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Optimising ED team performance


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Optimising ED team performance

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Optimising ED team performance

  1. 1. Tom Cassidy Optimising Trauma Team Performance 1/3/2018
  2. 2. Tom Cassidy Optimising Trauma Team Performance 1/3/2018 Optimising ED Team Performance
  3. 3. A tragedy in 3 Acts ❖ Performing under stress ❖ Specific fixes ❖ Tom’s folly ❖ Throughout the tragedy the following case will act as our foundation…
  4. 4. What makes stuff Stressful? ❖ Time ❖ Resources ❖ Skills ❖ Other people ❖ Environment ❖ Stakes
  5. 5. What makes for the most difficult sick person? ❖ No warning
  6. 6. Major Trauma ❖ Multiple Body systems involved ❖ Airway, head injury, neck, thorax, abdomen, long bones, coagulation ❖ Multiple Procedures ❖ IVA, chest drains, intubation, pelvic binding ❖ Multiple Specialities ❖ ED, Gen surg, ortho, radiology, anaesthetics ❖ Competing interests ❖ Intubation vs ICC, CT abdo vs straight to OT, permissive hypotension vs head injury
  7. 7. –Douglas Adams I briefly did therapy, but after a while, I realised it is just like a farmer complaining about the weather. You can't fix the weather - you just have to get on with it.
  8. 8. Individuals ❖ Force them to introduce themselves and wear ID ❖ Challenge vs threat ❖ Mental practice ❖ Closed Loop Communication
  9. 9. The trouble with teams ❖ Going back to our case
  10. 10. A bird in the hand… ❖ Utilise the time prior to presentation ❖ People, place, equipment, drugs, blood ❖ Pre-briefing -Assign roles ❖ Lay out a predicted course of management, including expectations and what to do if the case doesn’t follow the clinical course
  11. 11. –US Supreme Court Justice Potter Stewart “I know it when i see it.”
  12. 12. Tom’s Folly