Good patient outcome by luck alone is no longer acceptable: It is important for the appropriate process to occur in all interactions, including those between: patient and staff staff and staff the individual and the ‘systems’ within which they work
How: Crisis evolution / avoidance: active / latent factors: environmental organisational cultural individual team patient
Shared Mental Model: Communicate appropriately & effectively voice modulation & non-verbal communication direct specific instructions close communication loop open exchange of information Try see others perspective when communicating with them:
Situation Awareness: Know what is going on around you: Local Regional Systemic ‘Staying ahead of the game’
Conclusion: Systematic approach Knowledge, skill and understanding is required to make the appropriate clinical judgement decisions. Non-technical skills are also required to optimise patient outcome including:
–Anticipating and planning. –Appropriate team leadership. –Effective communication & sharing mental models. –Maintaining situation awareness and utilising appropriate personnel and resources. –Calling for help early enough.