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

Introduction

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

EMS Agenda 2050

• Key Goal: EMS systems designed to be inherently safe.
• Minimize exposure to injury, infections, illness, and stress.
• Culture of Safety:
  • Data collection, coordinated support and resources.
  • EMS education initiatives, safety standards, error reporting and investigation.
• Just Culture:
  • Balances fairness and accountability
  • Encourages reporting errors and near misses.
  • Focuses on risk management.

Team Healthcare

• Previous models worked separately, passing patients from one group to another.
• Continuum of Care:
  • Uniform team from first contact to discharge improves outcomes.
  • Example: Community paramedicine and mobile integrated healthcare (MIH).

Types of Teams

• Regular Teams:
  • EMTs who frequently work together.
  • Smoother transitions from step to step.
• Temporary Teams:
  • EMTs working with unfamiliar providers.
  • Requires collaboration over competition.
• Special Teams:
  • Fire, rescue, hazmat, tactical, special event EMS, bike teams.

Groups vs. Teams

• NIMS Definition of Group:
  • Organizes incident by function.
  • Performs functions across geographic boundaries.
• Team:
  • Assigned roles, interdependent, coordinated.
• Five Essential Elements of a Group:
  • Common goal, group image, sense of connection, shared values, different roles.

Effective Team Performance

• Shared Goal: Commitment to a common goal.
• Clear Roles and Responsibilities: Understanding what is expected.
• Diverse and Competent Skill Set: Familiarity with team tools and techniques.
• Collaboration and Communication:
  • Clear message, closed-loop communication, courtesy, and constructive intervention.
• Supportive Leadership:
  • Role assignments, coordination, decision-making.
  • Crew Resource Management (CRM): Uses PACE mnemonic (Probe, Alert, Challenge, Emergency).

Patient Care Transfers

• Transferring care introduces potential errors.
• Effective teams minimize transfers.
• Ensure uninterrupted care, minimal interference, respectful interaction, common priorities and language.

Basic and Advanced Life Support

• Coordination between basic life support (BLS) and advanced life support (ALS).
• Assisting with ALS Skills:
  • Patient preparation, equipment setup, procedure performance, continuing care.

Decision-Making in EMS

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

Troubleshooting Team Conflicts

• Techniques: Patient comes first, do not engage, keep cool, separate person from issue, choose battles.

Review Questions and Key Points

• Characteristics of regular teams: 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.
• Importance of team leader: Essential for success.
• Respect during verbal transfer of care.

Conclusion

• Importance of team approach in improving healthcare delivery.
• Emphasis on collaboration, communication, and leadership in team settings.