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Sample records for safety team emergency

  1. The culture of patient safety from the perspective of the pediatric emergency nursing team

    Directory of Open Access Journals (Sweden)

    Taise Rocha Macedo

    Full Text Available Abstract OBJECTIVE To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. METHOD A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. RESULTS Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. CONCLUSION Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario.

  2. How the nuclear safety team conducts emergency exercises at the IEA-R1 reactor

    International Nuclear Information System (INIS)

    Vaz, Antonio C.A.; Silva, Davilson G.; Toyoda, Eduardo Y.; Santia, Paulo S.; Conti, Thadeu N.; Semmler, Renato; Carvalho, Ricardo N.

    2015-01-01

    This work introduces the Diagram of Emergency Exercise Coordination designed by the Nuclear Safety Team for better Emergency Exercise coordination. The Nuclear Safety Team was created with the mission of avoiding, preventing and mitigating the causes and effects of accidents at the IEA-R1. The facility where we conduct our work is located in an area of a huge population, what increases the responsibility of our mission: conducting exercises and training are part of our daily activities. During the Emergency Exercise, accidents ranked 0-4 on INES (International Nuclear Events Scale) are simulated and involve: Police Department, Fire Department, workers, people from the community, and others. In the last exercise held in June 2014, the scenario contemplated a terrorist organization action that infiltrated in a group of students who were visiting the IEA-R1, tried to steal fresh fuel element to fabricate a dirty bomb. Emergency procedures and plans, timeline and metrics of the actions were applied to the Emergency Exercise evaluation. The next exercise will be held in November, with the simulation of the piping of the primary cooling circuit rupture, causing the emptying of the pool and the lack of cooling of the fuel elements in the reactor core: this will be the scenario. The skills acquired and the systems improvement have been very important tools for the reactor operation safety and the Nuclear Safety Team is making technical efforts so that these Emergency Exercises may be applied to other nuclear and radiological facilities. Equally important for the process of improving nuclear safety is the emphasis placed on implementing quality improvements to the human factor in the nuclear safety area, a crucial element that is often not considered by those outside the nuclear sector. Surely, the Diagram of Emergency Exercise Coordination application will improve and facilitate the organization, coordination and evaluation tasks. (author)

  3. How the nuclear safety team conducts emergency exercises at the IEA-R1 reactor

    Energy Technology Data Exchange (ETDEWEB)

    Vaz, Antonio C.A.; Silva, Davilson G.; Toyoda, Eduardo Y.; Santia, Paulo S.; Conti, Thadeu N.; Semmler, Renato; Carvalho, Ricardo N., E-mail: acavaz@ipen.br, E-mail: dgsilva@ipen.br, E-mail: eytoyoda@ipen.br, E-mail: psantia@ipen.br, E-mail: tnconti@ipen.br, E-mail: rsemmler@ipen.b, E-mail: rncarval@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2015-07-01

    This work introduces the Diagram of Emergency Exercise Coordination designed by the Nuclear Safety Team for better Emergency Exercise coordination. The Nuclear Safety Team was created with the mission of avoiding, preventing and mitigating the causes and effects of accidents at the IEA-R1. The facility where we conduct our work is located in an area of a huge population, what increases the responsibility of our mission: conducting exercises and training are part of our daily activities. During the Emergency Exercise, accidents ranked 0-4 on INES (International Nuclear Events Scale) are simulated and involve: Police Department, Fire Department, workers, people from the community, and others. In the last exercise held in June 2014, the scenario contemplated a terrorist organization action that infiltrated in a group of students who were visiting the IEA-R1, tried to steal fresh fuel element to fabricate a dirty bomb. Emergency procedures and plans, timeline and metrics of the actions were applied to the Emergency Exercise evaluation. The next exercise will be held in November, with the simulation of the piping of the primary cooling circuit rupture, causing the emptying of the pool and the lack of cooling of the fuel elements in the reactor core: this will be the scenario. The skills acquired and the systems improvement have been very important tools for the reactor operation safety and the Nuclear Safety Team is making technical efforts so that these Emergency Exercises may be applied to other nuclear and radiological facilities. Equally important for the process of improving nuclear safety is the emphasis placed on implementing quality improvements to the human factor in the nuclear safety area, a crucial element that is often not considered by those outside the nuclear sector. Surely, the Diagram of Emergency Exercise Coordination application will improve and facilitate the organization, coordination and evaluation tasks. (author)

  4. Behavioral Emergency Response Team: Implementation Improves Patient Safety, Staff Safety, and Staff Collaboration.

    Science.gov (United States)

    Zicko, Cdr Jennifer M; Schroeder, Lcdr Rebecca A; Byers, Cdr William S; Taylor, Lt Adam M; Spence, Cdr Dennis L

    2017-10-01

    Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies. A BERT was piloted on one MS unit for 5 months and expanded to two additional units for 3 months. Pre- and postimplementation staff surveys were conducted, and the number of staff assaults and injuries, restraint usage, and security intervention were compared. The BERT responded to 17 behavioral emergencies. The number of assaults decreased from 10 (pre) to 1 (post); security intervention decreased from 14 to 1; and restraint use decreased from 8 to 1. MS staffs' level of BERT knowledge and rating of support between MH staff and their staff significantly increased. Both MS and MH nurses rated the BERT as supportive and effective. A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety. © 2017 Sigma Theta Tau International.

