At the beginning of each 2 week rotation the attending and or team resident should conduct a team launch. Why is a team launch helpful and how should this be conducted? Airline pilots and surgeons (using the WHO surgical checklist) always conduct a team launch. This assures everyone understands their role, enhances communication and coordination of care. How to effectively conduct a team launch is described on pg 173-174 Critically Ill: 5-point plan to cure healthcare delivery https://www.amazon.com/Critically-Ill-5-Point-Healthcare-Delivery/dp/0991549805/) There are 8 steps to an effective team launch:
Team Launch (begin 15-30 minutes before the first work rounds with the new attending)
Introduction – Because teamwork is very important for improving the coordination of patient care, As the team resident I would like to conduct a team launch. This well tested method allows a team to come together more quickly and promises to improve the quality and efficiency of the care we deliver.
- Can everyone introduce them self? Please describe your greatest strength or strengths as well as share one weakness.
- Discuss our goals – to improve the health and wellbeing of our patients, and as a measurable goal propose completing work rounds in under 2 hours.
- Describe the importance of everyone knowing his/her specific roles on the team. Refer them to the Gatorounds website where each person’s roles are defined and suggest that if any member of the team disagrees with elements of their play book they are welcome to make suggestions for improvement. http://gatorounds.med.ufl.edu/how-do-i-implement-gatorounds/playbooks/
- Discuss the importance of using the SOAP+ disposition communication protocol for presentations of each patient’s progress. Have everyone watch the sample presentation video http://gatorounds.med.ufl.edu/how-do-i-implement-gatorounds/fundamental-communication-protocols/ These presentations should take only 2-3 minutes. (remember the attending should have reviewed the EMR prior to rounds)
- Milestone – Suggest the milestone be completing work rounds in under 2 hours within 7 days.
- Behavioral norms – What should we never do? We should never be disrespectful toward patients, students, nurses, residents or others working with us to care for our patients. What should we always do? Listen respectfully to our patients and our team members. We will huddle in a circle and create a zone of psychological safety where everyone feels comfortable sharing their ideas. If someone disagrees they should feel comfortable sharing their concerns. We want to be able to disagree, but disagree agreeably. Work will be shared among team members, the patients are the team’s patients and everyone on the team should be familiar with the details of every patient.. To encourage continual improvement at the end of work rounds each day we will ask, “What went well? Followed by, “What could be improved?” This will allow the implementation of improvements each day.
- Agree on how decisions will be made –. All members of the team should feel free to share their ideas and opinions on the management of each patient. When possible a consensus should be achieved. If there is not agreement the attending makes the final decision.
- Motivation statement – Describe the potential benefits of working effectively as team – more efficient care resulting in shorter lengths of stay, house staff completing work earlier (usually 1-2 hours/day), improved coordination of care and improved satisfaction of physicians, medical students, nurses and if conducted properly at the bedside improve patient and patient family satisfaction.