American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Incoming Presidential Address
Kindling Synergy: Building Effective Teams
Chris McKenna, MSN, CRNP Children’s Hospital of Pittsburgh of UPMC
Disclosure Information Speaker: Chris McKenna
I have no disclosures.
Accreditation Statement APSNA is an approved provider of continuing nursing education by NAPNAP. The NAPNAP contact hours is accepted by ANCC.
Objectives
Upon completion of this presentation, participants will be able to: • Define teams and teamwork • Describe essential roles of team members • Discuss characteristics of high-functioning
teams
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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“The greater our knowledge increases the more our ignorance unfolds”
-John F. Kennedy
How many of you think John F. Kennedy was a good president?
How long did it take to replace him?
Wednesday, April 9, 2014 8:05 AM
• Trauma pager: Level 1, 15 yo male, stabbed in chest and abdomen at school, difficulty breathing, coming by STAT, ETA 12 minutes
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Wednesday, April 9, 2014 8:12 AM
• Trauma pager: Level 1, 16 yo male, stabbed in chest at school, difficulty breathing, coming by STAT, ETA 10 minutes
Synergy (Wikipedia)
Synergy is the interaction of multiple elements in a system to produce an effect
different from or greater than the sum of their individual effects.
The term synergy comes from the Greek word synergia συνέργια from synergos, συνεργός,
meaning "working together".
Definitions of Team
Wikipedia: A team comprises a group of people or animals linked in a common purpose. Teams are especially appropriate for conducting tasks that are high in complexity and have many interdependent subtasks.
Merriam Webster Dictionary: 1team noun \ˈtēm\
• a group of people who compete in a sport, game, etc., against another group
• a group of people who work together • a group of two or more animals used to pull a wagon, cart,
etc.
Group Team
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Definition of Teamwork
From The Business Dictionary: “The process of working collaboratively with a group of people in order to achieve a goal.”
“Teamwork has its own arithmetic. Combine two or more people with a
common goal and suddenly one-plus-one is more than two.”
-Dan Zadra
Examples of Teams
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Cincinnati
Undergrad
Cincinnati
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Mike Hirsh, MD
Massachusetts
Mike Hirsh, MD
Massachusetts
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Pittsburgh
Pittsburgh
Barb Gaines, MD
Pittsburgh
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Trauma Program
Why Are Teams Important?
Command Physician- Surgical Fellow or
Senior Surgical Resident
Airway Management Physician-
CCM Fellow
Assisting Surgeon Right-
Junior Surgical Resident
Respiratory Therapy
Trauma Physician Left -ED Resident
Trauma RN Right
Trauma RN Left
Airway Management Physician Backup-
Anesthesia / CCM Attending
Assists Command Physician with assessment and stabilization of
injuries
Responsible for medical/surgical intervention as
directed by Command Physician
Provision of patient care at the direction of the
Command Physician
Assumes overall responsibility for
trauma resuscitation, team function, and
code evaluation. Assigns area(s) of management to individual team
members
Provision of patient care at
the direction of the Command
Physician
Trauma PCT Left
Stabilization and management of
airway with C-spine precautions at the direction of the
Command Physician
Assists with stabilization and management of
airway at the direction of the
Command Physician
Management of ventilatory support at the direction of
the Airway Management Physician or
Command Physician
Medication RN
Responsible for all resuscitation medications, and provision of patient care at the direction of
the Command Physician and Airway Management
Physician
Documentation RN
Ensures accurate and complete Trauma
Flow Sheet documentation
Trauma Surgical Attending Physician
Oversees trauma
resuscitation
ED RN Clinical Leader
Ensures appropriate staffing for trauma
resuscitation
Emergency Department Attending Physician
Oversees trauma
resuscitation
Emergency Department Fellow or Resident
Physician
Role TBD
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Back to our story…
• At Children’s – 1 patient emergently to OR – 1patient with chest tube in trauma bay – 3 treated and released
Franklin Regional
• 22 patients • Four helicopters (with two more on
stand-by), 11 ambulance companies – Closest trauma center- 8 patients – 3 other trauma centers- 1 patient each – Children’s- 5 patients – Non-trauma center- 10 patients (some
transferred)
Current Status
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Examples of Teams
• Sports • Healthcare • Industry • APSNA
Roles of Team Members
• Leader • Content Expert • Devil’s Advocate • Detective • Cheerleader
• Doer • Problem-solver • Other roles
• What makes a good day?
