Critical Care Teamwork Planning
(3/22/2012) Over the past 24 hours we have been discussing some approaches to improving the efficiency with which we can organize at the start of a critical care situation, and manage both the ER and the critical situation most effectively.
Today's discussions resulted in a number of suggestions, concerns, comments and ideas. Overall most people felt it was likely to improve use of the room having the medication cart and the airway cart moved. After discussion it was agreed that we would start immediately with the change and communicate the change between team members with any issues to be referred back to Chris or Gordon. The expectation is that this approach would be tried and evaluated over the next 3 months. Any changes should be discussed among all the staff and with good basis and agreement we would adjust the plan.
Specific concerns that were brought up today included:
Will the ventilator placement be acceptable based on the length of the air/oxygen hoses relative to the outlets?
Will the battery will last on the Zoll? Do we need to have a cord to keep it plugged in during a code?
Will the oxygen and suction hoses get in the way of effective movement around the patient with the bed further from the wall?
Are the contents of the crash cart are sufficient, or does the mediation nurse need to access the regular bedside cart?
How do we manage the situation with more or less people available to help?
How will we get these changes to be well known and practiced consistently?
If the process is communicated nurse to nurse, or clerk to clerk, how can they deal with teammates who don't want to consider the change and voice their dissent?
If we run mock codes, should we call other departments at the time?
Do we need to let other departments, including EMS, know of the changes we are making?
What is the best approach to dealing with staff who don't feel comfortable working with the patient from a particular position? How can we assure sufficient space for people to work?
What tools will we use to evaluate how well this is working? How will we go about making changes?
Should we be using the AutoPulse with every code? When is it appropriate to use it? Are the batteries charged?
Should we expect the chest compressors to always work from the same side, or opposite sides? What difference does it make?
Scribing is important to the process, but how important is that compared to other roles on the team?
How do we manage team members with limited skill levels who arrive early to the event?
The gist of our discussion is that we need to be flexible, communicate well, and know your role (including where to find everything you need). Starting with a clear plan is the only way to measure effectiveness, although the plan is likely to change with ongoing evaluation.
If you have other issues or concerns (or I missed something in the notes I took from today), please bring them up on the discussion board, to Chris or Gordon.
Today's discussions resulted in a number of suggestions, concerns, comments and ideas. Overall most people felt it was likely to improve use of the room having the medication cart and the airway cart moved. After discussion it was agreed that we would start immediately with the change and communicate the change between team members with any issues to be referred back to Chris or Gordon. The expectation is that this approach would be tried and evaluated over the next 3 months. Any changes should be discussed among all the staff and with good basis and agreement we would adjust the plan.
Specific concerns that were brought up today included:
Will the ventilator placement be acceptable based on the length of the air/oxygen hoses relative to the outlets?
Will the battery will last on the Zoll? Do we need to have a cord to keep it plugged in during a code?
Will the oxygen and suction hoses get in the way of effective movement around the patient with the bed further from the wall?
Are the contents of the crash cart are sufficient, or does the mediation nurse need to access the regular bedside cart?
How do we manage the situation with more or less people available to help?
How will we get these changes to be well known and practiced consistently?
If the process is communicated nurse to nurse, or clerk to clerk, how can they deal with teammates who don't want to consider the change and voice their dissent?
If we run mock codes, should we call other departments at the time?
Do we need to let other departments, including EMS, know of the changes we are making?
What is the best approach to dealing with staff who don't feel comfortable working with the patient from a particular position? How can we assure sufficient space for people to work?
What tools will we use to evaluate how well this is working? How will we go about making changes?
Should we be using the AutoPulse with every code? When is it appropriate to use it? Are the batteries charged?
Should we expect the chest compressors to always work from the same side, or opposite sides? What difference does it make?
Scribing is important to the process, but how important is that compared to other roles on the team?
How do we manage team members with limited skill levels who arrive early to the event?
The gist of our discussion is that we need to be flexible, communicate well, and know your role (including where to find everything you need). Starting with a clear plan is the only way to measure effectiveness, although the plan is likely to change with ongoing evaluation.
If you have other issues or concerns (or I missed something in the notes I took from today), please bring them up on the discussion board, to Chris or Gordon.