  5. The culture of patient safety from the perspective of the pediatric emergency nursing team.

    Science.gov (United States)

    Macedo, Taise Rocha; Rocha, Patricia Kuerten; Tomazoni, Andreia; Souza, Sabrina de; Anders, Jane Cristina; Davis, Karri

    2016-01-01

    To identify the patient safety culture in pediatric emergencies from the perspective of the nursing team. A quantitative, cross-sectional survey research study with a sample composed of 75 professionals of the nursing team. Data was collected between September and November 2014 in three Pediatric Emergency units by applying the Hospital Survey on Patient Safety Culture instrument. Data were submitted to descriptive analysis. Strong areas for patient safety were not found, with areas identified having potential being: Expectations and actions from supervisors/management to promote patient safety and teamwork. Areas identified as critical were: Non-punitive response to error and support from hospital management for patient safety. The study found a gap between the safety culture and pediatric emergencies, but it found possibilities of transformation that will contribute to the safety of pediatric patients. Nursing professionals need to become protagonists in the process of replacing the current paradigm for a culture focused on safety. The replication of this study in other institutions is suggested in order to improve the current health care scenario. Identificar a cultura de segurança do paciente em emergências pediátricas, na perspectiva da equipe de enfermagem. Pesquisa quantitativa, tipo survey transversal. Amostra composta por 75 profissionais da equipe de enfermagem. Dados coletados entre setembro e novembro de 2014, em três Emergências Pediátricas, aplicando o instrumento Hospital Survey on Patient Safety Culture. Dados submetidos à análise descritiva. Não foram encontradas áreas de força para a segurança do paciente, sendo identificadas áreas com potencial de assim se tornarem: Expectativas e ações do supervisor/chefia para promoção da segurança do paciente e Trabalho em equipe. Como área crítica identificaram-se: Resposta não punitiva ao erro e Apoio da gestão hospitalar para segurança do paciente. O estudo apontou distanciamento

  6. Exploring the importance of team psychological safety in the development of two interprofessional teams.

    Science.gov (United States)

    O'Leary, Denise Fiona

    2016-01-01

    It has been previously demonstrated that interactions within interprofessional teams are characterised by effective communication, shared decision-making, and knowledge sharing. This article outlines aspects of an action research study examining the emergence of these characteristics within change management teams made up of nurses, general practitioners, physiotherapists, care assistants, a health and safety officer, and a client at two residential care facilities for older people in Ireland. The theoretical concept of team psychological safety (TPS) is utilised in presenting these characteristics. TPS has been defined as an atmosphere within a team where individuals feel comfortable engaging in discussion and reflection without fear of censure. Study results suggest that TPS was an important catalyst in enhancing understanding and power sharing across professional boundaries and thus in the development of interprofessional teamwork. There were differences between the teams. In one facility, the team developed many characteristics of interprofessional teamwork while at the other there was only a limited shift. Stability in team membership and organisational norms relating to shared decision-making emerged as particularly important in accounting for differences in the development of TPS and interprofessional teamwork.

  7. [Does simulator-based team training improve patient safety?].

    Science.gov (United States)

    Trentzsch, H; Urban, B; Sandmeyer, B; Hammer, T; Strohm, P C; Lazarovici, M

    2013-10-01

    Patient safety became paramount in medicine as well as in emergency medicine after it was recognized that preventable, adverse events significantly contributed to morbidity and mortality during hospital stay. The underlying errors cannot usually be explained by medical technical inadequacies only but are more due to difficulties in the transition of theoretical knowledge into tasks under the conditions of clinical reality. Crew Resource Management and Human Factors which determine safety and efficiency of humans in complex situations are suitable to control such sources of error. Simulation significantly improved safety in high reliability organizations, such as the aerospace industry.Thus, simulator-based team training has also been proposed for medical areas. As such training is consuming in cost, time and human resources, the question of the cost-benefit ratio obviously arises. This review outlines the effects of simulator-based team training on patient safety. Such course formats are not only capable of creating awareness and improvements in safety culture but also improve technical team performance and emphasize team performance as a clinical competence. A few studies even indicated improvement of patient-centered outcome, such as a reduced rate of adverse events but further studies are required in this respect. In summary, simulator-based team training should be accepted as a suitable strategy to improve patient safety.

  8. Addressing Dual Patient and Staff Safety Through A Team-Based Standardized Patient Simulation for Agitation Management in the Emergency Department.

