Enhancing Situation Monitoring for Effective Team Communication
Situation Monitoring
Module 3
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Situation Monitoring Exercise:
Rebuild Your Tower
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Rules:
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Same goals and rules as the earlier tower building
exercise except one
BIG
change:
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The Color Guide cannot speak or write the name of any color.
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The Length Guide cannot speak or write any number.
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The Direction Guide cannot speak or write “north,” “south,”
“east,” or “west.”
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Your group will have 1 minute to plan and
2 minutes to build your tower.
2
Situation Monitoring Exercise:
Discuss Rebuilding Your Tower
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Discussion:
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Why was this round harder?
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What strategies did you use to communicate effectively
as a group?
•
What challenges confronting people with limited English
proficiency does this exercise highlight?
•
What situation monitoring concepts and tools
does this exercise illustrate?
3
Objectives
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Understand how situation monitoring affects team processes and
outcomes.
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Explain situation awareness and identify approaches to maximize it.
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Define a shared mental model and how it is cultivated within a team.
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List components of STEP and other mnemonic tools.
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Situation Monitoring…
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Ensures new or changing information is
identified for communication and
decision making.
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Leads to effective support of fellow team
members.
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Situation Monitoring:
A Continuous Process
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Situation Awareness Is…
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The state of knowing the current conditions affecting one’s work.
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It includes knowing…
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Status of the patient.
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Status of other team members.
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Environmental conditions.
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Current progress towards goals.
7
Situation Awareness Small
Group Discussion
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Goal:
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Identify factors that promote and prevent situation awareness.
Process:
•
In your group, compile a list of factors that affect situation
awareness in your team.
•
Create a list of ways other team members help or
hurt your situation awareness.
•
Discuss what group members do to help get and share
information with patients to foster situation awareness.
8
Conditions That Maximize
Situation Awareness
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When team members:
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Share information with the team
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Request information from others
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Direct information to specific team members
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Include patient or family in communication
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Use resources fully (e.g., status board, automation)
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Maintain documentation
•
Know and understand where to focus attention
•
Know and understand the plan
•
Inform team members when the plan has changed
9
How Shared Mental Models
Help Teams
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Lead to mutual understanding of situation
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Lead to more effective communication
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Enable backup behaviors
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Help ensure understanding of each other’
s roles and how they
interplay
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Enable better prediction and anticipation of team needs
•
Create commonality of effort and purpose
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A Shared Mental Model Is…
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The perception of,
understanding of, or
knowledge about a situation
or process that is shared
among team members
through communication.
Who Lacks the Shared Mental Model?
11
What Do You See?
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When and How To Share?
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When:
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Briefs
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Huddles
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Debriefs
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Transitions in care
How:
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SBAR
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Call-outs
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Check-backs
13
Tools To Support Situation
Monitoring
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Status of Patient
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Patient History
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Vital Signs
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Medications
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Physical Exam
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Plan of Care
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Psychosocial Condition
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Patient Preferences or Concerns
•
If Patient Has Limited English
Proficiency
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Team Members
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Fatigue
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Workload
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Task Performance
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Skill Level
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Stress Level
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Environment
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Facility information, including
occupancy levels
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Administrative information
and available staff
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Human resources
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Triage acuity
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Community or facility disease
outbreaks
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Equipment status
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Progress Toward Goal
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Call a Huddle!
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Status of Team’s Patients
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Goal of Team
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Tasks/Actions That Are or
Need To Be Completed
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Plan Still Appropriate
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Tools for Situation Monitoring:
I’M SAFE Checklist
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Tools for Situation Monitoring:
Cross-Monitoring
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What it is:
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“Watching each others’ back” to ensure team members’ actions are consistent with the
plan and advocating for the patient as needed when risks arise and help is needed.
•
Why it matters:
•
The plan may be unclear or misunderstood.
•
The plan may be forgotten or changed.
•
When plans are unclear or not implemented, a shared mental model is lost and patients
are at risk.
•
How to do it:
•
Make monitoring each other a group norm that’s expected and not a sign of mistrust.
•
Encourage asking questions to confirm that actions match the plan.
•
Express concerns when actions aren’t consistent with the plan.
•
Involve the patient whenever relevant.
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Cross-Monitoring Example
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What actions by the nurse
manager demonstrated cross-
monitoring?
•
Would your teams respond
positively to the use of cross-
monitoring by its members?
21
Tools for Situation Monitoring:
STAR
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What it is:
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A four-step mnemonic tool that is used extensively to elicit and share key
information about activities and their consequences.
•
Key elements include:
•
Stop: Pause to focus on the immediate task.
•
Think: Think methodically and identify the correct action.
•
Act: Perform the act.
•
Review: Confirm anticipated result has occurred or apply contingency if required.
•
Practice example:
•
Pick a task you were asked to perform by a family member or friend in the past
month that didn’t quite go as planned. Use STAR to explain what you did and what
you could have done differently to have achieved a better outcome.
22
Tools and Strategies Summary
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Applying TeamSTEPPS Exercise
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1.
Is your teamwork issue related to the team’s or individuals’
situation monitoring skills?
2.
If yes, what is the situation monitoring issue?
3.
Which situation monitoring tools or strategies might you
consider implementing to address the issue?
