The Specialty Care Gap - Texas Children's Hospital · Group of strangers/competitors with competing...
Transcript of The Specialty Care Gap - Texas Children's Hospital · Group of strangers/competitors with competing...
Building a Bridge with Collaboration
The Specialty Care Gap:
Dionne J.
Walker, MSN,
RNC-OB
Clinical
Specialist,
Women’s
Services
Miranda A.
Rodrigues,
MSN, CNL,
CCRN-K
Clinical
Specialist,
CVICU
Kellie S.
Kainer,
MSN, RNC
Assistant
Clinical
Director,
NICU
Page 1
xxx00.#####.ppt 2/23/2017 3:17:09 PMPage 1
Background
Page 2
xxx00.#####.ppt 2/23/2017 3:17:10 PMPage 2
U.S. Infant Mortality Rate/Causes
Rates Causes
•Birth defects
•Preterm birth (<37 weeks
gestation) & low birth weight
•Maternal complications of
pregnancy
•Sudden Infant Death
Syndrome (SIDS)
• Injuries (e.g., suffocation)
Page 3
xxx00.#####.ppt 2/23/2017 3:17:10 PMPage 3
U.S Maternal Mortality Rate/CausesRates Causes
The cause of death is unknown for 6.1% of all pregnancy-related deaths.
Page 4
xxx00.#####.ppt 2/23/2017 3:17:10 PMPage 4
State of Texas Maternal Deaths
(within 42 days Following End of Pregnancy)
Maternal Mortality Rate
Year
Center for Disease
Control,
National Center for
Statistics
Texas Department of
State Health Services
2010 18.6 18.7
2011 30.2 26.5
2012 38.7 28.8
2013 36.1 32.5
2014 33.8 31.5
Page 5
xxx00.#####.ppt 2/23/2017 3:17:10 PMPage 5
High Risk Obstetrics
Page 6
xxx00.#####.ppt 2/23/2017 3:17:10 PMPage 6
CVOB Partnership was formed
Page 7
xxx00.#####.ppt 2/23/2017 3:17:11 PMPage 7
https://www.youtube.com/watch?v=aU6e33FYgg0
Page 8
xxx00.#####.ppt 2/23/2017 3:17:11 PMPage 8
CollaborationCommunication
CoordinationConflict Resolution
Bridging the Gap
Page 9
xxx00.#####.ppt 2/23/2017 3:17:11 PMPage 9
Collaboration
Page 10
xxx00.#####.ppt 2/23/2017 3:17:12 PMPage 10
Teamwork versus Collaboration
Page 11
xxx00.#####.ppt 2/23/2017 3:17:12 PMPage 11
CollaborationInterdependence
Shared purpose
Group of strangers/competitors with competing
goals
Collaborative leaders emerge during the process
Complicated, emotionally charged, frustrating event
in which innovation is born!
Hard work
Page 12
xxx00.#####.ppt 2/23/2017 3:17:12 PMPage 12
Collaborative Teamwork
Page 13
xxx00.#####.ppt 2/23/2017 3:17:12 PMPage 13
Critical Care Teamwork Checklist
Brindley et al, Journal of Critical Care, 33(2016)
Page 14
xxx00.#####.ppt 2/23/2017 3:17:13 PMPage 14
Recognize that collaboration is a journey
Page 15
xxx00.#####.ppt 2/23/2017 3:17:13 PMPage 15
Communication
Page 16
xxx00.#####.ppt 2/23/2017 3:17:13 PMPage 16
CommunicationKey element of highly functioning team
NASA-Crew Resource Management 1979
United States Army 1980s
United States Air Force 1990s
United States Navy 1998
Page 17
xxx00.#####.ppt 2/23/2017 3:17:13 PMPage 17
1996
MedTeam
Project
Page 18
xxx00.#####.ppt 2/23/2017 3:17:13 PMPage 18
TeamSTEPPS
Developed in 2006 by the U.S.
Department of Defense in
collaboration with the Agency
for Healthcare Research and
Quality to further extend the
military’s research on team
training to the healthcare
industry.
Page 19
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 19
Page 20
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 20
Coordination
Page 21
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 21
Coordination defined…
co·or·di·na·tion
1. the organization of the different elements of a
complex body or activity so as to enable them to
work together effectively.
2. cooperative effort resulting in an effective
relationship.
Page 22
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 22
Page 23
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 23
Basics for Utilization
Relevant to group efforts and not individuals
Continual and Dynamic
Continuous in that it is achieved through process
Dynamic due to stimulation in change as a result
of the process
Page 24
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 24
Jody Hoffer Gittell’s theory on relational
coordination proses, “that highly interdependent
work is most effectively coordinated through
relationships of shared goals, shared knowledge
and mutual respect, supporting sufficiently
frequent, timely, accurate, problem-solving
communication” (Havens, 2010).
Relational Coordination
Page 25
xxx00.#####.ppt 2/23/2017 3:17:14 PMPage 25
Page 26
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 26
Conflict Resolution
Page 27
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 27
Recognize this logo?
Page 28
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 28
Pilots average of 75 simulation hours
before stepping onto an aircraft.
The U.S. Department of Transportation’s Bureau of
Transportation Statistics (BTS) reported today that U.S.
airlines and foreign airlines serving the United States carried
an all-time high of 848.1 million system-wide (domestic and
international) scheduled service passengers in 2014
In 2014, there
were 1320 deaths
Page 29
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 29
Healthcare Providers have no required simulation hours
In 2013, the number of U.S. hospital admissions was
reported to be around 35.4 million.
Page 30
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 30
“SBTT* and debriefing is an evolving educational strategy that
encourages work-based learning,
collaboration, and teamwork, and
improves communication”
‐Severson (2014)
*Simulation Based Team Training
Page 31
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 31
Debriefing
Page 32
xxx00.#####.ppt 2/23/2017 3:17:15 PMPage 32
Lavoi, Pepin & Boyer (2013) Reflective debreifing to promote clinical judgement after high-fidelity clinical simulation
Page 33
xxx00.#####.ppt 2/23/2017 3:17:16 PMPage 33
OB
CVICU NICU
ONE
AMAZING
TEAM!!!
Page 34
xxx00.#####.ppt 2/23/2017 3:17:16 PMPage 34
Thank you!