    Science.gov (United States)

    Wong, Ambrose H; Auerbach, Marc A; Ruppel, Halley; Crispino, Lauren J; Rosenberg, Alana; Iennaco, Joanne D; Vaca, Federico E

    2018-06-01

    Emergency departments (EDs) have seen harm rise for both patients and health workers from an increasing rate of agitation events. Team effectiveness during care of this population is particularly challenging because fear of physical harm leads to competing interests. Simulation is frequently employed to improve teamwork in medical resuscitations but has not yet been reported to address team-based behavioral emergency care. As part of a larger investigation of agitated patient care, we designed this secondary study to examine the impact of an interprofessional standardized patient simulation for ED agitation management. We used a mixed-methods approach with emergency medicine resident and attending physicians, Physician Assistants (PAs) and Advanced Practice Registered Nurses (APRNs), ED nurses, technicians, and security officers at two hospital sites. After a simulated agitated patient encounter, we conducted uniprofessional and interprofessional focus groups. We undertook structured thematic analysis using a grounded theory approach. Quantitative data consisted of responses to the KidSIM Questionnaire addressing teamwork and simulation-based learning attitudes before and after each session. We reached data saturation with 57 participants. KidSIM scores revealed significant improvements in attitudes toward relevance of simulation, opportunities for interprofessional education, and situation awareness, as well as four of six questions for roles/responsibilities. Two broad themes emerged from the focus groups: (1) a team-based agitated patient simulation addressed dual safety of staff and patients simultaneously and (2) the experience fostered interprofessional discovery and cooperation in agitation management. A team-based simulated agitated patient encounter highlighted the need to consider the dual safety of staff and patients while facilitating interprofessional dialog and learning. Our findings suggest that simulation may be effective to enhance teamwork in

  9. Emergency team personnel and technical equipment

    International Nuclear Information System (INIS)

    Muralt, R.

    1989-01-01

    The most important requirements for the emergency team can be summarized in three points. 1) The emergency team must be made up of top personnel from all fields and it should be functionally equiped. 2) The emergency teams must have complete command of their equipment. 3) The members of the team must be well motivated. 1 fig

  10. The Regional Environmental Emergency Team (REET)

    International Nuclear Information System (INIS)

    Maddock, M.

    2001-01-01

    This paper outlined the approach taken in Ontario to set up the Regional Environmental Emergency Team (REET) teams and the progress made in developing partnerships and coordination in response to environmental emergencies in Ontario. Environment Canada has been involved with the Ontario Regional Environmental Emergency Team (REET) Program for the past decade in order to review emergency response roles and responsibilities. REET is designed to enhance communication between emergency response agencies, foster recognition of the various responsibilities involved in an environmental emergency response and to increase the basic understanding of emergency response techniques and procedures within the emergency response community. During emergency response situations REET operates as a flexible and expandable multi-disciplinary and multi-agency team that provides comprehensive and coordinated environmental advice, information and assistance. The Ontario REET program currently consists of 18 area teams throughout the province with informal partnerships with Environment Canada, the Canadian Coast Guard, the Ontario Ministry of the Environment, Emergency Measures Ontario and the Ontario Ministry of Natural Resources. The program was inspired in 1970 and continues to provide an appropriate forum for environmental emergency planning and response. 6 refs., 1 fig

  11. The Nuclear Emergency Assistance Team, an Institution for Nuclear Emergency Relief

    Energy Technology Data Exchange (ETDEWEB)

    Boldyreff, P.; Kiefer, H.; Krause, H.; Zuehlke, K. [Gesellschaft fuer Kernforschung mbH, Karlsruhe, Federal Republic of Germany (Germany)

    1969-10-15

    The design of nuclear facilities is to exclude serious damage to the environment, even in case of the MCA (maximum credible accident). Although the likelihood of accidents exceeding the expected consequences of the MCA is extremely small, it is deemed reasonable to take general precautions against such accidents. Precautions of this type are customary also in the conventional field, and in this case they are to be implemented in part through the Nuclear Emergency Assistance Team. If the internal safety provisions of a nuclear facility are unable to prevent an impermissible leakage of radioactivity as the result of a major accident there is, at present, no possibility of decisively curbing the spread of activity throughout the environment in the first few hours after the accident. Hence the measures taken by the authorities as a result of the emission and immediately following upon it will have to be restricted to the protection of the population: analysis of intensity and pattern of distribution of activity, instructions.to seek closed shelters, or prohibition of the consumption of certain foodstuffs, distribution of blocking agents, etc. It is the purpose of the Nuclear Emergency Assistance Team to bring relief in the phase following the end of the emission. This may comprise the following steps: exact investigation of the external scope of the damage, in particular assessment of the contamination of ground, persons, and material; rapid personnel decontamination; securing and shielding radiation sources; fixing contamination and removing it immediately where this is deemed urgent for reasons of traffic or to keep the drinking water free from contamination; external containment of the source of danger; support in limiting the damage within the facility. In addition to these tasks of emergency protection, the Nuclear Emergency Assistance Team can take action also in disturbances within the facility which have no influence on the environment and where the operator

  12. 76 FR 42683 - Establishment of a Team Under the National Construction Safety Team Act

    Science.gov (United States)

    2011-07-19

    ...-01] Establishment of a Team Under the National Construction Safety Team Act AGENCY: National..., announces the establishment of a National Construction Safety Team pursuant to the National Construction Safety Team Act. The Team was established to study the effects of the tornado that touched down in Joplin...

