Back to all Culture of Safety Tactics
Cross-education and Shared Social Events Rebuilt Trust Between Anesthesia and Care Teams
Overview
What was the reason for the change?
Lack of communication and sentiment of unity.
What were we trying to accomplish?
Educating the other team members (OB and nursing) about what we do to emulate respect and trust of the anesthesia team.
How will we know that a change is an improvement?
Subjective feeling of “connecting” among team members and surveys sent to all team members regarding points such as communication, trust, safety…
Implementation
How long did it take to get up and running?
24 months.
How was readiness assessed & required resources identified?
Leadership buy-in mostly.
What were the missteps and lessons learned along the way?
Human relationships sometimes difficult to navigate: For example I came as a the new chief from another institution and nobody knew me. My chair gave me the wise advice to first observe and listen before initiating any changes. Which I did and it allowed me to know and understand people and their concerns. It also allowed people to know me and my team members as well as our skills.
Solution Design
What changes can we make that will result in an improvement?
1. Knowing each other through:
- face sheets: every month I create sheets with the residents pictures, names and year of training that get laminated and posted in each nursing pods, to allow for better interactions.
- social outings: nursing and anesthesia leadership going to Happy Hours, potlucks during holidays between anesthesia, nursing and OB teams, participating to each other holidays parties.
2. Knowing what are the competencies of other team members emulating trust in skills and knowledge, understanding what the other teams do and why: I organized training and lectures for nursing and OB residents/fellows. I do have the PPT presentations I created.
What was your implementation strategy and critical steps?
- Finding a leader (me for OB anesthesia but also would meet on regular basis and PRN with leaders from other teams to listen to feedback and address them with my team and vice versa) who would listen to the needs and frustrations of other team members.
- Establishing trust (through availability and genuine interest in what other team members have to say) toward this leader within its own team but also among other teams, establishing a network of leaders with the same goals, having team members who understand goals and purposes of team work, establishing protocols to limit variability and also manage expectations from other teams: for example some issues arose regarding IV placements so we creating an algorithm for nurses to activate anesthesia after having tried other options including asking their charge nurses.
Adoption & Sustainability
How did you communicate the tactic to those affected by it?
Having a clear plan, as well as goals and objectives not only carried out by leadership but also by all team members.
How did you design for sustainability of the change?
Endurance by repeating the same model until changes were obtained. This was actually the only way we were able to move things toward a positive culture of teamwork.
- interdisciplinary communication
- teamwork
- trust
