Resuscitation Team Organization for Emergency Departments: A Conceptual Review and Discussion

Abstract

Abstract:In this article we discuss code or resuscitation team organization. The goals of this article are to define the questions surrounding code team organization and structure, discuss how organization can make a difference, review resuscitation systems and processes, and discuss aspects of team structure and performance. Issues of team performance include teamwork, leadership, communication and safety.

A Qualitative Study Exploring Moral Distress Among Pediatric Resuscitation Team Clinicians: Challenges to Professional Integrity*

“…In contrast to the endorsement of the moral imperative for collaborative and horizontal model of teamwork (19)(20)(21)(22)(23), our clinicians' experiences suggest that they also value a clear vertical hierarchy, in which the team leader explicitly takes the responsibility to direct and regulate team dynamics. Clinicians emphasized that the team leader should help team members understand the patient's "big picture," reaffirm team members' role responsibilities, and clarify any misconceptions regarding variations in practice.…”

Teamwork and Leadership in Cardiopulmonary Resuscitation

“…One explanation for this finding may be that members of the pre-formed teams had the opportunity to access the same information about the patient as opposed to relying on 1 physician to relay information of his or her choosing. This highlights the importance of rules about resuscitations and other crisis events that require immediate and open sharing of specific findings and refraining from early diagnoses by individual team members (28).…”

“…If group members are concentrating on different parts of the task, they may not have an integrated view of the overall task. Many resuscitation teams adopt a countermeasure to this, assigning 1 member to record interventions and events (28). If this is not the case, specific communication habits (explicitly commenting on the ongoing task and progress (e.g., "this is the first defibrillation at 120 J") may help team members to remember important details (47,48).…”

Cognitive work analysis and simulation (CWAS): practical use of cognitive work analysis in system design

“…According to the roles, the Leader and the Recorder have the most communication, and the Leader has most decisions to make, making them the two team members with highest mental workload. For the Leader, the main concern is diverging from the protocol, an incident that occurs most when there is flawed communication (Mellick & Adams, 2009). Therefore, in this study the intention is to analyze the ACLS team and find proper improvement plans to overcome these challenges.…”

“…The data about the process were collected through using the official handbook of American Heart Association (AHA) and several instructional videos available online (Ali, 2012;American Heart Association, 2010, 2013Kalus, 2012;Patrawi, 2011). In addition, several research articles helped with understanding the different aspects of the process and the problems that health care personnel face (Marsch et al, 2004;McEvoy et al, 2014;Mellick & Adams, 2009;Rittenberger et al, 2006). In addition, considering the process is standardized, the timing of every event in the process is well defined.…”