  13. Team Psychological Safety and Team Learning: A Cultural Perspective

    Science.gov (United States)

    Cauwelier, Peter; Ribière, Vincent M.; Bennet, Alex

    2016-01-01

    Purpose: The purpose of this paper was to evaluate if the concept of team psychological safety, a key driver of team learning and originally studied in the West, can be applied in teams from different national cultures. The model originally validated for teams in the West is applied to teams in Thailand to evaluate its validity, and the views team…

  14. IAEA Operational Safety Team Reviews Cattenom Nuclear Power Plant

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: An international team of nuclear installation safety experts led by the International Atomic Energy Agency (IAEA) has reviewed operational safety at France's Cattenom Nuclear Power Plant (NPP) noting a series of good practices as well as recommendations and suggestions to reinforce them. The IAEA assembled an international team of experts at the request of the Government of France to conduct an Operational Safety Review (OSART) of Cattenom NPP. Under the leadership of the IAEA's Division of Nuclear Installation Safety in Vienna, the OSART team performed an in-depth operational safety review of the plant from 14 November to 1 December 2011. The team was made up of experts from Belgium, the Czech Republic, Finland, Germany, Hungary, Japan, Russia, Slovakia, South Africa, Sweden, Ukraine, the United Kingdom and the IAEA. The team at Cattenom conducted an in-depth review of the aspects essential to the safe operation of the NPP, which is largely under the control of the site management. The conclusions of the review are based on the IAEA's Safety Standards. The review covered the areas of Management, Organization and Administration; Training and Qualification; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry; Emergency Planning and Preparedness; and Severe Accident Management. Cattenom is the first plant in Europe to voluntarily undertake a Severe Accident Management review during an OSART review. The OSART team has identified good plant practices, which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: Sheets are displayed in storage areas where combustible material is present - these sheets are updated readily and accurately by the area owner to ensure that the fire limits are complied with; A simple container is attached to the neutron source handling device to ensure ease and safety of operations and reduce possible radiation exposure during use

  15. Smartphones let surgeons know WhatsApp: an analysis of communication in emergency surgical teams.

    Science.gov (United States)

    Johnston, Maximilian J; King, Dominic; Arora, Sonal; Behar, Nebil; Athanasiou, Thanos; Sevdalis, Nick; Darzi, Ara

    2015-01-01

    Outdated communication technologies in healthcare can place patient safety at risk. This study aimed to evaluate implementation of the WhatsApp messaging service within emergency surgical teams. A prospective mixed-methods study was conducted in a London hospital. All emergency surgery team members (n = 40) used WhatsApp for communication for 19 weeks. The initiator and receiver of communication were compared for response times and communication types. Safety events were reported using direct quotations. More than 1,100 hours of communication pertaining to 636 patients were recorded, generating 1,495 communication events. The attending initiated the most instruction-giving communication, whereas interns asked the most clinical questions (P WhatsApp helped flatten the hierarchy within the team. WhatsApp represents a safe, efficient communication technology. This study lays the foundations for quality improvement innovations delivered over smartphones. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Improving the non-technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™).

    Science.gov (United States)

    Cant, Robyn P; Porter, Joanne E; Cooper, Simon J; Roberts, Kate; Wilson, Ian; Gartside, Christopher

    2016-12-01

    This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  17. Occupational emerging risks affecting international virtual project Team Results

    Directory of Open Access Journals (Sweden)

    Dumitraşcu-Băldău Iulia

    2017-01-01

    Full Text Available The expansion of internet access, high-speed connection services, collaborative work platforms and tools, allowed employees to interact virtually offering companies the possibility to develop projects around the world, reducing operational costs and gain competitive advantage. Realizing the advantages and disadvantages of developing a project team in an international virtual work environment, requires adopting specific strategies to construct an effective team and ensure the project success. One of the most important disadvantages that we identified is that the new work environment brings new risks for both team members and managers. So, it becomes mandatory to identify and analyze the occupational emerging risks and their impact on the productivity of virtual team members, in order to prevent them efficiently and to ensure the safety and health of employees in a virtual working environment. This paper aims to highlight the necessity for project managers and organizations, to include in their specific project strategies, an efficient occupational risks management in the virtual workplace, to obtain a continuously improved virtual working environment, so to achieve a high performance from virtual employees.

