Book contents
- Frontmatter
- Contents
- Foreword
- Foreword
- Preface
- Acknowledgments
- Contributors
- 1 Mechanisms and Demographics in Trauma
- 2 Trauma Airway Management
- 3 Shock Management
- 4 Establishing Vascular Access in the Trauma Patient
- 5 Monitoring the Trauma Patient
- 6 Fluid and Blood Therapy in Trauma
- 7 Massive Transfusion Protocols in Trauma Care
- 8 Blood Loss: Does It Change My Intravenous Anesthetic?
- 9 Pharmacology of Neuromuscular Blocking Agents and Their Reversal in Trauma Patients
- 10 Anesthesia Considerations for Abdominal Trauma
- 11 Head Trauma – Anesthesia Considerations and Management
- 12 Intensive Care Unit Management of Pediatric Brain Injury
- 13 Surgical Considerations for Spinal Cord Trauma
- 14 Anesthesia for Spinal Cord Trauma
- 15 Musculoskeletal Trauma
- 16 Anesthetic Considerations for Orthopedic Trauma
- 17 Cardiac and Great Vessel Trauma
- 18 Anesthesia Considerations for Cardiothoracic Trauma
- 19 Intraoperative One-Lung Ventilation for Trauma Anesthesia
- 20 Burn Injuries (Critical Care in Severe Burn Injury)
- 21 Anesthesia for Burns
- 22 Field Anesthesia and Military Injury
- 23 Eye Trauma and Anesthesia
- 24 Pediatric Trauma and Anesthesia
- 25 Trauma in the Elderly
- 26 Trauma in Pregnancy
- 27 Oral and Maxillofacial Trauma
- 28 Damage Control in Severe Trauma
- 29 Hypothermia in Trauma
- 30 ITACCS Management of Mechanical Ventilation in Critically Injured Patients
- 31 Trauma and Regional Anesthesia
- 32 Ultrasound Procedures in Trauma
- 33 Use of Echocardiography and Ultrasound in Trauma
- 34 Pharmacologic Management of Acute Pain in Trauma
- 35 Posttrauma Chronic Pain
- 36 Trauma Systems, Triage, and Transfer
- 37 Teams, Team Training, and the Role of Simulation in Trauma Training and Management
- Index
- Plate section
- References
37 - Teams, Team Training, and the Role of Simulation in Trauma Training and Management
Published online by Cambridge University Press: 18 January 2010
By
Edited by
Book contents
- Frontmatter
- Contents
- Foreword
- Foreword
- Preface
- Acknowledgments
- Contributors
- 1 Mechanisms and Demographics in Trauma
- 2 Trauma Airway Management
- 3 Shock Management
- 4 Establishing Vascular Access in the Trauma Patient
- 5 Monitoring the Trauma Patient
- 6 Fluid and Blood Therapy in Trauma
- 7 Massive Transfusion Protocols in Trauma Care
- 8 Blood Loss: Does It Change My Intravenous Anesthetic?
- 9 Pharmacology of Neuromuscular Blocking Agents and Their Reversal in Trauma Patients
- 10 Anesthesia Considerations for Abdominal Trauma
- 11 Head Trauma – Anesthesia Considerations and Management
- 12 Intensive Care Unit Management of Pediatric Brain Injury
- 13 Surgical Considerations for Spinal Cord Trauma
- 14 Anesthesia for Spinal Cord Trauma
- 15 Musculoskeletal Trauma
- 16 Anesthetic Considerations for Orthopedic Trauma
- 17 Cardiac and Great Vessel Trauma
- 18 Anesthesia Considerations for Cardiothoracic Trauma
- 19 Intraoperative One-Lung Ventilation for Trauma Anesthesia
- 20 Burn Injuries (Critical Care in Severe Burn Injury)
- 21 Anesthesia for Burns
- 22 Field Anesthesia and Military Injury
- 23 Eye Trauma and Anesthesia
- 24 Pediatric Trauma and Anesthesia
- 25 Trauma in the Elderly
- 26 Trauma in Pregnancy
- 27 Oral and Maxillofacial Trauma
- 28 Damage Control in Severe Trauma
- 29 Hypothermia in Trauma
- 30 ITACCS Management of Mechanical Ventilation in Critically Injured Patients
- 31 Trauma and Regional Anesthesia
- 32 Ultrasound Procedures in Trauma
- 33 Use of Echocardiography and Ultrasound in Trauma
- 34 Pharmacologic Management of Acute Pain in Trauma
- 35 Posttrauma Chronic Pain
- 36 Trauma Systems, Triage, and Transfer
- 37 Teams, Team Training, and the Role of Simulation in Trauma Training and Management
- Index
- Plate section
- References
Summary
Objectives
Discuss the team unique competencies that enable individuals to perform safely.
