinate efforts with ALS tools and techniques.
Assisting with Advanced Life Support Skills
- Four-Step Process:
- Patient preparation
- Equipment setup
- Performing the procedure
- Continuing care
Decision-Making Process
- Stages:
- Pre-arrival: Rehearse care steps, designate leaders.
- Arrival: Scene size-up, assess life threats.
- During the call: Gather, interpret data, plan, and evaluate.
- After the call: Debrief and feedback.
Decision Traps
- Common Traps:
- Bias: Fixed beliefs
- Anchoring: Focusing on one cause early
- Overconfidence: Overestimating abilities
Troubleshooting Team Conflicts
- Techniques include:
- Prioritize patient
- Do not engage
- Keep calm
- Separate person from issue
- Choose battles wisely
Review Questions Recap
- Characteristics of regular teams: Consistent interaction with partners.
- Essential group elements: Shared goals.
- Interdependent groups: Shared responsibilities and goals.
- Closed-loop communication: Repeat messages for clarity.
- Team leader: Essential for team success.
- Respect during verbal transfer of care.
- Conflict resolution: Proceed and discuss afterward.
These notes summarize the key points from Chapter 9 on the team approach to healthcare, with a focus on improving patient outcomes through effective teamwork in emergency medical services (EMS).