Interprofessional Education

Today's installment of the Inter-Professional Education series was delivered by Kristi Larned, pharmacist, on situational awareness in the clinic between our IPE members. Our clinic consists of attending physicians, med students, nursing students, pharmacists, and other related healthcare professionals such as administrative assistants and patient recruiters.

Situational awareness: 

• Understanding of, or knowledge about, a situation or process that is shared among team members through communication.
• Being attentive to the environment.
• Technique used in decision-making in settings that need quick action.
• A skill that can be improved over time.

Situational monitoring:

• Pay attention to the status of the patient
• Cross-monitor team members
• Survey environment
• Preventing errors that may be caused
• Fosters mutual respect and communication for team members
• Ensures everyone on the team has an idea of what it should look like
• Enables team members to predict and anticipate better
• Creates commonality between members
• Progress toward goal

Barriers:

• Distraction
• Workload
• Fatigue
• Misinterpretation
• Failure to share information (forgot, distracted)

Shared mental model: 

• Perception
• Understanding of or knowledge about a situation or process that is shared among team members through communication.
• Increased accountability

Situation Monitoring Prescribed to:

• Rounds, which are quick
• When more attention is given to patients with more acute conditions.
• People are talking over the team so it's easy to miss information

Strategies to overcome this:

• Checklists
• Engage the patient when discussing regimen
• Helping others with a heavy workload
• Cosigner making sure you're doing everything complete
• Huddles, debriefs, more communication
• Cross-monitoring

Clinical encounter:

• 47 year old female
• History of coronary artery disease, diabetes, mild hypertension
• Status post CABG (Coronary Artery Bypass Grafting) and NSTEMI (Non-ST segment elevation myocardial infarction).
• Chief complaint: shortness of breath and intermittent substernal discomfort.

Our plan to address patient:

• Getting a set of vitals to figure out tests to run
• Approaching the pt directly to identify the cause of SOB
• Survey the scene for any helpful people around
• Notifying the appropriate personnel
• Start triaging

Take Home Points:

• Using situational monitoring and cross-monitoring to better serve our patients by having a protocol and communicating between teams to see if we can help each other with patients. 
• Have a peer to peer feedback survey.