Good Day Class!

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on’t forget to start a shift today

oday we are discussing chapter 9

he Team Approach to Health Car
 Scenario

When conflicts arise among health care teams, you should remember all the
following EXCEPT:

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A. that the patient comes first
B. to separate the person from the issue
C. to choose your battles
D. it is acceptable to shout at other providers
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The correct answer is:

D. it is acceptable to shout at other providers

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Scenario 2

The “C” in the PACE mnemonic stands for:

B. communication
C. challenge
A. choose

D. clear
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The correct answer is:

C. challenge
 Scenario 3

Assisting with an ALS skill does NOT include:

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A. patient preparation
B. equipment set up
C. continuing care
D. performing skills for which you are not authorized
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The correct answer is:

D. performing skills for which you are not authorized

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Unstable patients should be reassessed how often?
Scenario 4

C. 15 min
D. 20 min
B. 10 min
A. 5 min
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The correct answer is:

A. 5 min
 Scenario 5

Which of the following is NOT considered a type of breath sound?

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A. rhonchi
B. vibration
C. wheeze
D. stridor
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The correct answer is:

B. vibration
Introduction

 You are a critical member of the emergency health care team.

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 A key goal of EMS Agenda 2050 is EMS systems that are inherently safe.
 Minimize exposure to injury, infections, illness, or stress.
 Culture of safety
 Just culture
Types of Teams (1 of 2)

 Regular teams
 EMTs consistently interact with the same partner or team.

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 Temporary teams
 EMTs work with providers with whom they do not regularly interact or may not even
know.
Types of Teams (2 of 2)

 Special teams
 Fire team

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 Rescue team
 Hazardous materials (hazmat) team
 Tactical EMS team
 Special event EMS team
 EMS bike team
 In-hospital patient care technicians
 MIH technicians
Groups Versus Teams (1 of 3)

 A group consists of individual health care providers working independently to

help the patient.

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 Triage
 Treatment
 Transport
Groups Versus Teams (2 of 3)

 A team consists of a group of health care providers who are assigned specific
roles and are working interdependently in a coordinated manner under a

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designated leader.
Groups Versus Teams (3 of 3)

 Five essential elements of a group

 A common goal

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 An image of themselves as a “group”
 A sense of continuity of the group
 A set of shared values
 Different roles within the group
Dependent, Independent, and Interdependent Groups

 Dependent groups
 Each individual is told what to do, and often how to do it, by his or her supervisor or

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group leader.
 Independent groups
 Each individual is responsible for his or her own area.

 Interdependent groups
 Everyone works together with shared responsibilities, accountability, and a
common goal.
Effective Team Performance (1 of 2)

 A shared goal

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 Clear roles and responsibilities
 Diverse and competent skill sets
 Effective collaboration and communication
 Supportive and coordinated leadership
Effective Team Performance (2 of 2)

 Communication and team dynamics fostered from crew resource management

and team situational awareness

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 CRM recommends the use of the PACE mnemonic:
 Probe
 Alert
 Challenge
 Emergency
Transfer of Patient Care

 Transfers introduce the possibility of patient care errors.

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 General guidelines for a smooth transfer:
 Uninterrupted critical care
 Minimal interference
 Respectful interaction
 Common priorities
 Common language or system
BLS and ALS Providers Working Together

 BLS and ALS care cannot exist without each other.

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 BLS efforts must continue throughout the continuum of care.
 What may be a “paramedic only” skill in your EMS system may be common for
an EMT to perform in another.
Assisting with ALS Skills

 Assisting follows a four-step process:

 Patient preparation

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 Equipment
 Performing the procedure
 Continuing care
Critical Thinking and Decision Making in EMS (1 of 3)

 Effective decisions are based on:

 Sound, up-to-date knowledge

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 Information provided by the patient
 The patient’s history
 Physical examination
Critical Thinking and Decision Making in EMS (2 of 3)

 Stages of the decision-making process

 Prearrival

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 Arrival
 During the call
 After the call
Critical Thinking and Decision Making in EMS (3 of 3)

 Decision traps
 Bias

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 Anchoring
 Overconfidence
Troubleshooting Team Conflicts

 The patient comes first.

