Culture of Safety
Those who manage and work within an environment know the hazards and are alert to possible breaches.
What is Informed Culture.
Sender shares a message with an individual/group. Verbal and nonverbal communication impacts the delivery of the message to the sender.
What is Sender.
Establishing new standards/guidelines, trial and error, willing to change to the new, continuous feedback amongst the team.
What is Norming.
Determines the surgical intervention, offers possible alternative treatment options, discuss risk and benefits, identify the correct surgical site, surgical time-out, perform the surgery, follow-up patient care.
Who is the Surgeon.
Assist with preparing the OR, ensures all documents are signed and available, preoperative patient interview, assist anesthesia with transport to the OR, assist with positioning the patient, patient skin prep, connect cords/tubes from surgical field, surgical count with surgical tech, surgical time-out, maintain operative record, assist with appropriate care of specimens, etc.
Who is the Circulator.
Willing to implement major reform and changes to processes when indicated.
What is Flexible Culture.
The person who gets the message and determines its meaning based on the person's knowledge, background, and environment.
The team is able to perform without conflict, communication is effective, the team is able to take on new tasks and is self-directed, leadership is in place but not necessarily needed for day to day activities of the team.
What is Performing.
Sponging, suctioning, cutting suture, apply electrocautery to clamps on bleeders, hold retractors and instruments as directed by the surgeon.
Who is the Second Scrub Surgical Technologist.
Assess the patient preoperatively, determines the type of anesthesia, discusses the risks and benefits with the patient (informed consent), offer alternative anesthesia methods, manage all phases of anesthesia, perioperative monitoring of the patient, maintain patient homeostatic levels.
Who is Anesthesia.
Stop the line; briefing/debriefing focused on all contributing factors; root cause analysis of the event- focus is to find the cause, not to blame a person.
What is Reporting Culture.
What is the Message.
Roles of team members is established, plans are started, input from team members is contributed, feedback on ideas amongst the team members.
What is Storming.
Gather supplies, review patient information, arrange the OR furniture, perform the surgical scrub, don sterile gown/gloves, create and maintain the sterile field, label solutions, initial count with circulator, gown/glove other sterile team members, etc.
Who is the First Scrub Surgical Technologist.
Patient satisfaction surveys that focus on the care the patient received within the facility, the cleanliness of the facility, and if the patient was adequately prepared to be sent home from the facility.
What is Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS).
Willing to learn and competent to draw the correct conclusions; willing to teach and train others.
What is Learning Culture.
Not looking for the root cause, instead looking for the person to place the blame on.
What is Blaming.
Development of the team, development of the mission and vision for the team, leader is established during this part.
What is Forming.
Assist with positioning the patient, assist with draping the patient, participate in surgical time-out, provide exposure/visualization of the surgical field (suctioning, retracting, sponging), assist with identifying anatomy and landmarks, assist with achieving hemostasis/permanent hemostasis, closure of body planes, apply dressings, assist with patient transfer.
Who is the Surgical First Assistant.
Evidence-based set of teamwork tools, aimed at optimizing patient outcomes by improving communication and teamwork skills among healthcare teams.
What is Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS).
Fair to all; mistakes are not punished, instead they are learned from; errors in the process are identified and corrected.
What is Just Culture.
Too much information, information is not in order, the sender is overstimulated and unsure how to deliver the information through communication.
What is Overload.
Team debriefing occurs in this stage, what worked and did not work, what the outcome of the transition was, did the team meet their over all goal.
What is Adjourning.
Operates and maintains the equipment used to circulate blood during surgery or other medical procedures. Intentionally introducing drugs and/or fluids into the bloodstream such as during open heart surgery. Monitors patient's blood gas during cardiovascular procedures.
Who is the Perfusionist.
Name at least 4 of the 14 surgical specialties recognized by the American College of Surgeons (ACS) and American Board of Specialties (ABMS).
What are General, Orthopedic, Ophthalmic, Genitourinary, Neurosurgery, Cardiothoracic, Peripheral Vascular, Otorhinolaryngology, Oral, Maxillofacial, Obstetrics, Gynecology, Plastics, and Reconstructive.