Step 6: Team Process and Review
It is important for the team (including the team leader) to review the emergency experience, including what went right, what went wrong, whether needed supplies were easily available, and whether communications were optimal. Following a difficult case, team members may need emotional support.
We must keep each other willing and able to continue.
An optimistic attitude toward emergency care keeps the team vital. The whole team must nurture this attitude. Team members must have confidence in their abilities and know that their level of knowledge will ensure the survival of patients, if survival is at all possible. The team leader must recognize oversights and mistakes as human error, not as moral lapse or stupidity. However, to ignore mistakes is a mistake in itself. The team should strive to find a way to correct problems through education, protocols, and supportive communication. An ability to communicate effectively and pleasantly is essential, even under stressful circumstances. When a consultant is rude or overbearing, let him or her know at a later time. A letter is an effective communication tool. Consider communications with prehospital personnel. Always make sure you have the facts straight before making assumptions, interpretations, and judgments.
Equipment storage, shortage, and malfunction are common problems. Finding improved ways to order and store instruments is important. The operation of monitors and defibrillators can be problematic for physicians and nurses who seldom use them. Designate specific team members to troubleshoot problems as they arise.
Encourage team members to vent their feelings and frustrations; they must also be encouraged to respect the feelings and frustrations of fellow team members and others. Observe confidentiality.
Severe stress reactions to traumatic emotional events may occur. These may be avoided if a sympathetic ear at an unhurried time is made available to team members. Each medical community should develop a plan for such events. Clergy and staff support specialists may be enlisted to counsel and support team members and others who develop symptoms of severe stress reaction, such as anxiety, sleeplessness, flash backs, difficulty concentrating, nausea, and depression or sadness. National and state critical incident stress management programs are available to assist.
Having a form available for team members to jot down their ideas, concerns, and suggestions at the end of the case may be a method of obtaining useful information that would otherwise be lost. Please note that each facility should develop its own system for using this form. Use the form below to review emergency cases, positively or negatively. The form may be adapted as needed.
Emergency Case Review
Name _________________ Today's date _________________
Date and time of the case ________________
Your role in the case (team member?) ___________________________________
Areas of function for comment or suggestion:
* Team activation and preparation
* Immediate placement and control of the patient
* The initial survey: the ABCs
* Team actions
* Equipment availability and function
* Availability of supplies
* Documentation
* Pharmacy, laboratory, and x-ray services
* Preparation for admission or transfer
* Communication with the patient
* Communication with others
* Universal precautions and personnel safety
Please continue on an added sheet of paper if more space needed.
Comments:
_______________________________