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 Do not engage.
 Keep your cool.
 Separate the person from the issue.
 Choose your battles.
Review

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1. Which of the following is a characteristic of a regular team?
A. They serve a specialized role within the larger emergency health care system.
B. Members consistently interact with the same partner.
C. The team performs special functions across geographic boundaries.
D. Regular teams are more common in volunteer EMS systems.
Review

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Answer: B
Rationale: Members of a regular team consistently interact with the same partner.
This allows them to perform as a seamless unit. Special teams serve a specialized
role within the larger emergency health care team. Groups perform special
functions across geographic boundaries. Temporary teams are common in
volunteer EMT systems.
Review

1. Which of the following is a characteristic of a regular team?

A. They serve a specialized role within the larger emergency health care system.

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Rationale: Special teams serve a specialized role within the larger health care system.
B. Members consistently interact with the same partner.
Rationale: Correct answer
C. The team performs special functions across geographic boundaries.
Rationale: Groups perform special functions across geographic boundaries.
D. Regular teams are more common in volunteer EMS systems.
Rationale: Temporary teams are more common in volunteer systems.
Review

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2. Essential elements of a group that people must share include:
A. focusing on individual goals.
B. placing emphasis on one way of accomplishing a task.
C. working with a set of shared values.
D. promoting a personal identity.
Review

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Answer: C
Rationale: It is important for groups to have a set of shared values (how the group
wants to get things done). In a group the focus needs to be on a common goal.
Group members must have a sense of continuity and remember that the group
may work together more than once in a different configuration. Finally, a group
member should put forth an image of the group as a whole, not one person.
Review

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2. Essential elements of a group that people must share include:
A. focusing on individual goals.
Rationale: Groups are focused on a common goal.
B. placing emphasis on one way of accomplishing a task.
Rationale: Group members must have a sense of continuity and remember that
the group may work together more than once in a different configuration.
C. working with a set of shared values.
Rationale: Correct answer
D. promoting a personal identity.
Rationale: A group member should put forth an image of the group as a whole,
not one person.
Review

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3. Members of an interdependent group:
A. focus on the goals of their own individual areas.
B. rely on the group leader for task assignments.
C. have limited ability to adapt and deliver critical care medical care in an
uncontrolled field environment.
D. work together with shared responsibilities, accountability, and a common goal.
Review

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Answer: D
Rationale: Members of an interdependent group work together with shared
responsibilities, accountability, and a common goal. People who are part of a
independent group focus on the goals of their own individual area. Individuals who
are part of a dependent group rely on the leader for task assignments and have
limited ability to adapt and deliver critical medical care in an uncontrolled field
environment.
Review

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3. Members of an interdependent group:
A. focus on the goals of their own individual areas.
Rationale: People who are part of an independent group focus on the goals of
their own individual areas.
B. rely on the group leader for task assignments.
Rationale: People who are members of a dependent group rely on the group
leader for task assignments.
C. have limited ability to adapt and deliver critical medical care in an uncontrolled
field environment.
Rationale: People who are part of a dependent group have limited ability to adapt
and deliver critical medical care in an uncontrolled environment.
D. work together with shared responsibilities, accountability, and a common goal.
Rationale: Correct answer
Review

4. When a team member speaks, you should repeat the message back to him
or her. This is an example of:

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A. closed loop communication.
B. a clear message.
C. constructive intervention.
D. courtesy.
Review

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Answer: A
Rationale: Closed loop communication helps confirm that you heard and
understood the message and will act on it. A clear message is delivered when you
speak calmly, confidently, and concisely so that the information delivered, or the
action requested is clear to the listener. Constructive intervention takes place when
it is necessary for you to respectfully question or correct a team member or leader.
You extend courtesy when speaking politely to members of the group.
Review

