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Trauma - Non-technical skills - CW

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Summary

This on-demand teaching session is tailored to medical professionals, offering a comprehensive introduction to technical skills and human factors relevant to the setting of trauma. We will learn about the different techniques and processes involved, such as checklists, communication techniques and leadership, as well as how to make sure the patient's safety is the main priority at all times. We will draw on evidence, case studies, and the Swiss Cheese Model to understand how to avoid patient-safety incidents whenever we can. This is a great opportunity to succeed in providing safe care to all our patients.

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Learning objectives

Learning Objectives:

  1. Understand how various patient safety initiatives can reduce the incidence of avoidable harm.
  2. Understand the core components of the Swiss cheese model and how it applies to safety in the workplace.
  3. Recognize the importance of the use of communication with clarity, urgency and precision in medical settings.
  4. Use an established checklist to execute surgical or technical procedures effectively.
  5. Analyze and apply human factors principles to develop efficient and safe team practices.
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Computer generated transcript

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The following transcript was generated automatically from the content and has not been checked or corrected manually.

morning old man's calling here, going to check you today Trauma or technical skills? So we're gonna go through a brief introduction to your doctors on technical skills. Sure, you, some of these ideas and your healthcare Jennings for we'll talk a little bit about why he's How did your foods mark issues and how they help us batter traditions at to go after our patients better make sure that the work that we're doing if active, but probably not that it's see if patients we're going to apply these. Teo the setting of trauma. That's a trauma study day that's going be some evidence that you could take with you hopefully to think about even better. Change your behaviour. Whatever you're carrying. A trauma pictures you could read the colon screen. You've heard this many times. I do subscribe to this, however, just to So how do we get health care to A. To see if I come in For the people that are patients? Well, there's a journey get warm or halfway along that you have to say it's a massive journey. Yeah, but really, it's a bit high. We freeze kiss by case basis for physicians by organization. Business things. See if we do, you know that. Aren't you working a healthcare? We see that sharp band of this needle speak, but really, some of these things with some of the doctors. Well, something I think we can do. That safety profile on a day to day basis visited the questions. So, just briefly, I want you to come up with three numbers or 3% is what percentage a piece experience patients experience a patient safety. That's These are patients, By the way, how many percentage of patients experience a patient sees of these incidents? Hypomanic should get the death of the patients. Uh, ultimately what? We're interested today. What percentage of these December? So colossal. Okay, hopefully a good three numbers, but that's 1% of patients experience a patient, See if the answer off the admission. So they were looking at the data. This is a tablet application. Your admit it. Have a peach to see if the van's well. So what you say, You know, a lot of time weren't good enough. We could pick these sticks up and we work together as a team company took the backs, but actually the doctor would suggest that off those patients that suffer and it's in a 10% of that. What does that mean? What is that number? Looks like I'm gonna show your numbers x lighter to say from how many patients come on the question that I am interested in a lot of dressing and what could we do it? But many of these could be appointed. Well, good, yes, off the 70% off, these incidents can be avoided. Hopefully, Uh huh. For the pitch, the trauma patients, we expansion chance agents that experience it's it's 2, 50 or 70% of that, for usually was that are interested on the side of this? This quits to a 0.2 billion points, just deficiency that can be translated into the doctor's assistance and our environments. We have a faster than dressed both of our patients, probably, but also to previous the future cumin errors in healthcare. So 10% that can't The heart was after the I think, but actually, you know, this is being a daughter that is self reported, and this is the keppra the iceberg. But you can see how many do not Even that's probably the vast majority of that happened, we could be tweaked, but they tol possibly have recorded. This's really a doctor estimate off the 10% that do you suffer incident. This is the number that comes every year. You know that that's a staggering over 65 patients a year suffered peace and see if the answer that chance to really for patients. So that's why we're very so they have clinicals ever side. My first student supplies for everyone the cops work in the chest or good efforts that perhaps it there don't have the skills factors. Previous work visas discovered a great deal by Cupid. It's difficult mask. Spicer's Will changing are working practices. On this kind of a year ago, we were changing on a day by day basis, critical. So see parts of tickets to sleep on Ever crease. Be difficult. I really hope practices that those talents I ever do that they are for no safety. December percent of these issues are avoidable, even in the setting. Last