for OfficeBased Care Situation Monitoring OfficeBased Care Situation

for Office-Based Care Situation Monitoring

Office-Based Care Situation Monitoring n Process of actively scanning behaviors and actions to assess elements of the situation or environment n Enables team members to identify the potential issues or minor deviations n Benefits: n Fosters mutual respect and team accountability n Provides safety net for team and patient n Includes cross-monitoring Remember, engage the patient whenever possible! Mod Page 1 205. 2 Page 2 TEAMSTEPPS 05. 2

Office-Based Care Cross-Monitoring n A process of ongoing monitoring to recognize risk or unfolding error n An opportunity to interrupt or correct an action or event before there is harm or injury to the patient n “Watching each other’s backs” n Providing feedback to ensure the procedures are being performed appropriately “Mutual performance monitoring has been shown to be an important team competency. ” Mc. Intyre RM, Salas E. Measuring and managing for team performance: emerging principles from complex environments. In: Guzzo RA, Salas E, eds. Team effectiveness and decision making in organizations. San Francisco: Jossey-Bass; 1995. p. 9 -45. Mod Page 1 305. 2 Page 3 TEAMSTEPPS 05. 2

Office-Based Care Steps to monitor the situation Mod Page 1 405. 2 Page 4 TEAMSTEPPS 05. 2

Office-Based Care Situation Monitoring in the Medical Office Let’s watch the second office team demonstrate proper situation monitoring. Mod Page 1 505. 2 Page 5 TEAMSTEPPS 05. 2

Office-Based Care Situation Monitoring Exercise n How does that video compare to the scenario seen in the first lesson? n Ask yourself: Mod Page 1 605. 2 Page 6 n Was situation monitoring demonstrated in this video? n Was this strategy effective? Why was it effective or not effective? n Did you see any other opportunities for situation monitoring? n Have you encountered situations similar to this in your team? Have you encountered barriers to proper situation monitoring? TEAMSTEPPS 05. 2

Office-Based Care Situation Monitoring Exercise n Think about your daily office routine. n Have you encountered barriers to situation monitoring? n What strategy would you use to overcome them? Mod Page 1 705. 2 Page 7 TEAMSTEPPS 05. 2

Office-Based Care Front Office Scenario Susan was due for a mammogram and the provider ordered it. Upon arrival at the mammography service, Susan was told that she would have to pay for the mammogram, since her insurance company did not cover it. Confused, Susan returned to the clinic and told the administrative assistant that she did not have the money to pay for this. She was especially upset because her mother was a breast cancer survivor. The administrative assistant assessed (1) the status of the situation (that a billing specialist was needed); (2), the environment (the patient was upset); and (3) the progress toward the goal (patient was being denied access). The billing specialist then called the insurer and clarified that the insurer had the wrong dates and Susan’s mammogram was due. The insurer realized their error and covered the mammogram. Mod Page 1 805. 2 Page 8 TEAMSTEPPS 05. 2

Office-Based Care Establish a Shared Mental Model n An organized knowledge structure of relevant facts and relationships about a task or situation that are commonly held by team members. n n Mod Page 1 905. 2 Page 9 Team effectiveness will improve if team members have a shared understanding of the situation. In health care, if the wrong plan is developed, potentially all actions that follow are wrong, and the patient and caregiver are at risk. TEAMSTEPPS 05. 2

Office-Based Care Situation Monitoring BARRIERS n Hierarchical Culture n Lack of Resources n n n n or Information Ineffective Communication Conflict Time Distractions Workload Fatigue Misinterpretation of Data Failure To Share Information Mod Page 1 10 05. 2 Page 10 TOOLS and STRATEGIES Brief Huddle Debrief STEP Cross. Monitoring OUTCOMES n Situation n n TEAMSTEPPS 05. 2 Awareness Shared Mental Model Adaptability Team Orientation Mutual Trust 10