The art of handling crisis:
- EM
- May 2, 2021
- 2 min read
When thinking about Crisis Resource Management, some would name it non-technical soft skills. As an extra set of skills to add for healthcare personnel. But those skills are far from being soft, as it's the hard core skills that differentiate critical care and emergency personnel in their day to day practice. Given that the day to day chaotic work environment, high complexity and demanding pressures are inevitably notorious for human and system errors.
There is this great example how extensive training can result in improved outcome in high stake situations. Where prior Navy training helped this pilot in one her domestic flights where the airplane lost one of its engine, and she had to land this aircraft safely.
The adaptation of Crisis Resource Management principles from the aviation industry into Emergency Medicine training have resulted in great impact of better staff preparation, improved team work dynamics and patient safety.
Know your Environment:
familiarize your self with the physical space if new to you.
Locate your anticipated equipment and make sure they are functioning well.
Try to get to know the team you'l be working with and understand their capabilities. (especially if leading a multidisciplinary team)
Think ahead, Anticipate difficulties and share your plans:
identify factors that can affect performance of complex tasks:
Environmental setting: (interruptions, equipment failure, handovers)
Self factors: don't under estimate the HALTS factors:
Hungry, Angry, Late, Tired, Stressed.
Use Check lists to share the same mental model of the situation with your team.
Ensure effective communication:
Closed loop communication:
Sender ensure the message intended is received to the intended person, and receiver acknowledging to receive the intended message.
Clarify any misunderstanding to avoid confusion. Try to avoid assumptions.
Assign clear roles to your team based on their level of comfort and experience.
Establish shared cognition with your team by setting clear goals and expectations.
Ensure leadership role with a balanced collaborative team work:
Adapt participative decision making process and use collaborative approach to deal with conflicts.
Identify and share the common goal you intend to reach as a team.
Gather feedback from you team to approach the critical situation in hand.
Situational Awareness:
Ensure to monitor internal and external environments (family members interruptions, deterioration of patient vitals)
Delegate the tasks and distribute the workload to maximize your situational awareness.
Monitor and anticipate fixation errors
involve appropriate expertise in a timely manner.
More reading and references:
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