Facilitator First Screen: Call Nurse engages with PC Please choose the appropriate action: o...
Transcript of Facilitator First Screen: Call Nurse engages with PC Please choose the appropriate action: o...
CS DECISIONCONTINUENORMAL
DELIVERY CARE
NOTIFYSTANDARD
PERSONNEL INITIAL SUMMONSDATA UPLOADED
WARD CLERKNOTIFIES
ALTERNATE TEAM
INITIAL SUMMONSDATA UPLOADED
WARD CLERKNOTIFIES FIRST
TEAM
UPDATE TEAMSTATUS
OBGYN ASSIGNROLES
FIRST MINUTESTATUS ALLRESPONDED
THREEMINUTE ALLRESPONDED
STANDARDROLES
WARD CLERKSEND
BROADBANDSUMMONS
WORD CLERKNOTIFIES NEXT
PERSON
SECOND PERSON NOTRESPONDING !
FIRST PERSON NOTRESPONDING
SCRUB/PREPARETEAM
YESNO
YES
NO
NO
YES
NO
YES
YESNO
PREPARE TEAMSEQUENCE OF
EVENTS
Facilitator First Screen: Call Nurse engages with PC
Please choose the appropriate action:
o Facilitate Cesarean Section
o Input Call Team Information
oCustomize System Settings
REQUIREMENT: The Facilitator shall remind Team members what actions must be performed to successfully Notify surgical team: surgeon, anesthesia, pediatrician, nurses. REQUIREMENT: The Facilitator shall allow one person to simultaneously summon the entire first call CS Team within 3 minutes of the decision to do a CS
CONFIRM FIRST CALL MEDICAL PERSONNEL
The following medical personnel will be summoned on the first call:
o OBSTETRICIAN: Name of Obstetrician 1 (Primary contact #s)
o ANESTHESIOLOGIST: Name of Anesthesiologist 1 (Primary contact #s)
o NURSE: Name of Nurse 1 (Primary contact #s)
o PEDIATRICIAN: Name of Pediatrician 1 (Primary contact #s)
CONTINUECHANGE
REQUIREMENT: The Facilitator shall provide contact information for the medical personnel scheduled to be on call
CHOOSE FIRST CALL MEDICAL PERSONNEL
Please click in the circle next to an individuals name to select or deselect that individual:
OBSTETRICIANS ON CALL
Name of Obstetrician 1 (Primary contact #s)
o Name of Obstetrician 2 (Primary contact #s)
ANESTHESIOLOGISTS ON CALL
Name of Anesthesiologist 1 (Primary contact #s)
o Name of Anesthesiologist 2 (Primary contact #s)
NURSES ON CALL
Name of Nurse 1 (Primary contact #s)
o Name of Nurse 2 (Primary contact #s)
o Name of Nurse 3 (Primary contact #s)
PEDIATRICIANS ON CALL
Name of Pediatrician 1 (Primary contact #s)Continue
REQUIREMENT: The Facilitator should include a set of pre-recorded messages to use when summoning the Team
REQUIREMENT: The Facilitator shall *appropriately* prompt and permit the charge nurse to enter Initial Summons Data
REQUIREMENT: The Facilitator’s pre-recorded messages shall be in simple English
CHOOSE SUMMONS MESSAGE INFORMATION
Please choose the appropriate information to include in the initial summons message:
PATIENT STATUS
o Scheduled: Arrive within 20 min
o Urgent: Arrive within 15 min
o Crash: Arrive within 10 min
PATIENT NAME {Type block}
REASON FOR CS
o Reason 1
o Reason 2
o Reason 3
o Other: {Type Block}
PATIENT LOCATION
o Location 1
o Location 2
Continue
REQUIREMENT: The Facilitator shall remind Team members what actions must be performed to successfully
notify surgical team
CONFIRM FIRST CALL PERSONNEL AND MESSAGE
Click on the circle next to information in order to select or deselect it:
TEAM
o Name of Obstetrician
o Name of Anesthesiologist
o Name of Pediatrician
o Name of Nurse
PATIENT STATUS
o Urgent: Arrive within 15 min
PATIENT NAME
o Jane Doe
REASON FOR CS
o Fetal Intolerance
ASSEMBLY LOCATION
o OR 1 SENDCHANGE
REQUIREMENT: The Facilitator shall, if summoned team member does not respond affirmatively within 3 minutes of summons, immediately
suspend all subsequent summons to the team member, notify the charge nurse, and summon the next corresponding team member.
