Chapter 9: The Team Approach to Health Care

Vocabulary flashcards covering team dynamics, safety culture, communication techniques, and decision-making processes based on Chapter 9 of the EMT preparatory section.

Team

A group of health care clinicians who are assigned specific roles and are working interdependently in a coordinated manner under a designated leader.

Culture of Safety

A system designed to be inherently safe to minimize patient, EMS clinician, and public exposure to injury, infections, illness, or stress during patient response and care delivery.

Just Culture

An approach to leadership in organizations that balances fairness and accountability, encouraging people to report errors and near misses.

Human Error

An error committed when a person intended to do the right thing but chose the wrong treatment, performed a skill incorrectly, or meant to do something but did not follow through.

At-risk Behavior

A situation where an EMT actively makes a choice to take a risk, believing that the potential adverse outcome is insignificant or that it was justified in the moment.

Reckless Behavior

An action involving a conscious disregard for a significant and unjustified risk, which usually results in disciplinary action.

Normalization of Deviance

The process where procedures established to promote safety are routinely ignored until noncompliance with the procedure becomes the norm in the EMS system.

Continuum of Care

The concept of emergency health care clinicians working as a unified team from first patient contact to patient discharge to improve individual and team performance.

Regular Teams

A model in which EMTs consistently interact with the same partner or team, allowing them to develop rapport and train together as one seamless unit.

Temporary Teams

A team composed of clinicians who do not regularly interact or may not know each other, common during large events or disasters.

Group

A gathering of people sharing five essential elements: a common goal, an image of themselves as a group, a sense of continuity, shared values, and different roles.

Pit Crew CPR

An approach to cardiac arrest where each intervention, such as compressions or airway management, is clearly defined and assigned to clinicians before the call.

Closed-loop Communication

A communication technique where the receiver repeats the message back to the sender to confirm that it was heard and understood correctly.

Constructive Intervention

The act of respectfully questioning or correcting team members or the leader if it is believed a mistake has been or is about to be made.

Team Leader

The member responsible for role assignments, coordination, oversight, centralized decision making, and support for the team to accomplish its goals.

Team Situational Awareness

The knowledge and understanding of one's surroundings and the ability to recognize potential threats to safety.

Crew Resource Management (CRM)

A system that allows team members with different skill sets to collaborate and communicate to achieve the shared goal of the best possible patient outcome.

Latent Failures

Preexisting flaws in system design or processes that make it easier for an error to occur.

Active Failures

Situations where a person or team performs in an unsafe manner.

PACE Mnemonic

A tool for bringing potential problems to the attention of the team leader, consisting of: Probe, Alert, Challenge, and Emergency.

ALS Assist

The role in which an EMT supports an ALS clinician in performing advanced-level skills while remaining within the EMT scope of practice.

ROWS

An acronym used during patient assessment that stands for Rule Out Worst-case Scenario.

Back-step Debrief

An informal discussion that occurs between partners during the cleanup after a call to talk about what happened.

Bias

Fixed beliefs about something that can cause an EMT to remain locked into one idea while ignoring or not seeking other data.

Anchoring

A decision trap where an EMT settles on one possible cause of the patient's problems early and fails to consider other options.

Overconfidence

A decision trap where the EMT overestimates their ability in skills like assessment, driving, or decision making, potentially leading to patient harm.

Continuum of Care

The concept of emergency health care clinicians working as a unified team from first patient contact to patient discharge to improve individual and team performance.

Five Essential Elements of a Group

1. A common goal
2. An image of themselves as a group
3. A sense of continuity
4. Shared values
5. Different roles.

Advantages of a Team over a Group

Teams foster interdependence and collaboration, leading to enhanced communication and coordination. Regularly training and practicing together also builds rapport, trust, and efficiency, which enhances performance during emergencies.

Attributes of Effective Team Leaders and Members

Effective team leaders are responsible for role assignments, coordination, oversight, centralized decision making, and support for team goals. Team members should communicate openly, collaborate, and provide constructive feedback.

Crew Resource Management (CRM)

A system that allows team members with different skill sets to collaborate and communicate to achieve the shared goal of the best possible patient outcome, enhancing safety and efficiency.

Key Guidelines for Effective Patient Care Transfer

1. Ensure clear communication of vital patient information
2. Confirm understanding through closed-loop communication
3. Verify patient identity and situation
4. Document all information accurately.

Steps for Taking a Patient Care Report

1. Introduce yourself and clarify your role
2. Obtain essential patient information
3. Summarize the care provided and response to treatment
4. Answer any questions from the receiving clinician
5. Complete documentation.

Stages of Effective Decision-Making

1. Identify the problem
2. Gather and analyze relevant information
3. Generate options
4. Evaluate options and risks
5. Choose the best option
6. Implement the decision
7. Review the decision's effectiveness.

Decision Traps Leading to Errors

Common decision traps include:

• Anchoring: settling on one cause too early, ignoring other possibilities.
• Overconfidence: overestimating one's own skills and assessments.

Steps to Troubleshoot Interpersonal Conflicts for EMTs

1. Recognize the conflict and its impact
2. Openly communicate with those involved
3. Listen to all perspectives
4. Collaborate to find a resolution
5. Follow up to ensure the conflict is resolved.