Part 3: High Performance Teams

Question 1

What distinguishes high performance teams from others is ____

Answer 1

each team member is committed to ensuring the highest quality performance of the team rather than simply following orders.

Question 2

To function effectively, a high performance team needs to focus on:

Answer 2

• Timing: (immediate CPR and defibrillation, limiting pauses to achieve a chest compression fraction (CCF) of ideally greater than 80% preshock pause, EMS response time)
• Quality (best possible performance of each team member, eg, rate, depth, recoil)
• Coordination (team dynamics: team members working together seamlessly toward a common goal, proficient in their roles)
• Administration (leadership, planning ahead, obtaining additional resources, tailoring the interventions, CQI, measurement, assigned number or members working an arrest)

Question 3

High Performance Team

Timing:

Answer 3

• Time to first compression
• Time to first shock
• CCR ideally greater than 80%
• Minimizing preshock pause
• Early EMS response time

Question 4

High Performance Team

Quality:

Answer 4

• Rate, depth, and recoil
• Minimizing interruptions
• Switching compressors
• Avoiding excessive ventilation
• Use of a feedback device

Question 5

High Performance Team

Coordination:

Answer 5

• Team dynamics: team members working together seamlessly toward a common goal, proficient in their roles

Question 6

High Performance Team

Administration:

Answer 6

• Leadership
• Measurement
• Continuous quality improvement
• Number of code team members

Question 7

A team can achieve key metrics and increase CCF by doing the following:

Answer 7

• Precharge the defibrillator
• Perform a pulse check during the precharge phase in anticipation of an organized rhythm during analysis
• Compressor hovers over the chest
• Have the next compressor ready to take over immediately
• Intubate without pausing compressions
• Deliver medications during compressions
• Consider CPR protocols that deliver fewer pauses

Question 8

Successful high performance teams not only have medical expertise and mastery of resuscitation skills but also ____

Answer 8

demonstrate effective communication and team dynamics.

Question 9

All team members should understand their roles as part of the team. This awareness will help you anticipate:

Answer 9

• What actions will be performed next

* How to communicate and work as a member or as a leader of a high performance team.

Question 10

Every high performance team needs a leader to:

Answer 10

• Organize the group
• Monitor individual performance of team members
• Back up team members
• Models excellent team behavior
• Trains and coaches
• Facilitates understanding
• Focuses on comprehensive patient care
• Temporarily designates another member to take over as team leader if an advanced procedure is required

Question 11

The team leader is responsible for ____

Answer 11

making sure everything is done at the right time in the right way by monitoring and integrating individual performance of team members.

Question 12

The team leader should be able to explain why it is essential to :

Answer 12

• push hard and fast in the center of the chest
• ensure complete chest recoil
• Minimize interruptions in chest compressions
• Avoid excessive ventilation

Question 13

Whereas members of a high performance team should focus on their individual tasks, the team leader must focus on ____

Answer 13

comprehensive patient care.

Question 14

For a successful resuscitation attempt, high performance team members must be:

Answer 14

• Proficient in performing the skills in their scope of practice
• Clear about role assignments
• Prepared to fulfill their role responsibilities
• Well practiced in resuscitation skills
• Knowledgeable about the algorithms
• Committed to success

Question 15

The role of CPR coach supports performance of high quality BLS skills by ____

Answer 15

allowing the team leader to focus on other aspects of clinical care.

Question 16

The CPR coach can most effectively blended into the current responsibilities of ____

Answer 16

the monitor/defibrillator role.

Question 17

Responsibilities of the CPR coach:

Answer 17

• Coordinate the start of CPR
• Coach to improve the quality of chest compressions
• State midrange targets
• Coach to midrange targets
• Help minimize the length of pauses in compressions

Question 18

CPR coach should provide feedback about:

Answer 18

• The compressor’s rate, depth, and recoil
• Delivery of ventilations (rate and volume)
• Compression pauses

Question 19

Working closely with the team leader, the CPR coach should facilitate ____

Answer 19

all compression pauses, including intubation.

Question 20

High Performance Team

Resuscitation Triangle Roles:

Answer 20

• Compressor
• Monitor/Defibrillator - CPR coach
• Airway

Question 21

High Performance Team

Leadership Roles:

Answer 21

• Team Leader
• IV/IO Medications
• Timer/ Recorder

Question 22

The resuscitation triangle team owns the code. No team member leaves the triangle except to ____.

Answer 22

rotate compressors or to protect his or her safety

Question 23

Compressor Role:

Answer 23

• Assesses the patient
• Performs compressions according to local protocols
• Rotates every 2 minutes or earlier if fatigued

Question 24

Monitor/defibrillator - CPR coach Role:

Answer 24

• Brings and operates the AED/monitor/defibrillator and acts as the CPR coach if designated
• If a monitor is present, places it in position where is can be seen by the team leader (and most of the team).

Question 25

Airway Role:

Answer 25

• Opens the airway
• Provides bag-mask ventilation
• Inserts airway adjuncts as appropriate

Question 26

Team Leader Role:

Answer 26

• Every resuscitation team must have a defined leader
• Assigns roles to team members
• Makes treatment decisions
• Provides feedback to the rest of the team as needed
• Assumes responsibility for roles not defined

Question 27

IV/IO - Medications Role:

Answer 27

• An ALS provider role
• Initiates IV/IO access
• Administer medications

Question 28

Timer/ Recorder Role:

Answer 28

• Records the time of interventions and medications (and announces when these are next due)
• Records the frequency and duration of interruptions in compressions
• Communicates these to the Team Leader (and the rest of the team)

Question 29

When roles are unclear, team performance suffers. Signs of unclear roles include:

Answer 29

• Performing the same task more than once
• Missing essential tasks
• Assigning team members multiple roles when additional providers are available.

Question 30

During the stress of an attempted resuscitation, do not ____

Answer 30

practice or explore a new skill, especially without seeking advice from more experienced personnel.

Question 31

During a resuscitation attempt, ____ on a high performance team may need to intervene tactfully if a team member is about to ____.

Answer 31

• anyone

* take an inappropriate action

Question 32

Team leaders should avoid confrontation with team members and instead ____

Answer 32

debrief afterward if needed.

Question 33

What should be done when resuscitative efforts are ineffective?

Answer 33

Go back to the basics and talk as a team. Have conversations like, Well, we’ve observed the following on the primary assessment… Have we missed something?

Question 34

An essential role of the team leader is monitoring and evaluating interventions, assessment findings, and the patients status. Leaders should ____

Answer 34

periodically state this information to the team and announce the plan for the next few steps.

Question 35

When communicating with team members, the team leader should use these closed loop communication steps:

Answer 35

1. Give a message, order, or assignment to a team member
2. Request a clear response and eye contact from the team member to ensure that he or she understood the message
3. Confirm that the team member completed the task before you assign him or her another task.

Question 36

All healthcare providers should deliver clear messages ____ and ____, without ____ and ____.

Answer 36

• calmly and directly

* yelling or shouting

Question 37

The best high performance team members ____ each other and work together in a ____ manner.

Answer 37

• mutually respect

* collegial, supportive

Question 38

Everyone in a high performance team must ____ and ____ during the resuscitation attempt, regardless of any additional training or experience that specific team members may have.

Answer 38

• abandon ego and show respect