*******FIRST CALL TEAM NOTIFIED*******
CONFIRM ALTERNATE MEDICAL PERSONNEL
These ALTERNATE medical personnel will be notified in the case that one or more members of the first call team does not respond:
o OBSTETRICIAN: Name of Obstetrician 2
o ANESTHESIOLOGIST: Name of Anesthesiologist 2
o NURSE: Name of Nurse 2
o PEDIATRICIAN: None
CONTINUECHANGE
REQUIREMENT: The Facilitator shall store and provide information on alternate team members (2nd call, 3rd call) in the
event that one or more individuals on the initial contact list (1st call) is unable to respond
*******FIRST CALL TEAM NOTIFIED*******
SELECT ALTERNATE MEDICAL PERSONNEL
Please click in the circle next to an individuals name to select or deselect that individual:
OBSTETRICIANS ON CALL
Name of Obstetrician 1
o Name of Obstetrician 2
ANESTHESIOLOGISTS ON CALL
Name of Anesthesiologist 1
o Name of Anesthesiologist 2
NURSES ON CALL
Name of Nurse 1
o Name of Nurse 2
PEDIATRICIANS ON CALL
Name of Pediatrician 1
CONTINUE
REQUIREMENT: The Facilitator shall, if a summoned team member does not respond affirmatively within 1 minute of a summons,
immediately summon the team member by another means, if available.
*******FIRST CALL TEAM NOTIFIED*******
**Unconfirmed personnel have been summoned by alternate means**
TEAM RESPONSE STATUS
• Obstetrician 1: NO RESPONSE
• Anesthesiologist 1: NO RESPONSE
• Nurse 1: NO RESPONSE
• Pediatrician 1: NO RESPONSE
TIME UNTIL ALTERNATES ARE NOTIFIED
1 min 59 sec
CS PREPARATION MENU
REQUIREMENT: The Facilitator shall be capable of receiving responses from Team members confirming that they have received the summons
and that they are on the way to the hospital
*******FIRST CALL TEAM NOTIFIED*******
**Unconfirmed personnel have been summoned by an alternate means**
TEAM RESPONSE STATUS
• Obstetrician 1: CONFIRMED
• Anesthesiologist 1: CONFIRMED
• Nurse 1: UNAVAILABLE
*ALTERNATE NOTIFIED*
• Nurse 2: NO RESPONSE
• Pediatrician 1: NO RESPONSE
TIME UNTIL ALTERNATES ARE NOTIFIED
45 sec
CS PREPARATION MENU
REQUIREMENT: The Facilitator shall be capable of receiving responses from Team members confirming that they have received the summons
and that they are on the way to the hospital
*******FIRST CALL TEAM NOTIFIED*******
*******ALTERNATES NOTIFIED AS NECESSARY*******
TEAM RESPONSE STATUS
• Obstetrician 1: CONFIRMED
• Anesthesiologist 1: CONFIRMED
• Nurse 1: UNAVAILABLE
*ALTERNATE NOTIFIED*
• Nurse 2: CONFIRMED
• Pediatrician 1: NO RESPONSE
*NO ALTERNATE*
CS PREPARATION MENU
REQUIREMENT: The Facilitator shall remind team members what actions must be performed to successfully confirm surgical team
TEAM RESPONSE STATUS
• Obstetrician 1: CONFIRMED
• Anesthesiologist 1: CONFIRMED
• Nurse 2: CONFIRMED
• Pediatrician 1: NO RESPONSE
*NO ALTERNATE*
CS PREPARATION MENUASSIGN ROLES
REQUIREMENT: The Facilitator shall remind team members what actions must be performed to successfully assign roles and brief surgical
team
ASSIGN TEAM ROLES AND RESPONSIBILITIES
No Pediatrician is available. Please reassign standard Pediatrician roles to other team members by clicking on the circle next the appropriate person:
Pediatrician Responsibility 1:
o Obstetrician 1: CONFIRMED
o Anesthesiologist 1: CONFIRMED
o Nurse 2: CONFIRMED
Pediatrician Responsibility 1:
o Obstetrician 1: CONFIRMED
o Anesthesiologist 1: CONFIRMED
o Nurse 2: CONFIRMED
CONFIRM ROLES
System Design Concepts• Meet the Requirements • Prevent errors• Smooth flow
Team Members Receives Notification Message on PDA
ALERT! CS is Required
Name: Jane Doe
ID: 1234567890
Classification : Urgent
Location: OR 2Reason for CS: Fetal Intolerance
Arrive within: 15 min
Are you available?
YesNo
Members Receives Notification Message on PDA
Scroll & select or Use stylus
REQUIREMENT26: The Facilitator shall be capable of receiving responses from teammembers confirming that they have received the summons and that they are on the way to the hospital.
Initial Summons Data
2min 45sec
Countdown time to respond
ALERT! CS is Required
Identity: Angelina Jolie
Age: 30
Urgency : Urgent
Arrive within: 15 min
Location: OR 1
Are you
available?YesNo
The system will add you in a
Member list.
OKCancel
If Select “Yes”REQUIREMENT81: The Facilitator shall remind Team members what actions must be
performed to successfully Confirm surgical team.
Initial Summons Data
ALERT! CS is Required
Initial Info
Identity: Angelina Jolie
Age: 30
Urgency : Urgent
Arrive within: 15 min
Location: OR 1
Are you
available?YesNo
The system will summon
the next personnel.
OKCancel
If Select “No”REQUIREMENT81: The Facilitator shall remind Team members what actions must be
performed to successfully Confirm surgical team.
Initial Summons Data
1 minutes After NotificationREQUIREMENT66 :The Facilitator shall, if a summoned Team member does not respond
affirmatively within 1 minute of a summons, immediately summon the Team member by another means, if available.