  18. Defining Components of Team Leadership and Membership in Prehospital Emergency Medical Services.

    Science.gov (United States)

    Crowe, Remle P; Wagoner, Robert L; Rodriguez, Severo A; Bentley, Melissa A; Page, David

    2017-01-01

    Teamwork is critical for patient and provider safety in high-stakes environments, including the setting of prehospital emergency medical services (EMS). We sought to describe the components of team leadership and team membership on a single patient call where multiple EMS providers are present. We conducted a two-day focus group with nine subject matter experts in crew resource management (CRM) and EMS using a structured nominal group technique (NGT). The specific question posed to the group was, "What are the specific components of team leadership and team membership on a single patient call where multiple EMS providers are present?" After round-robin submission of ideas and in-depth discussion of the meaning of each component, participants voted on the most important components of team leadership and team membership. Through the NGT process, we identified eight components of team leadership: a) creates an action plan; b) communicates; c) receives, processes, verifies, and prioritizes information; d) reconciles incongruent information; e) demonstrates confidence, compassion, maturity, command presence, and trustworthiness; f) takes charge; g) is accountable for team actions and outcomes; and h) assesses the situation and resources and modifies the plan. The eight essential components of team membership identified included: a) demonstrates followership, b) maintains situational awareness, c) demonstrates appreciative inquiry, d) does not freelance, e) is an active listener, f) accurately performs tasks in a timely manner, g) is safety conscious and advocates for safety at all times, and h) leaves ego and rank at the door. This study used a highly structured qualitative technique and subject matter experts to identify components of teamwork essential for prehospital EMS providers. These findings and may be used to help inform the development of future EMS training and assessment initiatives.

  19. IAEA Team Concludes Peer Review of Greece's Regulatory Framework for Radiation Safety

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: An international team of senior nuclear safety and radiation protection experts yesterday concluded an 11-day mission to review the regulatory framework for nuclear and radiation safety in Greece. The Integrated Regulatory Review Service (IRRS) mission, which was conducted at the request of the Government of the Hellenic Republic, noted good practices in the country's nuclear regulatory system and also identified issues for improvement for the Greek Atomic Energy Commission (GAEC) and the Greek competent authorities. These are aimed at strengthening the effectiveness of the country's regulatory framework and functions in line with IAEA Safety Standards. ''The IRRS team enjoyed excellent cooperation from the GAEC throughout its mission,'' said Tom Ryan, mission leader and Director of Regulations and Information Management at the Radiological Protection Institute of Ireland. ''The GAEC staff were very open and candid in their discussions and provided the fullest practicable assistance.'' The main observations of the IRRS Review team included: While the Greek Government's commitment to safety is being demonstrated through its actions, the development of a comprehensive national policy and strategy expressed in a consolidated statement would provide a valuable framework and guidance for future actions in terms of safety; and GAEC has effective independence. The Greek government has ensured that GAEC is effectively independent in its safety-related decision-making and that it has functional separation from entities having responsibility or interests that could unduly influence its decision making. Strengths and good practices identified by the IRRS team included: Greece actively participates in the global safety regime including all relevant safety conventions; The nation's radiation monitoring system for the detection of illicit trafficking contributes significantly to identifying potential radiation emergencies due to events within or outside the country

  20. Reaping the benefits of task conflict in teams: the critical role of team psychological safety climate.

    Science.gov (United States)

    Bradley, Bret H; Postlethwaite, Bennett E; Klotz, Anthony C; Hamdani, Maria R; Brown, Kenneth G

    2012-01-01

    Past research suggests that task conflict may improve team performance under certain conditions; however, we know little about these specific conditions. On the basis of prior theory and research on conflict in teams, we argue that a climate of psychological safety is one specific context under which task conflict will improve team performance. Using evidence from 117 project teams, the present research found that psychological safety climate moderates the relationship between task conflict and performance. Specifically, task conflict and team performance were positively associated under conditions of high psychological safety. The results support the conclusion that psychological safety facilitates the performance benefits of task conflict in teams. Theoretical implications and suggestions for future research are discussed.

  1. An Evaluation Method for Team Competencies to Enhance Nuclear Safety Culture

    International Nuclear Information System (INIS)

    Hang, S. M.; Seong, P. H.; Kim, A. R.

    2016-01-01

    Safety culture has received attention in safety-critical industries, including nuclear power plants (NPPs), due to various prominent accidents such as concealment of a Station Blackout (SBO) of Kori NPP unit 1 in 2012, the Sewol ferry accident in 2014, and the Chernobyl accident in 1986. Analysis reports have pointed out that one of the major contributors to the cause of the accidents is ‘the lack of safety culture’. The term, nuclear safety culture, was firstly defined after the Chernobyl accident by the IAEA in INSAG report no. 4, as follows “Safety culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted their significance.” Afterwards, a wide consensus grew among researchers and nuclear-related organizations, that safety culture should be evaluated and managed in a certain manner. Consequently, each nuclear-related organization defined and developed their own safety culture definitions and assessment methods. However, none of these methods provides a way for an individual or a team to enhance the safety culture of an organization. Especially for a team, which is the smallest working unit in NPPs, team members easily overlook their required practices to improve nuclear safety culture. Therefore in this study, we suggested a method to estimate nuclear safety culture of a team, by approaching with the ‘competency’ point of view. The competency is commonly focused on individuals, and defined as, “underlying characteristics of an individual that are causally related to effective or superior performance in a job.” Similar to safety culture, the definition of competency focuses on characteristics and attitudes of individuals. Thus, we defined ‘safety culture competency’ as “underlying characteristics and outward attitudes of individuals that are causally related to a healthy and strong nuclear safety

