SPECIAL SECTION: Task Complexity in Emergency Medical Care and Its Implications for Team Coordination

Abstract

To elicit components of task complexity in emergency medical care, a study was conducted to contrast one medical procedure with two levels of task urgency in trauma patient resuscitation. Videotapes of actual resuscitation were reviewed to extract task characteristics of the procedure. Two levels of urgency were compared in the following areas: patient status, technical difficulty of tasks, the amount of available patient monitoring information, and the pace of work. Four components of task complexity in emergency medical care were identified: multiple and concurrent task, uncertainty, changing plans, and compressed work procedures and high workload. These components of task complexity pose challenges to team functions and can lead to problems in team coordination, such as conflicts in goals, tasks, and access to the patient. Training to increase explicit communications and improvements in the design of work procedures are necessary in order to meet the challenges of task complexity.

Teaching teamwork during the Neonatal Resuscitation Program: a randomized trial

“…This is due in part to expert groups such as the Institute of Medicine and regulators like the Joint Commission for Accreditation of Health-care Organizations who advocate some type of team training. In addition, research suggests the need for improved teamwork and communication in neonatal intensive care, 2,3,16 emergency departments, 10 the operating room, 17,18 trauma resuscitation [19][20][21] and among residents of all disciplines. 22 Despite this interest and research, two recent reviews concluded that no studies have shown that team training can improve teamwork and the quality of care, 11,12 and a cluster randomized trial of team training for labor and delivery teams did not find significant changes in the process of care or outcome measures.…”

Best Practices in Military Design Teams

“…Salas, Stagl, Burke, & Goodwin's (2007) review of the literature identified over 130 models and frameworks for team performance that range in level of specificity. While some models are generalizable and parsimonious, such as Salas, Sim's, and Burke's (2005) "Big Five" of teamwork, other models are much more task-or context-specific (for example Xiao, Hunter, Mackenzie, Jefferies, & Horst, 1996). Other models focus on specific team functions or processes .…”

Navigating Towards Improved Surgical Safety Using Aviation-Based Strategies

“…In surgery, human factors analysis has been used to analyze errors and near misses during neonatal cardiac operations [47,48]. Human factors analysis has also been used to examine an activity (e.g., an operation) in terms of its components such as technical and nontechnical skill demands [28], mental workload [49], interactions with technology [50] and the work environment [28], and team dynamics [51]. Using this framework for identifying and classifying errors may allow for a better understanding of why near misses and errors occur so as to develop preventive strategies.…”