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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• What makes a good day? – Got lots checked off my to do list – Left (relatively) on time – Adrenalin rush
Principles of Team-based Health Care
• Shared Goals • Clear Roles • Mutual Trust • Effective Communications • Measurable Processes and Outcomes
Characteristics of High Functioning Teams
• Cooperation • Equality • Coordination • Engagement
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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APSNA
• Mission: To promote excellence in pediatric surgical nursing practice through educational offerings, nursing research, professional collaboration, and peer support.
• Vision: All pediatric surgical patients will receive the highest quality nursing care that is patient and family centered.
APSNA
• Values: quality, compassion, family-centered, respect for diversity
• Goals & Objectives: – To promote the subspecialty of pediatric
surgical nursing – To serve as a resource for and provider of
pediatric surgical nursing education and research
– To provide a networking structure – To maintain communication systems
Why Are Teams Important?
• Patient Safety • Patient and Family Centered Care/The
Patient Experience • Patient Satisfaction
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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How To Build Effective Teams
• Formal Program – Crew Resource Management – Team STEPPS
• Plan • Practice – Simulation
• Debrief • Communicate, communicate,
communicate
Communication is Everything!!!
Five Processes to Improve High-Risk Team Effectiveness
1) Maintain Situational Awareness 2) Talk to the Room 3) Explicit Reasoning 4) Speaking Up 5) Closed-loop Communication
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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• Vision for your life? • Vision for your career? • Vision for APSNA?
• My commitment to you… APSNA membership and fellow board members…
The Breakfast Club
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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“Understanding and accepting diversity
enables us to see that each of us is needed. It also enables us to begin to think about
being abandoned to the strengths of others, of admitting that we cannot know
or do everything.” -Max DePree
“ We Save Lives”
High Functioning Teams APSNA
Challenge: How do we harness all of the talent, energy, and enthusiasm in this room and this organization?
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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Opportunities
• Share your expertise – Poster – Oral Abstract – Presenter – Teaching Sheet – Journal author
Opportunities
• Share your ideas and enthusiasm – Committee – SIG – Board
Opportunities
• Share your opinion – Complete your evaluation!!! – Send me an email: [email protected] – Call me! 412-692-6503 – Text me! 412-605-8184
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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If you want to travel fast, go alone. If you want to
travel far, go together. (African Proverb)
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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"Alone we can do so little; together we can do so much.“ -Helen Keller
CHP Team
American Pediatric Surgical Nurses Association 111 Deer Lake Rd., Suite 100● Deerfield, IL 60015 ● http://www.apsna.org
23rd Annual Scientific Conference | May 26-29, 2014 | Phoenix, AZ
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“Never doubt that a small group of thoughtful, committed people can change the world. Indeed, it is the
only thing that ever has.” -Margaret Mead
References
Clark, R. & Greenawald, M. (2013). Nurse-physician leadership: Insights into interprofessional collaboration. Journal of Nursing Administration, 43, 653-658.
Putnam, J., Ikeler, S., Raup, G., & Cantu, K. (2014). There’s no “I” in team: Evaluating nurse-physician collaboration. Nursing Management, January, 10-14.
Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb., C., … Von Kohorn, I. (2012). Core principles & values of effective team-based health care. Discussion Paper, Institute of Medicine. Washington, DC. www.iom.edu/tbc.
Zadra, D. (2006). Together we can: Celebrating the power of a team and a dream. Seattle: Compendium, Inc.
Salas, E., Tannenbaum, S., Cohen, D., & Latham, G. (2013). Developing and enhancing teamwork in organizations: Evidence-based best practices and guidelines. Danvers, MA: Jossey-Bass.
Children’s Hospital Association. (2013). Building Effective Teams. Retrieved from chex.omnisocialpc.mzinga.com