Transcript Situation Monitoring

Situation Monitoring
Situation
Monitoring
Objectives
 Discuss how situation monitoring affects team
processes and outcomes
 List components of the STEP mnemonic
 Explain situation awareness and identify
undermining conditions
 Define a shared mental model and how it is
cultivated within a team
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Situation
Monitoring
Endsley and Jones (2012) discussed Situation
Awareness as “being aware of what is happening
around you and understanding what information
means to you now and in the future.” The key
concepts:
 State of the environment.
 Decision-making ability.
 Performance of actions.
 Feedback that helps to identify important issues.
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Situation
Monitoring
Endsley (2012) Situation Awareness
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Situation
Monitoring
Situation Monitoring
Columbia Space Shuttle Disaster
Nova documentary
Video #1
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Situation
Monitoring
Situation Monitoring
Columbia Space Shuttle Disaster
Nova documentary
Video #2
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Situation
Monitoring
Situation
Monitoring
 Ensures new or
changing
information is
identified for
communication
and decisionmaking
 Leads to
effective support
of fellow team
members
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Situation
Monitoring
A Continuous Process
Situation
Monitoring
(Individual Skill)
Situation
Awareness
(Individual
Outcome)
Shared
Mental Model
(Team Outcome)
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Situation
Monitoring
Situation Monitoring
Code Black
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Situation
Monitoring
Components of
Situation Monitoring:
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Situation
Monitoring
Status of the Patient
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Patient History
Vital Signs
Medications
Physical Exam
Plan of Care
Psychosocial Condition
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Situation
Monitoring
Team Members
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Fatigue
Workload
Task Performance
Skill Level
Stress Level
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Situation
Monitoring
Situation Monitoring
How Did Dallas Nurse Catch Ebola?
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Situation
Monitoring
I’M SAFE Checklist
I = Illness
M = Medication
S = Stress
A = Alcohol and Drugs
F = Fatigue
E = Eating and Elimination
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Situation
Monitoring
Environment
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Facility Information
Administrative Information
Human Resources
Triage Acuity
Equipment
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Situation
Monitoring
Progress Toward Goal
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Call a Huddle!
Status of Team’s Patient(s)
Goal of Team
Tasks/Actions That Are or
Need To Be Completed
 Plan Still Appropriate
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Situation
Monitoring
Situation Awareness is…
The state of knowing the current conditions affecting
one’s work.
Includes knowing…
 Status of the patient
 Status of other team
members
 Environmental
conditions
 Current progress
toward the goal
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Situation
Monitoring
Conditions That Undermine
Situation Awareness
Failure to
 Share information with the team
 Request information from others
 Direct information to specific team members
 Include patient or family in communication
 Utilize resources fully (e.g., status board, automation)
 Maintain documentation
 Know and understand where to focus attention
 Know and understand the plan
 Inform team members the plan has changed
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Situation
Monitoring
A Shared Mental Model is…
The perception of, understanding
of, or knowledge about a
situation or process that is
shared among team members
through communication
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Situation
Monitoring
How Shared Mental Models
Help Teams
 Lead to mutual understanding of situation
 Lead to more effective communication
 Enable back-up behaviors
 Help ensure understanding of each other’s roles
and how they interplay
 Enable better prediction and anticipation of team
needs
 Create commonality of effort and purpose
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Situation
Monitoring
When and How to Share?
When:
How:
 Briefs
 SBAR
 Huddles
 Call-outs
 Debriefs
 Check-backs
 Transitions in Care
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Situation
Monitoring
Tools & Strategies Summary
BARRIERS
 Inconsistency in Team
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Membership
Lack of Time
Lack of Information Sharing
Hierarchy
Defensiveness
Conventional Thinking
Complacency
Varying Communication Styles
Conflict
Lack of Coordination and
Followup With Coworkers
Distractions
Fatigue
Workload
Misinterpretation of Cues
Lack of Role Clarity
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TOOLS and
STRATEGIES
Communication
• SBAR
• Call-Out
• Check-Back
• Handoff
Leading Teams
• Brief
• Huddle
OUTCOMES
 Shared Mental Model
 Adaptability
 Team Orientation
 Mutual Trust
 Team Performance
 Patient Safety!!
• Debrief
Situation Monitoring
• STEP
• I’M SAFE
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Situation
Monitoring
Situation Monitoring
Mayo Clinic
Video #1
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Situation
Monitoring
Situation Monitoring
Mayo Clinic
Video #2
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Situation
Monitoring
Situation Monitoring
Mayo Clinic
Video #3
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