Collaborative Caring: Stories & Reflections on Teamwork in Healthcare

collaborative caring suzanne gordon

A newly released book from our friend Suzanne Gordon and coauthors David Feldman, MD and Michael Leonard, MD. Suzanne is the coauthor of “Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety” (click the link to read my book review), and coeditor of “First, Do Less Harm”, both from Cornell. She is coeditor of the Culture and Politics of Health Care Work Series and was program leader of the Robert Wood Johnson– funded Nurse Manager in Action Program.

About Collaborative Caring:

Teamwork is essential to improving the quality of patient care and reducing medical errors and injuries. But how does teamwork really function? And what are the barriers that sometimes prevent smart, well-intentioned people from building and sustaining effective teams? Collaborative Caring takes an unusual approach to the topic of teamwork. Editors Suzanne Gordon, Dr. David L. Feldman, and Dr. Michael Leonard have gathered fifty engaging first-person narratives provided by people from various health care professions.

Each story vividly portrays a different dimension of teamwork, capturing the complexity—and sometimes messiness—of moving from theory to practice when it comes to creating genuine teams in health care. The stories help us understand what it means to be a team leader and an assertive team member. They vividly depict how patients are left out of or included on the team and what it means to bring teamwork training into a particular workplace. Exploring issues like psychological safety, patient advocacy, barriers to teamwork, and the kinds of institutional and organizational efforts that remove such barriers, the health care professionals who speak in this book ultimately have one consistent message: teamwork makes patient care safer and health care careers more satisfying. These stories are an invaluable tool for those moving toward genuine interprofessional and intraprofessional teamwork.



Praise for the New Book:

“Collaborative Caring makes a unique contribution in the scope and breadth of teamwork it considers. It is an important book.”—Audrey Lyndon, PHD, RNC, FAAN, University of California San Francisco.

“Teamwork is the neglected part of medical training and the new frontier for reliable delivery of quality care. It’s not enough to know what to do. Providers need to be able to deliver that care reliably—and that takes teamwork. This book emphasizes the essential elements of real teamwork: actions coordinated by a shared goal, shared mental model of the situation, cross-monitoring, a flat hierarchy, mutual respect, and trust. If your operating room team or patient care team does not have these characteristics, then this book is for you.”— John. R. Clarke, MD, Professor of Surgery, Drexel University; Clinical Director of Patient Safety and Quality Initiatives, ECRI Institute; Clinical Director, Pennsylvania Patient Safety Authority.

Get your copy of Collaborative Caring from Amazon today!


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Help Fund Movie That Connects Aviation Simulation to Healthcare Simulation

aviation team training into healthcare

IndieGoGo, a crowd-funding platform for independent projects, is hosting the opportunity to donate towards: “Beyond the Checklist: A Feature Length Documentary Film”, which explores how lessons from industries like aviation can provide solutions to the crisis of patient deaths and injuries in healthcare. I urge you to join me in pledging towards this important documentary film which will attempt to show how training in the aviation business using evolved communication practices has lead to an incredible safety record, especially in comparison to the number of deaths attributed to medical error now occurring in the United States.

The Concept Behind the Film:

“On January 9, 2009. US Airways Flight 1549 landed in the middle of the frigid Hudson River in New York. Captain Chesley “Sully” Sullenberger and his crew – as well as ferry and Coast Guard crews – had all practiced and trained in teamwork for years. Which is why not a single passenger or crew- member was seriously injured when the plane was totally disabled when struck by a flock of Canada Geese.

Our 60-minute film will demonstrate that healthcare can transform its culture and stem the epidemic of medical errors and injuries in the US and elsewhere. It can do this by learning lessons from the safety model and culture change movement that transformed commercial aviation over the last 30 years and that has been successfully adapted to make other high-risk industries much safer. The film “Beyond the Checklist” shows exactly how this safety model and culture can be implemented in the healthcare industry.