ppd. Spent what my system's way have fasted. Interesting Judy of character pitch to get good, Better these well seen these before. These methods that existed health care whether they've been expensive. We've had first hopping able to this or and sometimes they're a little bit. It is had curricula. Talk with healthcare forces that postcard matter what your professional sign if we just try harder, really disconsolate, focused, work harder to go. Really, it's off. Well, it's not realistic state. Now people are being asked the extra stress on extra. Judy's taking one responsibilities. There is a little point, but that cough mom, that's well slept be police. So what? The other side of that? There's a weekly difficult publishing. It's not just got some people that have taken the people like their their interests just don't like that hard enough. We said that one extra training was supervised courses with sets for objectives. You get money? Six. Really, That's not true. It's just how it just mark. I'm sure you've all been not. So this comes down into that this out first thinking about really some of these attacking the factors but really technical skills where we can that we stopped this patient. See if the incidences was off the heart, not comfortable. But if we are a well first well drilled these I believe literature that suggest that we could drastically. Oh, here we go. Swiss cheese model We've all seen this many times. This is trauma is no definite at a manager for processes, a playbook vigil level high that, um, it's a sensitive to the the environment there, working in which for us, a wrench departments can't be average each cheek and ever flux it. But then the processes and play All of these line up, but you could see there can be. Losses of losses are pinched. Safety harms patients if the incidence both either death better, they that that our patients suffer. And that's really what we're trying to do. Some of the skills will talk about today, will apply to the individual. Someone will be a team. There are environmental factors on the protests. Touch it all of these really today because the or slices we prevent there last likely it is that our patients So what are these human factors of these technical skills? After that bit of a preamble with science concerned with understanding the interactions among came It's off balance system. Other patients, if I How do we really it to each other, direct with each other situations of directions. Essentially, it's how do we do what we do in our office? Do you sleep again? Was Asian factors the relation factors? Research is researchers on the beach with us again, it is. Avoid human beings there road in their work. This how you could be better design the system off, are running the individual around the environment. They working well. Looky research being done across many industries taking it back about first women's first line by airline. Be clear about me away that have really got themselves to position being off to see if it was many different ideas about, uh, hiking. Approved. See if the on again this rings true. And some of that. The medical health care in the future. Research done on my patient safety as well to go on needed huge working necessary to use ice is really he identified when it comes time to trying to prove patient safety across the board, there are four real big headers that you can focus, but this place a trauma prices surgery in a place to keep keep Actis right across healthcare. So these are the four will focus on today. Just use the time streets, Jack List communication leadership on importantly, followership on that. Some of the process a supply of trauma. So check list. This is going on these surgical safety checklist. Quite with this sex checklists were that spot like hey, looked at across many different satings developed and first receptors as wells, Rural health care statics. They work. Yeah, not without a panacea, but they supply That's the great culture and see if he can you do get drastic. Interestingly enough, the top of the second column, the first box for a while. Teenagers have introduced sounds. Maybe, um, it was the one start peace, Uh, when you took a walk, except if it's for a checklist on enough before I said Really was bad for all the members. Introduced Sounds. Doesn't matter where you're working. That doesn't matter. It's a surgical safety checklist before operation or you'll see some additional this piece off. This no good of information is keep. Here we go. This is there, one that we have at ready for use in our be so strict, because I have to admit, I just always get used. But it's when the interventions. So it's a checklist. We have them in our e d of many different four months. This is what people use for any emergency. Entravision on again can be used settings. Trauma. You can see they're prepared. Tape all the kids bones. You should take a leader. Do we need to call anybody else for the help needed? So again, it's a technical side, highly like it looks like. Hopefully, if you see my realize that's for needed something. Well, you'll see something. Skills, another form of checklist. So we're not just taking a box here on what we're doing is a jigsaw puzzle are kept up again or the source base of these. But essentially, it's a checklist a different way. So don't just think that was a little box attack. Many different forms of Jack this, but they can't drastically improved off that. The culture about was, I eat how much more customers you breathe at the end of band or our person for like the task. You've got a checklist. He admit why I kept drastically. It's all these whatever number two that go on their data. Five. Was communication, a storage burn itch. All says it's necessarily that that already exists. This