Understand experiential learning tools such as simulation in enhancing the learning of health care providers.
Learn about how team training and simulation can enable safer and more reflective health care providers.
Explore the role of microsystems in health care.
Explore the role of simulation in training and assessment of health care providers.
INTRODUCTION AND BACKGROUND
The role of effective teamwork in accomplishing complex tasks is well accepted in many domains. Similarly, there is good evidence that outcome in trauma care depends on effective trauma team performance. Teamwork during trauma care can be deficient in a number of different ways (Table 37.1), and multiple deficiencies may interact to impair team success and patient outcomes. This chapter focuses on understanding, assessing, and improving trauma team performance. The need to train and evaluate the performance of trauma teams has emerged as an important topic during the past decade [1]. It is generally accepted that to ensure high-quality trauma care, institutions must establish and continuously assess their team-based processes for acute trauma resuscitation. This iterative evaluation must include the review of the secondary management including careful delineation of team structure, thorough and ongoing team training, effective support structures, and continuous quality improvement. Valuable tools for trauma team training and performance improvement, discussed in this chapter, include reflective learning and debriefing, simulation and videotape-based analysis.
Team training has a long history in aviation and the military, and, more recently, these experiences have been translated to health care.
- Type
- Chapter
- Information
- Trauma Anesthesia , pp. 579 - 590Publisher: Cambridge University PressPrint publication year: 2008
References
, , , et al. Trauma faculty and trauma team activation: Impact on trauma system function and patient outcome. J Trauma 1999; 47: 576–81.CrossRefGoogle ScholarPubMed
Foushee HC, Helmreich RL. Group interaction and flight crew performance. In , , ed. Human Factors in Aviation. San Diego, CA: Academic Press, 1988, pp 189–227.Google Scholar
, . Sources of situation awareness errors in aviation. Aviat Space Environ Med 1996; 67: 507–12.Google ScholarPubMed
, , . Communication indices of crew coordination. Aviat Space Environ Med 1989; 60: 56–60.Google ScholarPubMed
. Understanding adverse events: Human factors. Qual Health Care 1995; 4: 80–9.CrossRefGoogle ScholarPubMed
, . The Wisdom of Teams: Creating the High Performance Organization. Cambridge, MA: Harvard Business School Press, 1993.Google Scholar
, . Collective mind in organizations: Heedful interrelating on flight decks. Admin Sci Q 1993; 38: 357–81.CrossRefGoogle Scholar
, , , et al. A look into the nature and causes of human errors in the intensive care unit. Crit Care Med 1995; 23: 294–300.CrossRefGoogle ScholarPubMed
, , , et al. Problems for clinical judgement: Thinking clearly in an emergency. Canad Med Assoc J 2001; 164: 1170–5.Google Scholar
. Individual and group. In Dilemmas of Administrative Behavior. Englewood, NJ: Prentice-Hall, 1976, pp 75–95.Google Scholar
, . Advanced Trauma Life Support Course. Chicago, IL: American College of Surgeons, 2001.Google Scholar
, , , et al. The importance of the command-physician in trauma resuscitation. J Trauma 1997; 43: 772–7.CrossRefGoogle ScholarPubMed
, . Leadership of resuscitation teams: “Lighthouse Leadership.”Resuscitation 1999; 42: 27–45.CrossRefGoogle Scholar
, , , . Comparison of fixed versus formed aircrews in military transport. Aviat Space Environ Med 1994; 65: 153–6.Google ScholarPubMed