Take a trip on a $14 million dollar flight simulator, and see how pilots, fight attendants, ground crew, and air traffic controllers all learn to work together to make air travel safer. Sit in on training sessions that teach people on very different rungs of the health care hierarchy how to communicate so they can form quick teams and react instantly in crisis. Here, pilots aren’t only graded on how well they guide a plane during both routine flights and crises but on how well they communicate and work as a team with their crew. Flight attendants mechanics, and gate agents and many others learn to speak up when appropriate and challenge each other, as well as the captain and rather than experiencing “push back,” they are thanked for it.

“Crew Resource Management gave you a process and a language…so that if I said to you, captain I’m not comfortable with this, he had to hear that because it was done in a way that we were all trained,” recalls Nancy Burns, who was a flight attendant for 39 years both and experienced the change in culture when aviation introduced CRM. “It meant that if you spoke up they had to listen. It also meant that you had a responsibility to speak up.” Airline personnel are also encouraged to report mistakes – even serious violations – without being punished and all airlines share information about near misses, errors, and other problems to change practice and insure safety.

The film concludes by showing how the lessons of these pioneering practitioners and institutions can be implemented in every single hospital and health care facility so that every patient everywhere is safe. Each and every one of us will someday be a patient. Our lives and the lives of our loved ones depend on whether our caregivers are trained to work together as a team, can learn together to prevent mistakes, and are able to create a culture of safety in healthcare.”

Click here to learn more and donate to the Beyond the Checklist Documentary Film!

Upcoming Webinar: The Use of Simulation for Evaluating Interventions that Support Collaborative Teamwork

ipss

IPSS, or the International Pediatric Simulation Society, is providing a free webinar on May 27th 17:00 GMT (UTC: 0), on the topic of The Use of Simulation for Evaluating Interventions that Support Collaborative Teamwork, presented by Dr. Randall Burd.

Description of the webinar: 
In this webinar, Dr. Burd will present the use of simulation as an approach for evaluating new strategies for improving performance during resuscitation.

Objectives: 
At the conclusion of this workshop, participants will be able to:
1. Understand the advantages and limitations of simulation as an evaluation tool in this setting
2. Describe experimental considerations the should be considered in this setting
3. Understand the challenges of recruitment and how these may impact experimental findings

About the Presenter:
Dr. Burd has practiced pediatric surgery since 1997 and joined Children’s National Medical Center in 2008. He is the Chief of the Division of Trauma and Burn Surgery and an Associate Professor of Surgery and Pediatrics at the GWU School of Medicine and Health Sciences. He did his undergraduate work at Dartmouth College (BA in Mathematics) and obtained his MD at Columbia University College of Physicians and Surgeons (MD). He did his general surgery residency at the University of Minnesota where he also obtained a PhD in Surgery/Microbiology. He did his pediatric surgery fellowship at the Children’s Hospital of Michigan in Detroit, MI. His area of research interest is in developing new approaches for improving teamwork during trauma resuscitation and improving prehospital pediatric trauma triage. For the past ten years, Dr. Burd has led a multidisciplinary research team studying errors and teamwork in trauma resuscitation. This team includes collaborators in emergency medicine and surgery, human factors, informatics, computer science and biomedical engineering. His research in trauma resuscitation is now funded by grants from the NIH.

medical simulation webinars

To learn more and to sign-up for this FREE online event, please visit the IPSS Webinar page.


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“Bedside Manners” Play DVD and Workbook Help Demo & Teach Healthcare Communication Issues

I’m really excited to let you know that the play Bedside Manners by award-winning journalist and author Suzanne Gordon and Actress Lisa Hayes, is out in a wonderful new version. I have watched this play and recommend it and the workbook for ALL healthcare professional educators, especially those in simulation!

bedside manners dvd

Bedside Manners is a play and workbook designed to improve effective communication between healthcare professionals. Past participants have reported that its use enhances on-going efforts to reduce medical errors and injuries and helps to improve teamwork and workplace civility. This has resulted in improved patient safety and care.

The play is performed as reader’s theater, which means the actors do not memorize their lines but read from the script.

