Quiz 4 Review: Physician Assistants as Part of the Medical Team Flashcards
Define Team Strategies & Tools to Enhance Performance and Patient Safety (TeamSTEPPS)
Evidence-based framework to optimize team performance across the health care delivery system
TeamSTEPPS Framework and Competencies
I) Knowledge - Shared mental model II) Attitudes - Mutual trust - Team orientation III) Performance - Adaptability - Accuracy - Productivity - Efficiency - Safety
What are the 4 teachable-learnable skills of TeamSTEPPS?
I) Communication
II) Leadership
III) Situation Monitoring
IV) Mutual Support
Define Team Structure
The components of a multi-team system that must work together effectively to ensure patient safety
Define Communication
Structured process by which information is clearly and accurately exchanged among team members
Define Leadership
Ability to maximize the activities of team members by ensuring that team actions are understood, changes in information are shared and team members have the necessary resources
Define Situation Monitoring
Process of actively scanning and assessing situational elements to gain information or understanding or to maintain awareness to support team functioning
Define Mutual Support
Ability to anticipate and support team members’ needs through accurate knowledge about their responsibilities and workload
What is the Multi-Team System for Patient Care?
Safe and efficient care involves the coordinated activities of a multi-team system
Team structure process involves…
Patient –> Core Team & Contingency Team –> Coordinating Team & Ancillary/Support Services –> Administration
Define SBAR
Technique for communicating critical information that requires immediate attention and action concerning a patient’s condition
Define Situation
SBAR
What is going on with the patient
Define Background
SBAR
What is the clinical background or context
Define Assessment (SBAR)
What do I think the problem is
Define Recommendation and Request (SBAR)
What would I do to correct it
Define Call-Out
Strategy used to communicate important or critical information
What are characteristics of Call-Out
- Informs all team members simultaneously during emergent situations
- Helps team members anticipate next steps
- Important to direct responsibility to a specific individual responsible for carrying out the task
Define Check-Back
Using closed-loop communication to ensure that information conveyed by the sender is understood by the receiver as intended
What is the process of Check-Back?
- Sender initiates the message
- Receiver accepts the message and provides feedback
- Sender double-checks to ensure that the message was received
Define Handoff
Transfer of information, authority or responsibility during transitions in care across the continuum
Handoff allows for opportunity to…
Ask questions, clarify and confirm
What is an example of Handoff
Shift changes
What is the process of Handoff called?
“I Pass the Baton”
Explain the process of Handoff
- Introduction
- Patient
- Assessment
- Situation
- Safety concerns
- Background
- Actions
- Timing
- Ownership
What are responsibilities of effective team leaders?
- Organize the team
- Identify/articulate clear goals
- Assign tasks and responsibilities
- Monitor/modify the plan (communicate changes)
- Review team’s performance and provide feedback
- Manage/allocate resources
- Facilitate information sharing
- Encourage team members to assist one another
- Facilitate conflict resolution in a learning environment
- Model effective teamwork
What are the steps of Team Events?
I) Sharing the plan
II) Monitoring/modifying the plan
III) Reviewing the team’s performance
Define Brief
component of sharing the plan
Short session prior to start to share the plan and discuss team formation, assign roles and responsibilities, establish expectations and anticipate outcomes
Define Huddle (component of monitoring/modifying the plan)
Meeting to re-establish situational awareness and reinforce plans already in place
Define Debrief (component of reviewing the team’s performance)
Informal information exchange session designed to improve team performance and effectiveness through lessons learned and reinforcement of positive behaviors
What is the Situation Monitoring Process?
Situation Monitoring (individual skill) –> Situation Awareness (individual outcome) –> Shared Mental Model (team outcome)
Define Situation Monitoring
The process of continually scanning and assessing a situation to gain/maintain an understanding of what’s going on around you
Define Situation Awareness
State of “knowing what’s going on around you”
Define Shared Mental Model
Results from each team member maintaining situation awareness and ensures that all team members are “on the same page”
Define STEP
Tool for monitoring situations in the delivery of healthcare
What are the components of STEP
I) Status of the patient
II) Team members
III) Environment
IV) Progress toward goal
Components of Status of the Patient
- Patient history
- Vital signs
- Medications
- Physical exam
- Plan of care
- Psychosocial issues
Components of Team Members
- Fatigue
- Workload
- Task performance
- Skill
- Stress
Components of Environment
- Facility information
- Administrative information
- Human resources
- Triage acuity
- Equipment
Components of Progress Toward Goal
- Status of team’s patient(s)
- Established goals of team
- Tasks/actions of team
- Plan still appropriate
Define Cross-Monitoring
A harm error reduction strategy
Cross-Monitoring involves…
- Monitoring actions of team members
- Providing a safety net within the team
- Ensuring that mistakes/oversights are quickly and easily resolved
What are the characteristics of an I’M SAFE checklist?
- Illness
- Medication
- Stress
- Alcohol and Drugs
- Fatigue
- Eating and Elimination
Define Task Assistance
Helping others with tasks builds a strong team
Team members protect each other from work __________ situations.
Overload
Effective teams place all ________ and __________ for assistance in the context of __________ safety.
Offers; requests; patient
T/F Team members foster a climate where it is expected that assistance will be actively sought and offered
True
Define Feedback
Information provided to team members for the purpose of improving team performance
What are the components that make up Feedback?
Being…
- Timely
- Respectful
- Specific
- Directed
- Considerate
You must be an ___________ for the patient.
Advocate
As physicians you must assert a…
Corrective action in a firm and respectful manner
How can a physician accurately assert a corrective action?
- Make an opening
- State the concern
- State the problem
- Offer a solution
- Reach agreement on next steps
Define Two-Challenge Rule
Empowers all team members to “stop the line” if they sense of discover an essential safety breach
The Two-Challenge Rule occurs when…
An initial assertive statement is ignored
How do you conduct a Two-Challenge Rule?
- Assertively voice concern at least TWO TIMES to ensure that it has been heard
- Team members being challenged must acknowledge that concern has been heard
Define CUS
Assertive Statements
What does CUS stand for?
- I am CONCERNED
- I am UNCOMFORTABLE
- This is a SAFETY ISSUE
Define DESC Script
A constructive approach for managing and resolving a conflict
Define D in DESC Script
Describe the specific situation or behavior
Define E in DESC Script
Express how the situation makes you feel/what your concerns are
Define S in DESC Script
Suggest other alternatives and seek agreement
Define C in DESC Script
Consequences should be stated in terms of impact on established team goals (strive for consensus)
