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ALERT Presentation: Team leadership under stress –exploration of methods to improve performance Elizabeth Hunt, Mike Rosen
Background• Healthcare teams frequently operate under high stress conditions; the team leader’s ability to manage that stress can impact team functioning.• Effects of acute stress on performance – Individual level effects: E.g., degrades cognitive capacities, increases fixation errors – Team level effects: E.g., reduces meaningful communication and coordination, shift in focus from the team task to individual tasks• Knowledge Gaps – What are the most effective strategies for managing stress and improving resilient performance in time-critical healthcare teams? – What are the best methods for training these strategies?
PICO Question• Population – Teams of pediatric healthcare providers in simulated time-critical care emergencies• Intervention – A training program focused on improving leader and team functionality during highly stressful situation, i.e. to modulate stress with the intent of improving team functionality and adherence to guidelines• Comparison – Simulations where the healthcare teams have not had the stress modulation intervention• Outcome – Adherence to clinical guidelines (ex. PCCM shock guidelines, PALS guidelines, ATLS guidelines), Teamwork scores (tool to be used not yet decided), cortisol levels, oxytocin levels, self-report workload and stress measures from team leader and team members
Approach• Systematic training development and validation 1. Review the literature and existing training programs 2. Conduct qualitative field studies to elicit additional training requirements 3. Develop, pilot test, and refine training program 4. Implement and evaluate training program in the simulation center 5. Evaluate training program in clinical practice
3 Limitations / Challenges• Recruitment and scheduling of healthcare providers to participate in focus groups• Developing the necessary expertise to utilize stress biomarkers effectively• Developing a strategy for translational research, i.e. a long term strategy to measure teamwork in the clinical setting and whether the intervention developed in this project has an impact on performance and patient outcomes