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SMACCForce: Command gradient error in prehospital care


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SMACCForce: Command gradient error in prehospital care by Neil Jeffers

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SMACCForce: Command gradient error in prehospital care

  1. 1. CommandGradientError inPre-HospitalCare Neil Jeffers London’s Air Ambulance #smaccforce 2017
  2. 2. Descripti on The actual or perceived difference in rank that inhibits communication, leads to a loss in Joint Mental Model which could lead to an undesirable event
  3. 3. When Be Recepti ve Leading
  4. 4. When Be AssertiveFollowi ng
  5. 5. Graded assertiveness - PACE Probe Alert Challenge Emergenc y Is this right? Could we do this better? I am not sure that this is right? That’s not right! We need to re-assess!STOP! I have control
  6. 6. N.Jeffers@londonsairambulance.c @Capt_Dude @LNDairamb
  7. 7. Achieving the National Quality Forum's “Never Events” In most sentinel events, someone knew something was wrong but either did not speak up or spoke up but was ignored. Prevention of Wrong Site, Wrong Procedure, and Wrong Patient Operations Robert K. Michaels, MD, MPH,* Martin A. Makary, MD, MPH,† Yasser Dahab, MD,* Frank J. Frassica, MD,‡ Eugenie Heitmiller, MD,* Lisa C. Rowen, RN, DNSc,§ Richard Crotreau, MD,¶ Henry Brem, MD,∥ and Peter J. Pronovost, MD, PhD†
  8. 8. The effect of trans-cockpit authority gradient on Navy/Marine helicopter mishaps. Alkov RA1, Borowsky MS, Williamson DW, Yacavone DW. Equal rank yielded lowest rate Differing by 2 or more ranks – highest rate