Safety in Anesthesia and Intensive Care

Transcription

1 Safety in Anesthesia and Intensive Care How Team Spirit Affects Patients Outcome Prof. Dr. Martin Westphal Department of Anesthesiology, Intensive Care and Pain Medicine University Hospital of Muenster Chief Medical Officer Fresenius Kabi AG Bad Homburg, Germany

2 Working in anesthesia and the ICU Always challenging

3 How it should be? Respect and communication between the members of the stuff (physicians, nurses, physiotherapists etc.) Supervisors provide teaching and encouragement to residents Residents are thankful and respectful to supervisors Important decisions are explained to every involved member of the team (especially the when and why )

4 Working together could be so easy

5 How the reality may look like Every group works on his own Only essential details (if at all) are communicated Surgeons complain about nurses, nurses complain about patients and everybody complains about the anesthesiologist Work may be done because of necessity rather than conviction

6 Let s talk about team spirit

7 Back in 1991.

8 I am convinced that Team spirit, passion and humour are important contributors to performance and positive outcomes in anesthesia and the ICU

9 Is team spirit important in anesthesia and the ICU? Yes, acting as a team is essential in the ICU (and elsewhere)! Every profession is doing its part, but the team members are connected and (should) have a common goal Positive team spirit increases performance and satisfaction of team members Better team performance increases safety for patients Ideal combination: Team spirit and passion for the shared responsibility So how do we reach this?

10 Does an excellent physician need team skills?

11 125 ICM elite professionals were asked to name four outstanding ICM professionals (direct or indirect contact) Furthermore, they were asked to list the attributes that made these physicians excellent practitioners Ninety-six professionals from all over the world responded Attributes were ranked and listed

12 Listed attributes and their ranking

13 Results: In this analysis, attributes of excellence were listed according to the input from ICU elite professionals worldwide In addition to knowledge, commitment and clinical skills, team work and communication skills were highly ranked^(6 th and 8 th position)

14 So how does one improve team spirit best? Money? Coaching? Threats? Maybe better: Passion Humor

15 Humour and laughing at work just funny or even useful?

16 54 team meetings were videotaped and analyzed regarding humor and laughter Team performance was measured immediately and 2-years later Results Humor patterns triggered positive socio-emotional communication, procedural structure and new solutions Humor patterns at team level were positively related to teamperformance (under low job insecurity climate conditions)

17

18 Teamwork: The sorcerers' stone? Force I Common force Force II

19 Teamwork and safety Teamwork improves safety Some might have other methods

20 Another safety approach: The WHO checklist

21 Another safety approach: The WHO checklist Checklist requires (at least some) communication between anesthesiologists and surgeons This may not guarantee an improvement in team spirit, but is certainly a move into the right direction Helps to focus on relevant issues, thereby increasing patient safety Other problems might be recognized as well But whatever you do

22 Never underestimate your power! And in the left corner, with 2782 knockouts

23 Conclusions Team skills and communication skills are essential for working in anesthesia and the ICU Positive team spirit improves team performance Better team performance increases patients safety Coming together is a beginning. Staying together is progress. Working together is success. (Henry Ford)

24 Have fun at work!