  2. The Relationship between Management Team Size and Team Performance: The Mediating Effect of Team Psychological Safety

    OpenAIRE

    Midthaug, Mari Bratterud

    2017-01-01

    The purpose of this thesis is to explore the relationship between team size (number of team members) and team performance in management teams. There is a lack of empirical research exploring the potential links between these two elements within management teams. Further, little attention has been paid to potential mechanisms affecting this relationship. In this study, team psychological safety has been examined as a potential mediator in the size-performance relationship, hypothesizing that t...

  3. IAEA Team Reviews Safety Progress at French Nuclear Power Plant 19-23 May 2014

    International Nuclear Information System (INIS)

    2014-01-01

    An international team of nuclear installation safety experts led by the International Atomic Energy Agency (IAEA) has evaluated the Gravelines Nuclear Power Plant (NPP) in France to assess how the station has followed up on an Operational Safety Review Team (OSART) mission undertaken in 2012. The IAEA assembled a team of experts at the request of the Government of France to conduct the follow-up OSART mission at Gravelines NPP from 19 to 23 May 2014. Follow-up missions are standard components of the OSART programme; they are typically conducted 15-24 months after the initial OSART mission. The IAEA mission in 2012 made a number of recommendations and suggestions for consideration by the Gravelines NPP operators. The station thoroughly analyzed the OSART recommendations and suggestions and developed corrective action plans. In 18 months, the Gravelines plant has achieved the level ''resolved;; or ''satisfactory progress'' in almost all of the recommendations and suggestions made by the OSART in November 2012. During the follow-up mission, the team assessed that the operators have resolved the issues in several areas, including: Undertaking initiatives to improve fire prevention; Reinforcing contamination control practices; and Enhancing capabilities to protect emergency workers in the event of a release of radioactivity. The team identified some issues which have achieved satisfactory progress toward resolution, but need further work, including: Further improvement of measures to preventing the ingress of items or chemicals into circuits and equipment; Comprehensive application of the corrective actions programme; and Reinforcement of the containment protection system in the event of an extremely adverse situation. The team identified the following issue as one which has made insufficient progress toward resolution and needs further work: Emergency response arrangements do not follow current IAEA safety standards recommending that the plant should have a person on

  4. IAEA Expert Team Completes Mission to Review Japan's Nuclear Power Plant Safety Assessment Process, 31 January 2012, Tokyo, Japan

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: A team of international nuclear safety experts today completed a review of Japan's two-stage process for assessing nuclear safety at the nation's nuclear power plants. The team began its work on 23 January and delivered a Preliminary Summary Report to Japanese officials today and plans to finish the final report by the end of February. National safety assessments and their peer review by the IAEA are a key component of the IAEA's Action Plan on Nuclear Safety, which was approved by the Agency's 152 Member States following last year's nuclear accident at Fukushima Daiichi Nuclear Power Station. At the request of the Government of Japan, the International Atomic Energy Agency (IAEA) organized a 10-person team to review the Japanese Nuclear and Industrial Safety Agency's (NISA) approach to the Comprehensive Assessments for the Safety of Existing Power Reactor Facilities and how NISA examines the results submitted by nuclear operators. The IAEA safety review mission consisted of five IAEA and three international nuclear safety experts. To help its review, the team held meetings in Tokyo with officials from NISA, the Japanese Nuclear Energy Safety (JNES) Organization, and the Kansai Electric Power Company (KEPCO), and the team visited the Ohi Nuclear Power Station to see an example of how Japan's Comprehensive Safety Assessment is being implemented by nuclear operators. 'We concluded that NISA's instructions to power plants and its review process for the Comprehensive Safety Assessments are generally consistent with IAEA Safety Standards', said team leader James Lyons, director of the IAEA's Nuclear Installation Safety Division. In its Preliminary Summary Report delivered today, the team highlighted a number of good practices and identified some improvements that would enhance the overall effectiveness of the Comprehensive Safety Assessment process. Good practices identified by the mission team include: Based on NISA instructions and commitments of the

  5. Building a culture of safety through team training and engagement.

    Science.gov (United States)

    Thomas, Lily; Galla, Catherine

    2013-05-01

    Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.

  6. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond.

    Science.gov (United States)

    Rosenman, Elizabeth D; Branzetti, Jeremy B; Fernandez, Rosemarie

    2016-07-01

    Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature.