Topical, real-life healthcare scenarios are played out in 21 scenes that run for approximately two to five minutes. Each vignette covers topics ranging from routine daily interactions, to the breakdown of communication between team members in high stress scenarios. They also include examples of excellent teamwork and communication.

Every situation portrayed in the play is based on actual events that highlight both successful and frustratingly poor communication practices.

The best way to perform the play is to recruit members of your facility, students, or participants at a conference to act in the play. Using a combination of professional actors and staff, students, or participants is also an excellent way to present the play. The play can be presented between a half hour and sixty minutes. It is useful to follow up with a discussion or workshop, using the powerpoint provided in the teaching package or suggestions and exercises in the Bedside Manners workbook. The teaching package also contains extra scenes that include many different healthcare professionals.

When performed by professional actors, only 3 to 4 are needed. The play can also be cast with members of your staff. Using a combination of professional actors and staff is the best way to present the play. The play can be presented in less than 60 minutes.

beside manners workbook

Each character expresses the point of view and experiences of healthcare staff. Although the play focuses on the interaction between doctors and nurses, it can be adapted to incorporate the experiences of other healthcare professionals and staff.

Because all sides of communication issues are portrayed, audience members feel “their side” of the story has been expressed. This not only engages the audience members, but gives them the tools to help resolve complex workplace problems, resulting in improved team work, patient safely and job satisfaction.

Cornell University Press has published the play and workbook as a book in its Culture and Politics of Health Care Work series.  The workbook is co-authored by internationally renowned interprofessional education expert Scott Reeves.

Even more exciting is the fact that they now have a video recording of the play! Thanks to a collaboration with the National Patient Safety Foundation, the play was filmed when performed for 900 people at the NPSF Congress in New Orleans in 2013. You can either purchase the DVD, or rent/purchase the film online through vimeo.

The DVD has an introduction by Patient Safety hero Lucian Leape. Acting in it are physicians, nurses, and other health care professionals. The DVD also has a segment on how it can be used as a teaching tool in educational and healthcare institutions, as well as substitute scenes that can be used for different healthcare settings.  As well, included with the dvd is a short powerpoint on Team Intelligence that can be used in post-performance discussions.

You can learn more about the multiple ways to use Bedside Manners as both a powerful tool enhance patient safety as well as teamwork and collaboration in healthcare by going to their website www.bedsidemannerstheplay.com.

SPECIAL EVENT MARCH 5th!

Are you near the San Francisco Bay Area?

You’re invited to the world premiere screening of the play Bedside Manners and the launch of a new documentary film project “Beyond the Checklist” — March 5th at 7PM at Point Richmond.

The widely-performed play Bedside Manners dramatizes how failures in teamwork and communication cause hundreds of thousands of preventable deaths each year.

The film Beyond the Checklist will provide solutions to this tragic problem–ones that have been initiated and implemented by commercial airlines over the past 30 years to make airline travel safer than it’s ever been.

Join them for an intimate gathering at:

The Magick Lantern Theatre – 125 Park Place, Point Richmond, California
Wednesday, March 5, 2014 at 7:00PM

Film showing will be followed by Q&A with the playwright Suzanne Gordon, film-makers Ed Herzog and Bob Laird, and airline pilot Patrick Mendenhall. The panelists will be discussing their next health care-related film project, narrated by actor Peter Coyote – a documentary version of the book Beyond The Checklist: What Else Health Care Can Learn From Aviation Safety. They hope you’ll think about contributing to a documentary that offers a solution to many of the safety related problems depicted in Bedside Manners. Hosted by: Kathleen Burke, RN, patient advocate, Julia Hallisy, DDS, and former hospital administrator Gail Eierweiss. Wine and cheese will be served!

For more information about this event or to RSVP, simply reply to this email or call 510.842.5282.

For more on Bedside Manners and Beyond The Checklist, see www.bedsidemannerstheplay.com and www.beyondthechecklist.com.

