Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care.
Critical care
Pandemics
Patient care team
Stroke
Journal
Neurocritical care
ISSN: 1556-0961
Titre abrégé: Neurocrit Care
Pays: United States
ID NLM: 101156086
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
18
05
2020
accepted:
20
07
2020
pubmed:
15
8
2020
medline:
3
10
2020
entrez:
15
8
2020
Statut:
ppublish
Résumé
Management of stroke patients in the acute setting is a high-stakes task with several challenges including the need for rapid assessment and treatment, maintenance of high-performing team dynamics, management of cognitive load affecting providers, and factors impacting team communication. Crisis resource management (CRM) provides a framework to tackle these challenges and is well established in other resuscitative disciplines. The current Coronavirus Disease 2019 (COVID-19) pandemic has exposed a potential quality gap in emergency preparedness and the ability to adapt to emergency scenarios in real time. Available resources in the literature in other disciplines and expert consensus were used to identify key elements of CRM as they apply to acute stroke management. We outline essential ingredients of CRM as a means to mitigate nontechnical challenges providers face during acute stroke care. These strategies include situational awareness, triage and prioritization, mitigation of cognitive load, team member role clarity, communication, and debriefing. Incorporation of CRM along with simulation is an established tool in other resuscitative disciplines and can be incorporated into acute stroke care. As stroke care processes evolve during these trying times, the importance of consistent, safe, and efficacious care facilitated by CRM principles offers a unique avenue to alleviate human factors and support high-performing teams.
Sections du résumé
BACKGROUND AND PURPOSE
Management of stroke patients in the acute setting is a high-stakes task with several challenges including the need for rapid assessment and treatment, maintenance of high-performing team dynamics, management of cognitive load affecting providers, and factors impacting team communication. Crisis resource management (CRM) provides a framework to tackle these challenges and is well established in other resuscitative disciplines. The current Coronavirus Disease 2019 (COVID-19) pandemic has exposed a potential quality gap in emergency preparedness and the ability to adapt to emergency scenarios in real time.
METHODS
Available resources in the literature in other disciplines and expert consensus were used to identify key elements of CRM as they apply to acute stroke management.
RESULTS
We outline essential ingredients of CRM as a means to mitigate nontechnical challenges providers face during acute stroke care. These strategies include situational awareness, triage and prioritization, mitigation of cognitive load, team member role clarity, communication, and debriefing. Incorporation of CRM along with simulation is an established tool in other resuscitative disciplines and can be incorporated into acute stroke care.
CONCLUSIONS
As stroke care processes evolve during these trying times, the importance of consistent, safe, and efficacious care facilitated by CRM principles offers a unique avenue to alleviate human factors and support high-performing teams.
Identifiants
pubmed: 32794144
doi: 10.1007/s12028-020-01057-4
pii: 10.1007/s12028-020-01057-4
pmc: PMC7426067
doi:
Types de publication
Editorial
Langues
eng
Sous-ensembles de citation
IM
Pagination
338-346Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
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