Command gradient error in Prehospital Care: Neil Jeffers
Command gradient error in Prehospital Care: Neil Jeffers
Neil starts off by telling us a story about a plane that took off from JFK and flew to Portland. As they approached to land, they realised that they had a problem with the undercarriage. Instead of listening and taking advice from the flight engineer, who was on board and aware of the problem, the pilot chose to continue to fly the plane around in circles. This led to the plane eventually running out of fuel and a subsequent plane crash. Tragically, the plane crash killed multiple passengers on board, including the flight engineer. The moral of the story? Don’t be the captain who doesn’t listen and don’t be the flight engineer who didn’t speak up. Neil defines command gradient error as the actual or perceived difference in rank which inhibits communication, leads to a loss of the shared mental model and ultimately an undesirable event. We as healthcare professionals are doing much more to patients than we’ve ever done before. This sparks the need more than ever, to generate teams that are functional and collaborative. As we go through any single job, we may move between leading and following the situation. We should embrace this model of teamwork. Neil’s advice for those leading is to be receptive. We should develop an environment that allows people to question our actions and decisions. When following, we should be assertive. After all, it is usually the people following that have the bandwidth to identify a problem in the first place. In this podcast, Neil Jeffers explains how Command gradient error in Prehospital Care can ultimately lead to tragic circumstances. We should focus on collaborative teamwork and clear communication to ensure that we avoid tragic outcomes for our patients. For more like this, head to our podcast page. #CodaPodcast
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- 3. CommandGradientError inPre-HospitalCare Neil Jeffers London’s Air Ambulance #smaccforce 2017
- 4. 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
- 8. When Be Recepti ve Leading
- 9. When Be AssertiveFollowi ng
- 11. 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
- 14. N.Jeffers@londonsairambulance.c o.uk @Capt_Dude @LNDairamb
- 15. 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†
- 16. 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
Editor's Notes
- ASH: Neil Jeffers is our first SMACCFORCE pilot to give a talk His talk is Command gradient error in Prehospital Care. At end of Talk, ASH says: I’ll leave you guys to fight over the remote
- ASH Questions Twitter: Command gradient error in Prehospital Care - Neil Jeffers I’m going to let you fight over the remote <fight over remote> - Next is Channel Flicks: Conor & Brian