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Flashcards in IPE Test 2 Deck (26):
1

Team roles

are sets of expectations that apply to people performing various functions. Team roles always exist in relationship with another role e.g. provider-patient.

2

Core vs Peripheral Team Roles

o Core ‐ team members provide care continuously to a patient
o Peripheral ‐ team members provide specific input dependent on situation or
point in care. Including peripheral members can be challenging to maintaining
group stability and creativity

3

Task/action roles help accomplish goals by

Task/action roles help accomplish goals by initiating actions, requesting and sharing
information, facilitating procedures, seeking and providing opinions, clarifying,
summarizing and synthesizing

4

Maintenance/social roles promote social support among individuals by

Maintenance/social roles promote social support among individuals by providing social
support, harmonizing, relieving tension, energizing, leading, following, compromising, and gate‐keeping

5

Responsibilities

Responsibilities are tasks that must be performed to meet role expectations.

6

Role responsibilities can be influenced by t

Role responsibilities can be influenced by team member by scope of practice,
disciplinary expertise, as well as the needs of the clinical situation.
E.g. Role – team scribe/historian. Responsibilities include recording all
medications, vitals, actions taken, key points of history, calls made for consultation or lab requests.

7

‘Response – Ability’

‘Response – Ability’ is a term used to ascribe roles dependent on the team member’s ability to respond in the moment.
E.g. In a team, Jean, a nursing student, is assigned the responsibility of conducting a basic physical exam of the patient, but is asked by the team leader to complete the patient’s medication history. Sam, a physical therapy student is the team scribe but is able to take over the physical exam. The team leader requests Sam move into this role to provide task assistance while Jean is occupied.

8

Role ambiguity:

Overall lack of clarity as to how a particular role should be performed can adversely impact performance. Lack of clarity about who is responsible for care and for decision‐making has often been a major contributor to medical error (as identified in root cause analyses of sentinel events and poor outcomes). Degree to which patients and families are included as active team members and how to coordinate their participation can challenge teams

9

Role conflict:

Actual incompatibility between two roles inhabited by one person. Exacerbated through role expansion (common in health care). Not meaningfully associated with poor performance

10

Power resides in

resides in the relationships between people...

11

Power is performed during the communication interactions and is exercised by the person who

 defines terms
 creates the agenda
 limits information
 determines participation
 pays attention to and gets paid attention to
 uses talk time
 silences
 closes discussion

12

Reward power

based in ability to grant or deny rewards to someone

13

Coercive power

based in ability to threaten punishment

14

Legitimate power

based in positional authority over someone

15

Referent power

based in identification with others

16

Expert power

based in certain knowledge, skills or information

17

Connection power

based in who others know and their larger system of support

18

Authority

Authority is a legitimate or socially sanctioned use of power and can be charismatic (personal characteristics and power), traditional (positional, based on tradition), legal-rational (bureaucracy).

19

authority gradient

Most teams require some degree of authority gradient otherwise roles are blurred and decisions cannot be made in a timely fashion. Effective team leaders consciously establish a command hierarchy appropriate to the training and experience of team members.

20

SBAR provides a framework for

SBAR provides a framework for team members to communicate about a situation. In health care it is focused on communicating critical information about a patient’s condition. Importantly, it provides a vehicle for team members to speak up and express concern in a uniform manner.

21

SBAR

• Situation—What is happening with the patient?
• Background—What is the clinical background?
• Assessment—What do I think the problem is?
• Recommendation—What would I recommend?

22

handoff

There are also times when a team member will be temporarily or permanently relieved of authority and responsibility. At those times there is a risk that necessary information about the patient might not be communicated.

23

The handoff strategy is designed to:

 Transfer knowledge and information about the degree of uncertainty (or certainty about diagnoses, etc.), response to treatment, recent changes in condition and circumstances, and the plan (including contingencies).
 Transfer authority and responsibility to maintain continuity of care despite changing caregivers and team members.
 It also includes an opportunity to ask questions, clarify and confirm.

24

Handoff acronym

"I PASS THE BATON"

25

"I PASS THE BATON"

I
Introduction

P
Patient

A
Assessment

S
Situation

S
Safety

THE
B
Background

A
Actions

T
Timing

O
Ownership

N
Next

26

"I PASS THE BATON" - In depth

I
Introduction
Introduce yourself and your role/job (include patient).
P
Patient
Name, identifiers, age, sex, location.
A
Assessment
Present chief complaint, vital signs, symptoms, and diagnosis.
S
Situation
Current status/circumstances, including code status, level of (un)certainty, recent changes, and response to treatment.
S
Safety
Critical lab values/reports, socioeconomic factors, allergies, and alerts (falls, isolation, etc.).
THE
B
Background
Comorbidities, previous episodes, current medications, and family history.
A
Actions
Explain what actions were taken or are required. Provide rationale.
T
Timing
Level of urgency and explicit timing and prioritization of actions.
O
Ownership
Identify who is responsible (person/team), including patient/family members.
N
Next
What will happen next? Anticipated changes?
What is the plan?
Are there contingency plans?