  7. IAEA Operational Safety Team Reviews Saint-Alban Nuclear Power Plant, France

    International Nuclear Information System (INIS)

    2010-01-01

    Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has reviewed safety practices at France's Saint-Alban Nuclear Power Plant (NPP) and has highlighted a set of strong practices as well as a series of recommendations to reinforce them. The IAEA assembled the team at the request of the Government of France to conduct an Operational Safety Review (OSART) of the Saint-Alban NPP. Under the leadership of the IAEA's Division of Nuclear Installation Safety in Vienna, the OSART team performed an in-depth operational safety review from 20 September to 6 October 2010. The team was made up of experts from Belgium, Canada, the Czech Republic, Germany, Lithuania, the Netherlands, Slovakia, Sweden and the USA. An OSART mission is designed to review programmes and activities essential to operational safety. It is not a regulatory inspection, nor is it a design review or a substitute for an exhaustive assessment of the plant's overall safety status. The team at Saint-Alban conducted an in-depth review of the aspects essential to the safe operation of the NPP, which largely are under the control of the site management. The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Training and Qualification; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry; and Emergency Planning and Preparedness. The OSART team has identified good plant practices, which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: A safety guideline for outages; The use of remote video surveillance of fuel inspection and handling activities; A motivational tool for plant staff regarding the benefits of operating experience and associated corrective actions; and Use of a sophisticated key control system

  8. IAEA Operational Safety Team Review Bohunice Nuclear Power Plant, Slovak Republic

    International Nuclear Information System (INIS)

    2010-01-01

    Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has reviewed Slovakia's Bohunice Nuclear Power Plant (BNPP) for its safety practices and has noted a series of good practices as well as recommendations to reinforce them. The IAEA assembled an international team of experts at the request of the Government of Slovak Republic to conduct an Operational Safety Review (OSART) of Bohunice NPP. Under the leadership of the IAEA's Division of Nuclear Installation Safety, the OSART team performed an in-depth operational safety review from 1 to 18 November 2010. The team was made up of experts from Belgium, Canada, China, the Czech Republic, France, Sweden, the United Kingdom and the IAEA. An OSART mission is designed as a review of programmes and activities essential to operational safety. It is not a regulatory inspection, nor is it a design review or a substitute for an exhaustive assessment of the plant's overall safety status. The team at BNPP conducted an in-depth review of the aspects essential to the safe operation of the NPP, which largely is under the control of the site management. The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry and Emergency Planning and Preparedness. Long Term Operation assessment has been requested by the plant in addition to the standard OSART program. The OSART team has identified good plant practices which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: BNPP has implemented a comprehensive set of technical and organizational measures which have significantly reduced the production of liquid radioactive waste; BNPP has developed an automatic transfer of dosimetry data

  9. IAEA-led Operational Safety Team Reviews Dukovany Nuclear Power Plant, Czech Republic

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has commended the Dukovany Nuclear Power Plant (NPP) in the Czech Republic for its safety practices and has also made a series of recommendations to reinforce them. The IAEA assembled an international team of experts at the request of the Government of the Czech Republic to conduct an Operational Safety Review (OSART) of Dukovany NPP. Under the leadership of the IAEA's Division of Nuclear Installation Safety in Vienna, the OSART team performed an in-depth operational safety review of the plant from 6 to 23 June 2011. The team was made up of experts from Armenia, Germany, Hungary, Romania, Slovenia, Sweden, the UK and the USA. An OSART mission is designed as a review of programmes and activities essential to operational safety. It is not a regulatory inspection, nor is it a design review or a substitute for an exhaustive assessment of the plant's overall safety status. The team at Dukovany conducted an in-depth review of the aspects essential to the safe operation of the NPP, which is largely under the control of the site management. The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Training and Qualification; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry; and Emergency Planning and Preparedness. The OSART team has identified good plant practices, which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: The plant uses an integrated approach to recruit, select, psychologically assess and train new employees. This approach has resulted in consistently high success rates for licensed operator examinations and the identification of potential candidates for various plant departments; The performance

  10. Assessing Team Leadership in Emergency Medicine: The Milestones and Beyond

    Science.gov (United States)

    Rosenman, Elizabeth D.; Branzetti, Jeremy B.; Fernandez, Rosemarie

    2016-01-01

    Background Team leadership is a critical skill for emergency medicine physicians that directly affects team performance and the quality of patient care. There exists a robust body of team science research supporting team leadership conceptual models and behavioral skill sets. However, to date, this work has not been widely incorporated into health care team leadership education. Objective This narrative review has 3 aims: (1) to synthesize the team science literature and to translate important concepts and models to health care team leadership; (2) to describe how team leadership is currently represented in the health care literature and in the Accreditation Council for Graduate Medical Education Milestones for emergency medicine; and (3) to propose a novel, evidence-based framework for the assessment of team leadership in emergency medicine. Methods We conducted a narrative review of the team science and health care literature. We summarized our findings and identified a list of team leadership behaviors that were then used to create a framework for team leadership assessment. Results Current health care team leadership measurement tools do not incorporate evidence-based models of leadership concepts from other established domains. The emergency medicine milestones include several team leadership behaviors as part of a larger resident evaluation program. However, they do not offer a comprehensive or cohesive representation of the team leadership construct. Conclusions Despite the importance of team leadership to patient care, there is no standardized approach to team leadership assessment in emergency medicine. Based on the results of our review, we propose a novel team leadership assessment framework that is supported by the team science literature. PMID:27413434

  11. Safety Teams: An Approach to Engage Students in Laboratory Safety

    Science.gov (United States)

    Alaimo, Peter J.; Langenhan, Joseph M.; Tanner, Martha J.; Ferrenberg, Scott M.

