Leadership, teamwork and resuscitation aids

3 Leadership, teamwork and resuscitation aids



Chapter Contents



Introduction


Pointers for effective team leading


Conclusion



Introduction


Leadership competence is often overlooked as a core proficiency in clinical medicine. In emergency medicine, the ability to influence a team of personnel treating a critical patient is vital for a successful outcome. In the ED, since a team of rescuers is usually working simultaneously on a patient, this group must have a team leader to direct their efforts towards a common goal. Furthermore, a well-organized team of people can perform rapidly and achieve a great deal in a short time.


Too often this imperative is overlooked and mayhem is the order of the day, with too many people calling the shots with no apparent direction, or no-one willing to take the lead, resulting in a laissez-faire cop out. The patient bears the ultimate brunt of this failure to lead a team of individuals toward the common goal of effective and efficient resuscitation.


The good news is that leadership in this context is a skill that can be learnt and improved upon. For example, it has been shown that even one person trained as an ALS team leader can impact survival positively. Here are a few pointers to assist you:



Pointers for effective team leading




1. A leader must firstly be identified – either a willing volunteer or a pre-appointed senior clinician could assume this role. If possible, pre-allocation of roles, especially the team leader role, can avoid delay and consternation when an actual resuscitation is encountered.


2. Confidence comes from practice and is vital for a resuscitation team leader. It comes from knowing the resuscitation guidelines (or other protocols) well enough to apply them automatically. Do as much clinical work as you can under an experienced team leader whom you respect. Confidence also comes from good quality, practical, integrated, scenario-based training (see Box 3.1).


3. Self-confidence is also derived from knowing where to access the information you need during the management of an emergency. It is important to know where to get the information, the relevant algorithms and resuscitation aids, as well as how they work. Do not be pressured into trying to recall information, dosages and causes. It will be far more accurate and consistent to refer to resuscitation aids (see Box 3.2).


4. The leader should delegate functions to each team member in accordance with their expertise, experience and abilities. This can either be done immediately as the team forms around the patient or at the beginning of the shift in an ED.


5. Management by objectives is an age-old leadership tool which can neatly be applied in the resuscitation setting. The objectives for the resuscitation or medical procedure (e.g. rapid sequence intubation), as well as how these will be achieved, must be clear to all concerned. These should be voiced during the actual resuscitation so that everyone involved knows what is intended, or which algorithm is being followed, or what is being prepared and anticipated.


6. Managing by measurement is another leadership strategy which, when translated into ED practice, dictates that the ultimate goal beyond a single resuscitation is to improve performance by learning from experiences, mistakes and successes. The only way to improve quality is to measure everything that is being done, so that this can be assessed and reflected upon to identify gaps, errors, and areas for improvement. The time taken to perform interventions, the sequence of events, all results, drug and defibrillator energy dosages should be recorded to help the team leader keep track of progress, and to document a detailed synopsis of the resuscitation for the clinical records. This is vital for meaningful review and research purposes.

Related posts:

Default ThumbnailDrug dosing guidelines: Pearls and pitfalls Practical pharmacology in paediatric emergencies How to use this book Equipment guidelines: Pearls and pitfalls Emergency infusions dosing charts Useful formulas and information for managing paediatric emergencies

Stay updated, free articles. Join our Telegram channel
Tags:
Jun 14, 2016 | Posted by in EMERGENCY MEDICINE | Comments Off on Leadership, teamwork and resuscitation aids

Full access? Get Clinical Tree
Get Clinical Tree app for offline access