Simon R, Morey JC, Rice MM, et al. Reducing errors in emergency medicine through team performance: The MedTeams project. In , , ed. Enhancing Patient Safety and Reducing Errors in Health Care. Chicago, IL: National Patient Safety Foundation, 1998, pp 142–6.Google Scholar
, , , et al. A prospective study of the performance of the trauma team leader. J Trauma 1995; 38: 79–82.CrossRefGoogle Scholar
, , , . Pilot personality and crew coordination: Implications for training and selection. Int J Aviat Psychol 1991; 1: 25–44.CrossRefGoogle Scholar
. Competence in experts: The role of task characteristics. Organ Behav Human – Decision Processes 1992; 53: 252–62.CrossRefGoogle Scholar
, . Situation awareness: A critical but ill-defined phenomenon. Int J Aviat Psychol 1991; 1: 45–7.CrossRefGoogle Scholar
. Measurement of situation awareness in dynamic systems. Human Factors 1995; 37: 65–84.CrossRefGoogle Scholar
Cannon-Bowers JA, Salas E, Converse S. Shared mental models in expert team decision making. In , ed. Individual and Group Decision Making: Current Issues. Hillsdale, NJ: Lawrence Erlbaum Associates, 1993, pp 221–46.Google Scholar
Cannon-Bowers JA, Salas E. A framework for developing team performance measures in training. In , , , eds. Team Performance Assessment and Measurement. Mahwah, NJ: Lawrence Erlbaum, 1997, pp 45–62.Google Scholar
, , , et al. Video recording trauma resuscitations: An effective teaching technique. J Trauma 1988; 28: 435–40.CrossRefGoogle ScholarPubMed
, . Videotaping in the admitting area: A most useful tool for quality improvement of the trauma care. Eur J Emerg Med 1997; 4: 94–6.CrossRefGoogle ScholarPubMed
, , , et al. Effect of videotape feedback on anaesthetists' performance while managing simulated anaesthetic crises: A multicentre study. Anaesthesia 2002; 57: 169–82.CrossRefGoogle ScholarPubMed
, , , . Videotape review leads to rapid and sustained learning. Am J Surg 2003; 185: 516–20.CrossRefGoogle ScholarPubMed
, , , et al. A multi-state survey of videotaping practices for major trauma resuscitations. J Emerg Med 1999; 17: 597–604.CrossRefGoogle ScholarPubMed
, , , . Video capture of clinical care to enhance patient safety: The nuts and bolts. Qual Safe Health Care 2004; 13: 136–44.CrossRefGoogle Scholar
, , , et al. Assessment of clinical performance during simulated crises using both technical and behavioral ratings. Anesthesiology 1998; 89: 8.CrossRefGoogle ScholarPubMed
, . The use of standardized patients for teaching and assessing clinical skills. Eval Health Prof 1990; 13: 79–80.CrossRefGoogle Scholar
, , , . Use of a computerized advanced cardiac life support simulator improves retention of advanced cardiac life support guidelines better than a textbook review. Crit Care Med 1999; 27: 821–4.CrossRefGoogle ScholarPubMed
Gaba DM. Human work environment and anesthesia simulators. In , ed. Anesthesia, 5th edition. New York: Churchill-Livingstone, 2000, pp 2613–68.Google ScholarPubMed
, , . Innovative Simulations for Assessing Professional Competence. Chicago, IL: University of Illinois, 1999.Google Scholar
, , . Ethical and professional concerns of simulation in professional assessment and education. Am J Anesth 2000; 12: 228–31.Google Scholar
, , , et al. Anesthesia crisis resource management: Real-life simulation training in operating room crises. J Clin Anesthesiol 1995; 7: 675–87.CrossRefGoogle ScholarPubMed
, , , . Incorporation of a computerized human patient simulator in critical care training: A preliminary report. J Trauma 2002; 53: 1064–7.CrossRefGoogle ScholarPubMed
