Understanding multiteam systems in emergency care: one case at a time
Lazzara, Elizabeth H.
Keebler, Joseph R.
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Paul Misasi , Elizabeth H. Lazzara , Joseph R. Keebler (2014), Understanding Multiteam Systems in Emergency Care: One Case at a Time, in Marissa L. Shuffler , Ramón Rico , Eduardo Salas (ed.) Pushing the Boundaries: Multiteam Systems in Research and Practice (Research on Managing Groups and Teams, Volume 16) Emerald Group Publishing Limited, pp.157 - 183
Purpose - Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs). Approach - To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case. Findings - Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions. Originality/value - By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.
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