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Crisis Management & Team Work

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  • Field: Healthcare
  • Venue: e-REAL Lab at the Harvard Center for Medical Simulation, Boston, MA and e-REAL Online Lab
  • Simulation Team: Jenny Rudolph, Roxane Gardner, Rebecca Minehart, Francine Morin, Geraldine Pettersen, Ignacio del Moral, Jose Maestre, Alexandre “Sacha” Ghuysen, Christian Balmer, Andree Sansregret, Arielle Levy
  • Instructional Design Team: Jenny Rudolph, Roxane Gardner, Fernando Salvetti, Andree Sansregret, Arielle Levy, Francine Morin, Geraldine Pettersen
  • Multimedia Design & Tech Team: Matteo Lana, Rocco Luigi Tartaglia, Anca Gavril, Frank Guevara, Alessandro Lombardi

A quick workshop to learn how to reduce cognitive-load and help clinical teams to quickly organize and effectively manage patient care during acutely emerging critical events.

Crisis resource management principles encompass the non-technical skills required for effective team work during a crisis situation in complex environments. Poor teamwork and communication are common factors which contribute to errors and adverse events, especially while managing critical clinical events. Effective verbal communication is key to ensure a shared mental model and tap into the cognitive processes of the entire team.

Health care professionals often find it challenging to effectively organize a team and establish explicit team leadership when managing critical events. There is a transition between regarding resuscitation “leaders” as having “all the answers” while team members await their orders, to one of being an effective leader with teammates actively speaking up during a crisis. It is essential that team members communicate information openly if it impacts patient outcome and also mandatory to practice horizontal communication and use non-mitigating speech.

A strategy developed by faculty at the Center for Medical Simulation in Boston (MA, USA) is to practice a short mnemonic for teamwork and communication, known as “Name-Claim-Aim”. It is also easy to remember and encompasses all the CRM principles. “Name” is for naming the problem or the change in situation; “Claim” is for claiming leadership and distributing roles to ensure organization, inviting input from team members who may have ideas, and ensuring team member engagement throughout the crisis; “Aim” is for directing the team towards next steps and initiating additional input from team members. In order to acquire a “muscle memory” for using the mnemonic “Name-Claim-Aim”, it is coupled with rapid-cycle deliberate practice(RCPD). When done successfully, this RCDP approach facilitates introduction of “Name-Claim-Aim” prior to a simulated case, and then “pausing” during the case to deliberately practice using “Name-Claim-Aim” accurately to efficiently communicate and organize the team or to reinforce participant use.

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