, , , et al. Evaluation of trauma team performance using an advanced human patient simulator for resuscitation training. J Trauma 2002; 52: 1078–86.CrossRefGoogle ScholarPubMed
, , , et al. Trauma assessment training with a patient simulator: A prospective, randomized study. J Trauma 2003; 55: 651–7.CrossRefGoogle ScholarPubMed
, . Unplanned incidents during comprehensive anesthesia simulation. Anesth Analg 1990; 71: 77–82.CrossRefGoogle ScholarPubMed
, , , et al. Testing internal consistency and construct validity during evaluation of performance in a patient simulator. Anesth Analg 1998; 86: 1160–4.Google Scholar
Oser RL, Salas E, Merket DC, Bowers CA. Applying resource management training in naval aviation: A methodology and lessons learned. In , , , ed. Improving Teamwork in Organizations: Applications of Resource Management Training. Mahwah, NJ: Lawrence Erlbaum, 2001, pp 283–301.Google Scholar
Christansen U, Barach P. Simulation in anesthesia. In , ed. Anesthesia Generale Speciale: Principles Procedures and Techniques, 2nd edition. Turin, Italy: Pergamon Press, 2004.Google Scholar
. General System Theory: Foundations, Development, Applications. New York: George Braziller, Inc., 1968.Google Scholar
, , , , , . Microsystems in Health Care: Part 5. How Leaders Are Leading. Joint Commission J Qual Safety 2003; 29(6):297–308.CrossRefGoogle ScholarPubMed
. Out of the Crisis. Cambridge, MA: Massachusetts Institute of Technology Center for Advanced Engineering Study, 1986.Google Scholar
Donaldson MS, Mohr JJ. Improvement and Innovation in Health Care Microsystems. A Technical Report for the Institute of Medicine Committee on the Quality of Health Care in America. Princeton, NJ: Robert Wood Johnson Foundation, 2000.
, , , , , , , , . Continually improving the health and value of health care for a population of patients: The Panel Management Process. Qual Manage Health Care 1997; 5(3):41–51.CrossRefGoogle ScholarPubMed
, , , . Peri-operative Readiness Information Management System. Technical Report. Woburn, MA: Aptima, Inc., 2004.Google Scholar
, . The role of patient hand-offs in health care. Proceedings of the Society of the Human Factors, pp. 754–762, 2005.Google Scholar
, , , , . Microsystems in health care. Joint Commission J Qual Safety 2003; 29: 5.CrossRefGoogle ScholarPubMed
, , et al. Microsystems in health care: Part 6. Designing Patient Safety into the Microsystem. Joint Commission J Qual Safety 2003;(29):401–408.CrossRefGoogle ScholarPubMed
Mohr JJ, Batalden PB, Barach P. Inquiring into the quality and safety of care in the academic clinical microsystem. In , , ed. Continuous Quality Improvement in Health Care, 3rd edition. Frederick, MD: Aspen Publishers, 2005, pp 407–23.Google Scholar
, , , , . The role of teamwork in the professional education of physicians: Current status and assessment recommendations. Joint Commission J Qual Safety 2005; 31(4):185–202.PubMed
Billington J. The three essentials of an effective team. Harvard Business School Management Update. 1997;2:1–4. Modified by Barach and Weinger.
Hill LA. Managing your team. Harvard Business School Teaching Note. 9–494–081. March 28, 1995.
Adapted from “Performance Measurement in Teams.” Team Training Series, Book 2. Orlando, FL: Naval Air Warfare Center Training Systems Division.
, , . Microsimulators in medical education: An overview. Simul Gaming 2001; 32: 250–262.Google Scholar
, , et al. Communication failures in patient sign-out and suggestions for improvement: A critical incident analysis. Quality and Safety in Health Care 2005; 14: 401–407.CrossRefGoogle ScholarPubMed