mutual support 医疗团队资源管理(trm).ppt

* * * * * * * Invoked when an initial assertion is ignored… It is your responsibility to assertively voice your concern at least two times to ensure that it has been heard The member being challenged must acknowledge If the outcome is still not acceptable Take a stronger course of action Use supervisor or chain of command “Empower any member of the team to “stop the line” if he or she senses or discovers an essential safety breach.” This is an action never to be taken lightly, but it requires immediate cessation of the process and resolution of the safety issue. * * * * A constructive approach for managing and resolving conflict D—Describe the specific situation E—Express your concerns about the action S—Suggest other alternatives C—Consequences should be stated A constructive approach for managing and resolving conflict D—Describe the specific situation E—Express your concerns about the action S—Suggest other alternatives C—Consequences should be stated * * * * * * * * * * Scenario 婦產科醫師出現了……. 周醫師(怒氣沖沖地衝進外科來診): 誰說要打Pitressin的,有沒有一點常識啊! 我們婦產科病人什麼時候用過pitressin? 這是誰開的order?出事的話,請他自己負責! 蔡醫師: 幹嘛那麼凶?照會你來看病人,沒來看病人還愛用電話order,這樣對嗎? 我是好心幫你忙,才幫你開order耶!自己沒講清楚,才害我開錯藥.早知道你是這種人,我才懶得幫你呢! * 如果重新再來一遍,你會怎麼做? 你是Dr蔡,你會怎麼做? 你是Dr周,你會怎麼做? 你是Nurse侯,你會怎麼做? 你是Nurse田,你會怎麼做? * Advocacy and Assertion 從病患的角度出發(Advocacy) 在團隊成員的意見與主事者的決定不同時，應以這個角度來思考 堅持己見(Assertion) 以尊重且堅定的語氣，提出不同的意見 * 訊息紛爭 (We have different information!) Two-Challenge rule 重申關切 解決紛爭 個人紛爭 (Hostile and harassing behavior) “自覺” (Self-Awareness) DESC口訣 * 重申關切 (Two-Challenge Rule ) 1 2 * 重申關切 (Two-Challenge Rule) 當團隊中任何成員發現或是感到病患安全有疑慮時，都有權責喊「卡！」 不要小看這個動作，反而要正視並且立刻停下程序，並設法解決病患安全問題！ * Be a nice Challeng”ee” Thank you for telling me!! 好險!! * 解決個人紛爭 : “自覺” (Self-Awareness) 對於解決衝突和紛爭的建設性做法: 先停下來問自己三個主要問題: 1. 發生了什麼事？ 我現在在做什麼？ 我現在感覺如何？ 我現在在想什麼？ 我現在想要什麼？ 我現在所做的事情當中，有那些會阻礙我得到我想要的東西？ 此時，要做個選擇。 深深吸一口氣，繼續往下走。 * 表示異議 - DESC 口訣 尊重並支持主事者 清楚的陳述自己的疑問與建議 採用堅定的語氣(不具攻擊性，但著重在重要的資訊上) D—Describe 描述此一特殊狀況 E—Ex