is tricky on always well, they There's no one easy fix for communication and regions. But hopefully we go through a few bets that really that my practice of my experience really reduced. Likely. Why doesn't feel Michael's wrong? Well, there are many different caveats, and if you have more time to play through these, both teams a few bits. But really, this lack of urgency really hire two different beast high second, your company to find it. This was back up many years ago in its development off the huge of the pew score for each individual fish is commonly given and a sense of urgency. That direction of travel for this patient, the lack of critical language began critical, and you talk about the waist here body for Do you have a second child with lunch? Rash has a temperature. He's got the period of the last six. Ours really. Do you have a query? Manage itis Meningitis. The word Majesty, a pediatrician. We'll get that instantaneous response. Uh huh. So it's using that language appropriately, avoiding up acuity, right? The fashion structure. This is where as far comes in and again you're off the other systems with the indigestion. Why they adopted as far situation back response a lack of mutual respect that we talked about this in a little better. Uh, we discussed talk to your Children are 26 over very. And this this idea of closed so the head and hope this is really, uh, pipe at the language that we use. Hey, really close attached. Oh, what we say if we say the shots or no, the PSATs are below 80%. Sunset up in these air a leg samples of different ways. You kidding? Trying not time. Couldn't conspiring to really give me a satchel. Information and concise fashion sorts of step below below 90% to storage, fished attempt at the oxygen. Very clear. Direct step. And to bring everybody on for sure that that bottle we're not. Do you think you've had enough time there? I'm not sure that the satchel of the whole for this, these are all, um, figured biggest. That's so basketball. Take practice. You have to see somebody. But it's really important that we get it right. Closed loop communication. This is really a feedback mechanism widely used across many definitely streets. But you'll hear us doing it on a shot for, um Well, again, a lot of this. A lot of you will do the tube of late. Our colleagues sent to be absolutely actually to this particular about six and seven is cold. You don't speak to the medical institute, he still have a fish. Oh, by the way, come back and tell you because they know what a way So absolutely just closed kids. Does the picture that I have My my percent. It's, uh, seeing that nature seems like it's really just can you could confirm that the past improved communication. So how do we go about it? Well, the shallow hierarchy and you've heard me go on. But first, the entire so important. But he's pretty much on the We want first term. Real reason for that. Greedy it there, this critical language we talked about this. That postpartum hemorrhage is that I think a couple child what is the critical language is how we be precise with closely really confirmed that the patient that the person that you're asking could do a task. One is able to do that to come back from the past briefings again. You'll see this down the street like this. Pre brave with what? A few bottles. But they're sharing the mental models something called the street of consciousness. But really, that looking after a patient, you Can you can you describe what your thing? I like this fish against that rest of the tape. A chance to really evaluate that feed in any extra information Will either firmer or maybe a prompt a response from you. Uh, or I'll remember starting to really, really about You know how we got this right? Do we need to stick again? I'll be on the right track. Really? Sharing that metal on with the rest of It's absolutely key. Keep it the fish. 60 bills number three. That was leadership on the portal Followership. So Fuller Ship has been on that laterally in recent years. But really leadership for the was there. So again, a little pop quiz there. That may just be the Hobbit prizes for anybody that come back on the group shot. I give me the beings before people like you see on screen, you know, for about 20 seconds. So maybe I hope you don't be there because you're giving presents. If anybody needs clarity. Me what? Their legends, right and different capacities. Different news. But they all deserve the title off a create leader. My No. So here it is. It's, uh, it's three. In the morning. There's been an RTC. Uh huh. It's yourself one of the rescue in resource. You are about six. You have to junior but capable of confident. It's a very sick patient. It's a trauma call. There's a lot going on. A lot of people. It's noisy and blood products on the form fever you're trying to realign. Not me to help with Binder. They're away issues. We're trying to get that statics to manage a difficult airway, because patients I could put you on that situation on that surround. This is difficult, but all of us the consult works it on everybody. Lack of science. Johnny's right severance walked into the nail is here. Here is our credible, confident person outside of relief. Collective Saif. The recipe here is about your woman who knows what they're doing to take charge. You can effectively hounded some rules decisions and probably on a a fashion, really tick tick. True off this chaos, that's what the leader is you can look down almost conferences. You can see all that less than you could see that man. It faster me on. So I reacted that we do take that collective sigh of relief. Hard, big cup started, foot muscle tasks, everything leader that's treatable. This doesn't matter what, how we are exploring experience. We have, but not