Developing a Strong Simulation Operations Team

simulation staff development

Earlier this week I posted on The Most Common Mistake in Simulation Operations Hiring. There has been a lot of support for this article by both simulation community members and vendors alike! We continue this discussion with a recent poster entitled “Super Technical Teams: Continuing Professional Development to Support Sim Ops” from IMSH 2014 by Nicole Jones de Rooy, who works for the School of Medicine’s Simulation Program at Australia’s Griffith University.

Nicole reminds us that:

“Simulation Centres recruit staff from a variety of backgrounds – including people with distinct educational, clinical, technical and administrative skillsets. In practice, roles have been blended, and staff routinely find that they need to bridge multiple skillsets to complete their duties. 

These circumstances and the demands of keeping the magic going1 has seen individuals try to step up and address their individual needs with varying success or support. Circumstances force these staff to develop their missing knowledge in an ad hoc manner through trial and error and over time job satisfaction can decrease. 

As Simulation Centres grow in size and complexity, questions of their long-term staffing needs come to the fore. Only through a strong cooperative and collegial inter-professional culture and a more formal system of professional development, particularly for staff from technical backgrounds, will future success be assured. 

The author’s experience across several organisations informs a basic taxonomy of approaches for guiding the professional development of Simulation Centre staff, including: following student learning; inter-professional coaching and cooperation; mentoring; and formal training offered by associated institutions. Differing approaches will be suitable for organisations with different needs and budgetary capabilities. 

It is paradoxical that Simulation Centres, which are entirely focused on the professional development of their ‘customers’, are often not conscious of the role that professional development must play in the long-term delivery of their services. As well as looking outwards, Centres must looking inwards towards the skill set and skill mix of their staff. “

Nicole then helps us identify the roles involved, and plan for action steps to continue professional development and education with, or without, a budget!

You can download the entire Sim Tech Ops Poster by Nicole Jones de Rooy here!

Nicole has also put together some wonderful “scoop.it” online digests for Simulated Learning Environments and Workforce Training, which you should also really check out!


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What Else Healthcare Can Learn From Aviation

Beyond the Checklist

Beyond the Checklist has been reviewed as a book that “has the potential to revolutionize the structure of the healthcare system”. Watch this video highlight below to gain a better understanding about the opportunity that exists for healthcare providers to learn from the aviation industry.  All of which will have direct implications for the medical simulation community!

About “Beyond The Checklist: What Else Can Healthcare Learn From Aviation Teamwork and Safety”:

The U.S. healthcare system is now spending many millions of dollars to improve “patient safety” and “inter-professional practice.” Nevertheless, an estimated 100,000 patients still succumb to preventable medical errors or infections every year. How can health care providers reduce the terrible financial and human toll of medical errors and injuries that harm rather than heal?

Beyond the Checklist argues that lives could be saved and patient care enhanced by adapting the relevant lessons of aviation safety and teamwork. In response to a series of human-error caused crashes, the airline industry developed the system of job training and information sharing known as Crew Resource Management (CRM). Under the new industry-wide system of CRM, pilots, flight attendants, and ground crews now communicate and cooperate in ways that have greatly reduced the hazards of commercial air travel.

The coauthors of this book sought out the aviation professionals who made this transformation possible. Beyond the Checklist gives us an inside look at CRM training and shows how airline staff interaction that once suffered from the same dysfunction that too often undermines real teamwork in health care today has dramatically improved. Drawing on the experience of doctors, nurses, medical educators, and administrators, this book demonstrates how CRM can be adapted, more widely and effectively, to health care delivery.

The authors provide case studies of three institutions that have successfully incorporated CRM-like principles into the fabric of their clinical culture by embracing practices that promote common patient safety knowledge and skills.They infuse this study with their own diverse experience and collaborative spirit: Patrick Mendenhall is a commercial airline pilot who teaches CRM; Suzanne Gordon is a nationally known health care journalist, training consultant, and speaker on issues related to nursing; and Bonnie Blair O’Connor is an ethnographer and medical educator who has spent more than two decades observing medical training and teamwork from the inside.  

Purchase Beyond the Checklist through Amazon today!