Due to the "Virus Crisis," President Trump has declared a national emergency and asked all hospitals to implement their emergency plans. Emergency decision-makers and their teams are required to process massive amounts of information, which is sometimes incomplete or faulty, under severe time constraints. The team's performance- while executing rarely performed actions when under stress - will depend on great teamwork and communication skills.
Here are 7 LifeWings skills that will improve your team's performance as they execute your emergency plan in this national battle.
Conduct Briefings
Before every "event" in your emergency plan, conduct a briefing with the team. Cover these items:
1. Introductions (Who is on the team?)
2. Objective (Why are doing this and what is the desired result?)
3. Roles (Who does what?)
4. Contingencies (What might happen and who does what if it does?)
5. Warning signs (How will we know things are off the rails?)
6. Safety Statement (Explicitly request for input and crosscheck)
Use Team Problem Solving
During this emergency, you'll make many decisions about new situations and problems. For those decisions where you have the time to gather inputs, the Team Problem Solving methodology is the most efficient process to use.
1. Announce what you are trying to solve
2. Gather input, data, ideas, and discuss
3. Recap the options that have emerged from the discussion (e.g. " We can do Option A, Option B, or Option C...")
4. Solicit recommendations - start with the most junior member of the team first (e.g. "What do you recommend and why?")
5. Clearly announce the decision
6. Brief the gameplan necessary to execute on the decision (e.g. Who does what by when?)
Stop-the-Line
Executing a rarely-used emergency plan will require 200% accountability - with an uncompromising willingness to speak up when problems with the plan and/or patient care are perceived. Use this script for speaking up:
1. Get attention - use a name and title
2. Make an "I" statement - "I'm concerned," I'm uncomfortable," or "I need clarity."
3. State the problem - without hinting or hoping
4. Propose a solution - use "Let's" or "We" language
Debrief
Your team's learning curve during the Virus Crisis must be steep. Adapt quickly or fail. The fastest learning is accomplished during short debriefing sessions at the end of the day, end of the shift, or after every event. The team leader begins the debrief by asking these three questions:
1. What went well?
2. What could we improve?
3. How can we make that improvement happen? (Who will do what by when?)
Close the Loop
Research is clear that team performance in novel situations with never-before-seen problems improves dramatically when team members close the loop on their communications. Communications not acknowledged - didn't happen. To close the loop...
1. Ask for a "Readback"
2. Provide a "Readback" (even if not asked for one)
See It, Say It, Fix It
Remember that every adverse outcome is preceded by at least 4 Red Flags or warning signs. Here are 4 Red Flags for which you should be alert during the execution of your emergency plan:
1. Ambiguity - 2 or more sources of information (or people) disagree
2. Not meeting targets - failure to meet deadlines, timelines, or not getting desired results
3. Violating policy, procedure or protocol - in an emergency, it may be necessary, but it should always be acknowledged and discussed
4. Fatigue - you are going to work long hours. 24 hours of wakefulness decreases performance to that of someone who is legally "under the influence"
Ask for a Cross-Check
Your team is on the front lines of a national battle. The hours will be long and arduous. Fatigue and Stress will degrade everyone's performance - including yours. You are not super-human regardless of how tough your residency training was. If you are tired, admit it to yourself and your team, and ask for a cross-check. We succeed or fail as a team.
The current COVID-19 pandemic is a global tragedy with profoundly human consequences. It is also creating situations providing for extraordinary human performance and growth, as team members and leaders come together to do what they can to help those around them. Research suggests that, during an emergency, the most successful teams communicate effectively amongst themselves and as the emergency intensifies, a flatter communication hierarchy develops with more (unsolicited) information coming from the front lines to the command center. Each of these seven skills is designed to get that flatter communication hierarchy critical to successful performance.
All of us at LifeWings are deeply grateful for the heroic work you are doing on the frontlines.
It is our honor to be your partners and to have played a role in preparing you for this moment.
Together, we will prevail.