REQUIREMENT24: The Facilitator shall deliver the Initial Summons Data to the summoned Team members in both text and voice modes.
Press 1= AvailablePress 2= Unavailable
OR
CS is Required
Patient’s name is……
Age …
Press 1 if available, otherwise……
ALERT!
CS is Required
Name: Jane Doe
ID: 1234567890
Classification : Urgent
Location: OR 2
Reason for CS: Fetal Intolerance
Arrive within: 15 min
Are you available?
YesNo
Initial Summons Data
ALERT! CS is Required
Initial Info
Identity: Angelina Jolie
Age: 30
Urgency : Urgent
Arrive within: 15 min
Location: OR 1
Are you available?
YesNo
3 minutes has passed.The next alternate
personnel was summoned.
OK
3 minutes After NotificationREQUIREMENT64: The Facilitator shall, if a summoned team member does not respond affirmatively within 3 minutes of summons, immediately suspend all
subsequent summons to the Team member, notify the charge nurse, and summon the next corresponding Team member.
Initial Summons Data
0min 00sec
Program Ends
Thank you for your cooperation.
Good bye
Confirmation Finishes & Loading Menu Screen
Please head to the hospital .
Loading Preparation Menu
Menu
1.Initial Summons Data
2.Function Specific Data
3.Full Patient Chart
4.Assigned Roles
5.Member Status
Assemble Location : OR2
Team Preparation MenuShow all the information that the member need to know
Reminder of the assemble location REQUIREMENT82: The Facilitator shall remind Team members what actions must be
performed to successfully Assemble team.
Preparation Menu
Basic CS data
Role specific data
Full chart
Assigned Roles
Member lists
Initial Summons Data
•Name: Jane Doe
•Age:24
•ID:1234567890
•Location:OR2
•Reason for CS:
Fetal Intolerance
Team Preparation Menu 1: Initial Summons Data
menu
In case of the member want to check the summons data again.
Indicates the which direction to scroll
CS Data for “Nurse” • Current Medication: None
• Allergies: NKDA
• Health during pregnancy:
No major problems
• Past major illness: None
•Contraction interval: X min
•Contraction duration: X sec
Team Preparation Menu 2: Function Specific Critical Data
REQUIREMENT34: The Facilitator shall provide patient briefing data to the surgical team.
menu
REQUIREMENT33: The Facilitator shall be able to be programmed to provide customized, function-specific Critical Patient Data.
Team Preparation Menu 3: Full Patient Medical Data
Patient Medical Data
•Name: Jane Doe•Age:24 / G:2 / P:0•EGA:37•Reason for CS: Fetal tolerance•Current Medication: None•Allergies: NKDA•Health during pregnancy: No major Problems•Past Major Illnesses:None•Membrance Rupture: Time/Color/Amount
menu
In case the member want to check the medical data other than their main interest.
Team Preparation Menu 4: Assigned Roles.
Assigned Roles1. OB Practitioner
Name Initial Role
Dr.
Dr.
2. Surgeon
Name Initial Role
Dr.
Dr.
REQUIREMENT83:The Facilitator shall remind Team members what actions must be performed to successfully Assign roles and brief surgical team
menu
Team Preparation Menu 5: Member’s Status
Member Status1. OB Practitioner
Name Status_
Dr. Arrived
Dr. On the way
2. Surgeon
Name Status_
Dr. Unavailable
Dr. Not responded
menu
Make the member maintain better situation awareness
Failures To Prepare Team
Weather delay Power failure. Storms. Floods. Down trees. Traffic signals out.
Traffic delay. Accident. Injuries require
physician/technician attention.
Weather solution Alternative routes to
provide redundant pathways to hospital to avoid, possible, flooding, downed, trees, traffic signal outages, traffic delays.
• Physician / technician call immediately charge nurse to alert backup person if help at accident scene is required.
Failures To Prepare Team
System failure Hard drive/device
failure. Program crashes. Time out area no signal
received.
System solution Backup system daily. Automatic save feature of
transactions every minute once CS initiated.
Continuous real time printout of all transactions communications and processes (teletype).
Have redundant computer system ready to take over for down system.
Failures To Prepare Team
• System failure Program crashes
during calling.
System solution Nurse resorts to
paperback up and calls each person on the team left to notify.
Failures To Prepare Team
• Human causes Multiple births Multiple
Physician/technician illness or unavailable.
• Human solution Multiple areas that can
be readied within 5 minutes to accommodate mother and staff for procedure.
Multiple movable patient monitoring devices.
Multiple anesthesia carts.
Failures To Prepare Team
Human causes Multiple
Physician/technician illness or unavailable
Human solution Multiple anesthesia
packs with all of the types of anesthesia necessary for doctor.
Increase cross training of nurses and doctors to increase the resource pool in case of an extreme need case.
Requirements Discussion
• The Facilitator shall remind Team members what action must be performed to successfully Dress/scrub surgical team
• The Facilitator shall remind Team members what action must be performed to successfully Address team Activities of Daily Living (ADL)