first right really important to recognize those people at work with them and see leadership ability to set the after action to really go over a nice deep, said a patient. What are they actually doing? Harder. They go about it Really a day supply to sleep or ship called me said See, there there's a point, that calm approach, mindfulness of off language, really thinking that step ahead. But some of it does come with experience. Doesn't matter what your professional background is experienced person. How's good leadership? All the feedback, sometimes I ever need arises. Looks like this. This is a difficult one. Uh, I like it nice. The decade nous and this leaders eyes like times. I'd be there personally as well. You just don't have any more decisions to get one crisis to another. You're trying to my situation is best you can Oh, really effects Are you just if you do decisions for the day, they're know well after that time. And so as followers with that not it's really important that you could try and support that leader. It really helped their help. Your talk about them help. Sometimes there is a little issue. There is a decision density that just stocks up. I'm really that leader that or I might not be the best. First one is that and it might not be in a situation physically, psychologically, emotionally to leave that pain, get the best I can for the patient, not support this followers that we recognize that assist those people to really do the best we could not You are someone else is not really taking on that ship duty. And I see that how the times that we've done it for each other and this is all part of working at the tape, but really just being mindful about were those people are in the system. We can see our hero arriving on a shining night of armor, but actually, it's just being called us. Is that, uh, you know, particularly and I, with their density off stations being asked the leader. It can be difficult at school support, and that's with the with the following to be supportive. Understand the situation may be actually at times to take that needle. Well, because ultimately that's a bite. Where that where that leaders, trying to get to inspire those people who are team members or take follows to that step up a pick up leaders. Enough. This why many people across the board with define good leadership, really essential part of being a good leader is to bring on those leaders in the future. Here's a slide on disability to the sir on increasingly commonly part by subject know overdo with in healthcare. We do know that them from the studies they would suggest that on a weekly basis, healthcare professionals would experience move this sensibility at the point of undermining or even aggression didn't speak to about 30%. Healthcare workers would experience that once a week. That's far too much, but we do know that that impacts their behavior in the work best that Paxil patient safety and had patients safety instability kills a lot of one that they cannot emphasize this enough that we must speak to each other, a professional aspect for water. There is so for its ability or weakness on my true but the language colleagues, patients by patients fight colleagues on four. There's no shortage of that conversation being overheard or thanks being said that wish they had. So please leave my form of I'd highly of drug plus each other a day. End of the day. A lot of this started would suggest that we know this itude of the is, well blue, the sensibility off the top of a feeling of stress or fear or anxiety. People may see like the depths. They may feel that they're over well, and so it's a port. Recognize a problem, too, that really trying to fuse and the issues before the arrives. Okay, we're coming on to our last topic technical skill point. If he's a processors, so listen. These are vast, varied within a burdensome and a simple, particularly the Detrol. There's a lot happening short speech on really as peace to ride, particularly the departments. Easy to look up the medical one, Cialis or Swellings Spierce, but actually is a shop way we can attribute Is there some way that we can reassess the situation? Body situation? Definitely. This has been done across for these processes. Could be back O. R. I grew to the point where a micro process that was my next was about the initiation of the major trauma, that work of which were apart. So again, a flux a drastic, very issue Care are constipated. Cheaper soften trauma will really have a central hope off. The Royal Major Trauma Center on a spook system has drastically improved the light off a trauma When I come to get a better year on here, yeah, has been established for that. It comes our benefit from a process there that's being looked at the dressed. This hope that spook trauma Unit Trauma Center model is a previous care of life. So it's a very low level, just doesn't know what could we do? Well, really, it is avoid getting closer to the patient in our day to day practice. This is one of the things we could do from a tape activation. You've seen this in our red and I asked, It's really just understanding what we're dealing with here. We have a physiology parameter on the left. We take any of those along west either that one or for a lot of meat. Medici In a setting of trauma, we should be setting off probably. So do you have a physiological disturbance with either and not only mechanism or a little bit of the yesterday that we need that would activate a tropical? But this is the honest. It's not a one stop shop process. Stop shopping pines could be re evaluated. It should be. Is this you might not meet criteria or I asked information. Standby foods might not be the criteria when the patient is a resource for the 1st 20 minutes, but it maybe half an hour or into that