2.50
Hdl Handle:
http://hdl.handle.net/10755/162919
Type:
Presentation
Title:
ED Nurses and Physicians Training Together to Improve Teamwork
Abstract:
ED Nurses and Physicians Training Together to Improve Teamwork
Conference Sponsor:Emergency Nurses Association
Conference Year:2006
Author:Robin, Nancy M., RN, MEd, CEN
P.I. Institution Name:Miriam Hospital
Title:Emergency Department Professional Practice Development Specialist
Contact Address:164 Summit Ave., Providence, RI, 02906, USA
Contact Telephone:(401) 793-3339
Clinical Topic: Emergency nurses know that effective communication is crucial to patient safety in the high paced, often chaotic environment of the emergency department. Five years ago, our ED department, serving 40,600 ED patients annually, noted failures in communication between nurses, physicians and other ED staff. Each had information the other needed, yet sharing information was inconsistent, resulting in unnecessary errors. To address these problems, ED staff reviewed the research literature and determined the best solution was to design a communications system structured around teamwork and guided by aviation principles. Aviation, like emergency medicine, involves high stress situations where miscommunication and poor performance can lead to disastrous results. Most importantly, nurses and physicians would be trained together to learn how to work as a team. Implementation: Teamwork training, begun in 2001, and ongoing, is based on a medical research study conducted by Dynamics Research, whose preliminary results are published in the Annals of Emergency Medicine. 1) The multi-center military and civilian research project, called MedTeams, found that teamwork training reduced clinical errors and increased patient satisfaction in the ED. We chose MedTeams because of its encouraging preliminary results and because our affiliate hospital was a participant in its multi-site study. 2) The training focuses on five team dimensions: team structure and climate, planning and decision-making, communication within the team, workload management, and improving team skills. Based on the study, our department is now divided into separate teams. In 2001, selected ED staff attended external training sessions to become Emergency Team Coordination Course Instructors. These staff members have since trained all ED staff, including all new hires, in 8-hour in-house training sessions that teach how to communicate and work as a team. Techniques employed include "check backs" (verifying that a message sent was heard), "cross-monitoring" (monitoring the action of other team members and intervening to reduce or avoid errors), "assertion," (used when a team member disagrees with the decision of another), and the "two challenge rule," whereby team members who don't feel heard repeat the message at least twice. "Rounding" (team briefing) also occurs at the beginning of and several times during each shift in which team members introduce themselves, and share information, and set priorities. Outcomes: Since implementing the program in 2001, MedTeams' principles have become ingrained in our work environment. Team techniques, such as "rounding" and others have increased communication among caregivers at every level, improved ED staff performance and morale, and have enhanced patient safety. Recommendations: The implementation of a teamwork curriculum can reduce patient error and ensure patient safety by improving performance in the emergency department. Training physicians and nurses together promotes an attitude of working as a team. Recently, we have incorporated the use of a medical simulation center to better demonstrate how communication techniques can improve teamwork. We continue to train all new employees in teamwork principles and coach and mentor all staff so we might continue to better protect and care for our patients. References: 1) Risser, D., Simon, R. Rice, M. Salisbury, M. (1999). The Potential for Improved Teamwork to Reduce Medical Errors in the Emergency Department. Ann of Emerg Med. 34, 373-383. and 2) Morey, J.C., Simon, R., Jay, G.D., Wears, R.L., Salisbury, M., Dukes, K.A., Berns, D. (2002). Error reduction and performance improvement in the emergency department through formal teamwork training: Evaluation results of the MedTeams project-Quality of Care. Health Services Research.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleED Nurses and Physicians Training Together to Improve Teamworken_GB
dc.identifier.urihttp://hdl.handle.net/10755/162919-
dc.description.abstract<table><tr><td colspan="2" class="item-title">ED Nurses and Physicians Training Together to Improve Teamwork</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Robin, Nancy M., RN, MEd, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Miriam Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Department Professional Practice Development Specialist</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">164 Summit Ave., Providence, RI, 02906, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(401) 793-3339</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">nrobin@lifespan.org</td></tr><tr><td colspan="2" class="item-abstract">Clinical Topic: Emergency nurses know that effective communication is crucial to patient safety in the high paced, often chaotic environment of the emergency department. Five years ago, our ED department, serving 40,600 ED patients annually, noted failures in communication between nurses, physicians and other ED staff. Each had information the other needed, yet sharing information was inconsistent, resulting in unnecessary errors. To address these problems, ED staff reviewed the research literature and determined the best solution was to design a communications system structured around teamwork and guided by aviation principles. Aviation, like emergency medicine, involves high stress situations where miscommunication and poor performance can lead to disastrous results. Most importantly, nurses and physicians would be trained together to learn how to work as a team. Implementation: Teamwork training, begun in 2001, and ongoing, is based on a medical research study conducted by Dynamics Research, whose preliminary results are published in the Annals of Emergency Medicine. 1) The multi-center military and civilian research project, called MedTeams, found that teamwork training reduced clinical errors and increased patient satisfaction in the ED. We chose MedTeams because of its encouraging preliminary results and because our affiliate hospital was a participant in its multi-site study. 2) The training focuses on five team dimensions: team structure and climate, planning and decision-making, communication within the team, workload management, and improving team skills. Based on the study, our department is now divided into separate teams. In 2001, selected ED staff attended external training sessions to become Emergency Team Coordination Course Instructors. These staff members have since trained all ED staff, including all new hires, in 8-hour in-house training sessions that teach how to communicate and work as a team. Techniques employed include &quot;check backs&quot; (verifying that a message sent was heard), &quot;cross-monitoring&quot; (monitoring the action of other team members and intervening to reduce or avoid errors), &quot;assertion,&quot; (used when a team member disagrees with the decision of another), and the &quot;two challenge rule,&quot; whereby team members who don't feel heard repeat the message at least twice. &quot;Rounding&quot; (team briefing) also occurs at the beginning of and several times during each shift in which team members introduce themselves, and share information, and set priorities. Outcomes: Since implementing the program in 2001, MedTeams' principles have become ingrained in our work environment. Team techniques, such as &quot;rounding&quot; and others have increased communication among caregivers at every level, improved ED staff performance and morale, and have enhanced patient safety. Recommendations: The implementation of a teamwork curriculum can reduce patient error and ensure patient safety by improving performance in the emergency department. Training physicians and nurses together promotes an attitude of working as a team. Recently, we have incorporated the use of a medical simulation center to better demonstrate how communication techniques can improve teamwork. We continue to train all new employees in teamwork principles and coach and mentor all staff so we might continue to better protect and care for our patients. References: 1) Risser, D., Simon, R. Rice, M. Salisbury, M. (1999). The Potential for Improved Teamwork to Reduce Medical Errors in the Emergency Department. Ann of Emerg Med. 34, 373-383. and 2) Morey, J.C., Simon, R., Jay, G.D., Wears, R.L., Salisbury, M., Dukes, K.A., Berns, D. (2002). Error reduction and performance improvement in the emergency department through formal teamwork training: Evaluation results of the MedTeams project-Quality of Care. Health Services Research.</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:25Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:25Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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