24
Explore the importance of situation monitoring in team processes, emphasizing situation awareness, shared mental models, and mnemonic tools. Engage in interactive exercises to understand challenges in communication and decision-making. Discover how effective situation monitoring ensures new information is communicated promptly and supports team members effectively.
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Presentation Transcript
Situation Monitoring Module 3 1
Situation Monitoring Exercise: Rebuild Your Tower Situation Monitoring Rules: Same goals and rules as the earlier tower building exercise except one BIG change: The Color Guide cannot speak or write the name of any color. The Length Guide cannot speak or write any number. The Direction Guide cannot speak or write north, south, east, or west. Your group will have 1 minute to plan and 2 minutes to build your tower. 2
Situation Monitoring Exercise: Discuss Rebuilding Your Tower Situation Monitoring Discussion: Why was this round harder? What strategies did you use to communicate effectively as a group? What challenges confronting people with limited English proficiency does this exercise highlight? What situation monitoring concepts and tools does this exercise illustrate? 3
Situation Monitoring Objectives Understand how situation monitoring affects team processes and outcomes. Explain situation awareness and identify approaches to maximize it. Define a shared mental model and how it is cultivated within a team. List components of STEP and other mnemonic tools. 4
Situation Monitoring Situation Monitoring Ensures new or changing information is identified for communication and decision making. Leads to effective support of fellow team members. 5
Situation Monitoring: A Continuous Process Situation Monitoring 6
Situation Monitoring Situation Awareness Is The state of knowing the current conditions affecting one s work. It includes knowing Status of the patient. Status of other team members. Environmental conditions. Current progress towards goals. 7
Situation Awareness Small Group Discussion Situation Monitoring Goal: Identify factors that promote and prevent situation awareness. Process: In your group, compile a list of factors that affect situation awareness in your team. Create a list of ways other team members help or hurt your situation awareness. Discuss what group members do to help get and share information with patients to foster situation awareness. 8
Conditions That Maximize Situation Awareness Situation Monitoring When team members: Share information with the team Request information from others Direct information to specific team members Include patient or family in communication Use resources fully (e.g., status board, automation) Maintain documentation Know and understand where to focus attention Know and understand the plan Inform team members when the plan has changed 9
How Shared Mental Models Help Teams Situation Monitoring Lead to mutual understanding of situation Lead to more effective communication Enable backup behaviors Help ensure understanding of each other s roles and how they interplay Enable better prediction and anticipation of team needs Create commonality of effort and purpose 10
Situation Monitoring A Shared Mental Model Is The perception of, understanding of, or knowledge about a situation or process that is shared among team members through communication. Who Lacks the Shared Mental Model? 11
Situation Monitoring What Do You See? 12
Situation Monitoring When and How To Share? When: Briefs Huddles Debriefs Transitions in care How: SBAR Call-outs Check-backs 13
Tools To Support Situation Monitoring Situation Monitoring Tool Primary Use STEP I M SAFE Cross-Monitoring Status of Environment and Other Team Members STAR Status of Specific Activities or Tasks Patient Status Team Member Status 14
Situation Monitoring Status of Patient Patient History Vital Signs Medications Physical Exam Plan of Care Psychosocial Condition Patient Preferences or Concerns If Patient Has Limited English Proficiency 15
Situation Monitoring Team Members Fatigue Workload Task Performance Skill Level Stress Level 16
Situation Monitoring Environment Facility information, including occupancy levels Administrative information and available staff Human resources Triage acuity Community or facility disease outbreaks Equipment status 17
Situation Monitoring Progress Toward Goal Call a Huddle! Status of Team s Patients Goal of Team Tasks/Actions That Are or Need To Be Completed Plan Still Appropriate 18
Tools for Situation Monitoring: I M SAFE Checklist Situation Monitoring 19
Tools for Situation Monitoring: Cross-Monitoring Situation Monitoring What it is: Watching each others back to ensure team members actions are consistent with the plan and advocating for the patient as needed when risks arise and help is needed. Why it matters: The plan may be unclear or misunderstood. The plan may be forgotten or changed. When plans are unclear or not implemented, a shared mental model is lost and patients are at risk. How to do it: Make monitoring each other a group norm that s expected and not a sign of mistrust. Encourage asking questions to confirm that actions match the plan. Express concerns when actions aren t consistent with the plan. Involve the patient whenever relevant. 20
Situation Monitoring Cross-Monitoring Example What actions by the nurse manager demonstrated cross- monitoring? Would your teams respond positively to the use of cross- monitoring by its members? 21
Tools for Situation Monitoring: STAR Situation Monitoring What it is: A four-step mnemonic tool that is used extensively to elicit and share key information about activities and their consequences. Key elements include: Stop: Pause to focus on the immediate task. Think: Think methodically and identify the correct action. Act: Perform the act. Review: Confirm anticipated result has occurred or apply contingency if required. Practice example: Pick a task you were asked to perform by a family member or friend in the past month that didn t quite go as planned. Use STAR to explain what you did and what you could have done differently to have achieved a better outcome. 22
Situation Monitoring Tools and Strategies Summary 23
Situation Monitoring Applying TeamSTEPPS Exercise 1. Is your teamwork issue related to the team s or individuals situation monitoring skills? 2. If yes, what is the situation monitoring issue? 3. Which situation monitoring tools or strategies might you consider implementing to address the issue? 24