resource journey for the vision that drama activation could be done. According to this criteria, you will find us a Z, experienced trauma graders or consultants. We may decide to given our experience truck cool. A tropical before are really er than we do to check these boxes. It's absolutely fine. It's done in the appropriate, but really understand that the process is playing. How we better hold those processes to get a good patient. Yeah, we could take the process of looking ourself was in it so high the we'd monitor less if we talked about being high grade. It's an important one. Whatever the red for goes off the yeah, listen to you take the details. Then you ask what's the was in that EDTA in my head? I'm asking how if I had a drink? Do I need to do we? Is there anything else I can do to better prepare myself as an individual before the trauma rides that there is a little bit about a self care I would encourage you to do that with, regardless of trauma or no support, Your back is nice of science. With that yourself, this's a little bit of ah ha tickets. Well again along those lines. Take it to the next steps. It's called step up studio model. That was done on that. You could see the top there first. Three STV really revolver, right? Highly. Prepare the resource situation. I do. You prepare yourself off, which we talked about that we signed. Do you prepare your team on allocating rules given trauma bibs? Absolutely. I can change anything about anything. You're on again. That could be decanted resource. It can be a reduced number of trauma. Team is activated. Can we get some people? I don't need to be there right away. Well, maybe we need more people. Do we need to call something else? It's not be triggered on Saturdays. Comes to mind because they're not triggered by the trauma. Take on. Then you could see the rest with the patient. The primary survey A B C D. You should be covered in there as well. This mental model. So again you do your A B. C d. You have this Get this picture for the team, for the team leader. Or if you're the one of the end of the bad that everybody can advise you. Yes, I agree with that. Doctors fit that because I think a picture that I have and then the priorities is soft with the leader Consent. What goals with, um, So we're trying to do. Are we having for a CT scan within 30 minutes of drafting theater, or is this a call in san, uh, part of the process of what not to take? The patient Is Allah kidding? Rooms and again you see this morning. But at What is your Do you have their course? My bedroom. Are you Are you appropriate to be felt that really heard this patient blood? If you have a circulation, you should be right pace. My compliments ideally happened with the safest of the airway. Exactly. So again, it's high. We are located in positions of those rules to your confidence. Now this is a sort of well accepted it well formed layout of how we approach your patient trouble patient. Plus think of it. See the line there by the time dinner. Really want to cross out line? That's fight it to you by the tape leader was after the communication improves on the wise. The people later back and forward across the line to really establish that the best direct, direct, careful, fine second line to get done stated earlier, were really the patient is not really off the opulence. They've ruled into the B cells. Bad they're still on the armpits trolley. But really that's fine. Second and last eats fresh is they are very clear, isn't last of extra beat is samples And if all of those are good, I'd come We could stop take a hard over from the armpits at once, the patients moved across to the E D. Trauma. If we're not happy with the airway, if there is possible extra bleeding or we were not sure by the phones, then intervention would happen there on the opulence. Truly, the held over will be held until we address is life threatening situations. Ultimately, you don't want your patients who have expired by the time you go to fill up. This is to church is a process is probably Estes. Five seconds to your patients. See if the shots here is around this time over and again are red back. It's still good long these lines. It's accepted commonly used on it by our our Parents Creek colleagues that you have to pass a job. Difficult situation it's worth probably them are around over time to just give you only mission. You sure you want Speak down? We're not speak. So what treatments being administered all the information there because Austin, once they are flow. But if you are on this system copies really do you take the time to get that up? Okay, so in somebody with a comfortable technical skills, really, things can go wrong, but it's being it's taken some of the responsive mention they're being mindful of them, showing constant consistencies, pure her communication practices and the fact of leadership was a lack of psychological. See if they had not began that, except by the leader of the psychological CFTR. Actually, I do you have a concern or no, I don't share that mental bottle or how we sort of this. He's a very, very see, if appropriate interactions. Teo Flag up to leader It's really high that meter establishes the environment, this culture of see if the next one we talked about that, can you use concerns, not seen her mind that amount of food up studio the agenda, that particular when they're taking it with the environment of the process, that saddle, Can we get everything established? We can Anyway, questions was happy. Dancers come talk to me a cure or get anybody colleagues here. I cannot really question here or a few tickle messages for you, so I'll let you take those. Thank you very much for your time this morning. Hopefully outcomes too long. That's the thank you very much joint yesterday