4. When a team member speaks, you should repeat the message back to him
or her. This is an example of:

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A. closed loop communication.
Rationale: Correct answer
B. a clear message.
Rationale: A clear message is delivered when you speak calmly, confidently,
and concisely so that the information delivered, or the action requested is clear
to the listener.
C. constructive intervention.
Rationale: Constructive intervention takes place when it is necessary for you to
respectfully question or correct a team member or leader.
D. courtesy.
Rationale: You extend courtesy when speaking politely to members of the
group.
Review

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5. A team leader:
A. helps individual team members to work together.
B. is often defined by policy, procedure, or statute.
C. provides coordination, oversight, centralized decision making and support for the
team.
D. All of the above.
Review

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Answer: D
Rationale: A team leader is an essential part of successful team. The team leader
is often defined by policy, procedure, or statute. He or she provides coordination,
oversight, centralized decision making and support for the team. In addition, the
team leader will help individuals to not only do their jobs, but also to work together.
Review

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5. A team leader:
A. helps individual team members to work together.
Rationale: Correct answer. A team leader helps individual team members to work
together.
B. is often defined by policy, procedure, or statute.
Rationale: Correct answer. A team leader is often defined by policy, procedure, or
statute.
C. provides coordination, oversight, centralized decision-making and support for the
team.
Rationale: Correct answer. A team leader will provide coordination, oversight,
centralized decision-making and support for the team.
D. All of the above.
Rationale: Correct answer
Review

6. When verbal transfer of care occurs, all team members should do their best
to ensure that:

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A. the transfer of care occurs in a place where many staff members are present to
hear.
B. lifesaving care is not interrupted if it is being performed by the person giving
report.
C. everyone is respectful of each team member’s role.
D. patient care is centered around what you believe is the correct treatment.
Review

Answer: C

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Rationale: Whenever the verbal transfer of care occurs, all team members
should do their best to ensure that each team member is respectful of each other.
Transfer of care should occur in a location with the least interference possible.
The team member giving the report and the member receiving report should hand
off lifesaving care to another team member. Finally, it is important to remember
that the team members involved in the transfer of care focus on doing what
provides the best care for the patient.
Review

6. When verbal transfer of care occurs, all team members should do their best to
ensure that:

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A. the transfer of care occurs in a place where many staff members are present to
hear.
Rationale: The transfer of care should occur in a location with the least
interference possible.
B. lifesaving care is not interrupted if it is being performed by the person giving
report.
Rationale: Lifesaving care should be handed off to another team member.
C. everyone is respectful of each team member’s role.
Rationale: Correct answer
D. patient care is centered around what you believe is the correct treatment.
Rationale: Team members involved in the transfer of care must focus on their
common priority: the best possible patient outcome.
Review

7. Your partner is working a 48-hour shift and has had little sleep. He disagrees
with you over how to position the patient and how you should drive to the

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hospital. You should:
A. follow your partner’s orders and discuss the call after the patient has been
dropped off at the hospital.
B. confront your partner about his or her behavior in front of the patient.
C. tell your partner he or she does not know that they are talking about.
D. ask the patient who he or she thinks is correct.
Review

Answer: A

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Rationale: If the problem causing the conflict does not directly and immediately
impact patient care, it is best to wait until after the call to discuss the matter with
your partner. It is also important to not have a heated discussion in front of the
patient. Rather than contribute to a conflict, take a deep breath and count to 10.
Let cooler heads prevail. Finally, do not involve the patient in a conflict; it takes
the focus off of patient care.
Review

7. Your partner is working a 48-hour shift and has had little sleep. He disagrees
with you over how to position the patient and how you should drive to the

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hospital. You should:
A. follow your partner’s orders and discuss the call after the patient has been
dropped off at the hospital.
Rationale: Correct answer
B. confront your partner about his or her behavior in front of the patient.
Rationale: Do not confront your partner in front of the patient. Keep the focus on
providing quality patient care.
C. tell your partner he or she does not know that they are talking about.
Rationale: Rather than confront your partner, take a deep breath can count to
10.
D. ask the patient who he or she thinks is correct.
Rationale: Never involve a patient in a personal conflict. Remain focused on the
goal: quality patient care.