    2010-01-01

    We developed and implemented a yearlong safety program into our organic chemistry lab courses that aims to enhance student attitudes toward safety and to ensure students learn to recognize, demonstrate, and assess safe laboratory practices. This active, collaborative program involves the use of student "safety teams" and includes…

  12. The patient safety culture as perceived by staff at two different emergency departments before and after introducing a flow-oriented working model with team triage and lean principles: a repeated cross-sectional study.

    Science.gov (United States)

    Burström, Lena; Letterstål, Anna; Engström, Marie-Louise; Berglund, Anders; Enlund, Mats

    2014-07-09

    Patient safety is of the utmost importance in health care. The patient safety culture in an institution has great impact on patient safety. To enhance patient safety and to design strategies to reduce medical injuries, there is a current focus on measuring the patient safety culture. The aim of the present study was to describe the patient safety culture in an ED at two different hospitals before and after a Quality improvement (QI) project that was aimed to enhance patient safety. A repeated cross-sectional design, using the Hospital Survey On Patient Safety Culture questionnaire before and after a quality improvement project in two emergency departments at a county hospital and a university hospital. The questionnaire was developed to obtain a better understanding of the patient safety culture of an entire hospital or of specific departments. The Swedish version has 51 questions and 15 dimensions. At the county hospital, a difference between baseline and follow-up was observed in three dimensions. For two of these dimensions, Team-work within hospital and Communication openness, a higher score was measured at the follow-up. At the university hospital, a higher score was measured at follow-up for the two dimensions Team-work across hospital units and Team-work within hospital. The result showed changes in the self-estimated patient safety culture, mainly regarding team-work and communication openness. Most of the improvements at follow-up were seen by physicians, and mainly at the county hospital.

  13. Psychological Safety and Norm Clarity in Software Engineering Teams

    OpenAIRE

    Lenberg, Per; Feldt, Robert

    2018-01-01

    In the software engineering industry today, companies primarily conduct their work in teams. To increase organizational productivity, it is thus crucial to know the factors that affect team effectiveness. Two team-related concepts that have gained prominence lately are psychological safety and team norms. Still, few studies exist that explore these in a software engineering context. Therefore, with the aim of extending the knowledge of these concepts, we examined if psychological safety and t...

  14. Leader humility and team creativity: The role of team information sharing, psychological safety, and power distance.

    Science.gov (United States)

    Hu, Jia; Erdogan, Berrin; Jiang, Kaifeng; Bauer, Talya N; Liu, Songbo

    2018-03-01

    In this study, we identify leader humility, characterized by being open to admitting one's limitations, shortcomings, and mistakes, and showing appreciation and giving credit to followers, as a critical leader characteristic relevant for team creativity. Integrating the literatures on creativity and leadership, we explore the relationship between leader humility and team creativity, treating team psychological safety and team information sharing as mediators. Further, we hypothesize and examine team power distance as a moderator of the relationship. We tested our hypotheses using data gathered from 72 work teams and 354 individual members from 11 information and technology firms in China using a multiple-source, time-lagged research design. We found that the positive relationship between leader humility and team information sharing was significant and positive only within teams with a low power distance value. In addition, leader humility was negatively related to team psychological safety in teams with a high power distance value, whereas the relationship was positive yet nonsignificant in teams with low power distance. Furthermore, team information sharing and psychological safety were both significantly related to team creativity. We discuss theoretical and practical implications for leadership and work teams. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  15. Development of an Evaluation Method for Team Safety Culture Competencies using Social Network Analysis

    International Nuclear Information System (INIS)

    Han, Sang Min; Kim, Ar Ryum; Seong, Poong Hyun

    2016-01-01

    In this study, team safety culture competency of a team was estimated through SNA, as a team safety culture index. To overcome the limit of existing safety culture evaluation methods, the concept of competency and SNA were adopted. To estimate team safety culture competency, we defined the definition, range and goal of team safety culture competencies. Derivation of core team safety culture competencies is performed and its behavioral characteristics were derived for each safety culture competency, from the procedures used in NPPs and existing criteria to assess safety culture. Then observation was chosen as a method to provide the input data for the SNA matrix of team members versus insufficient team safety culture competencies. Then through matrix operation, the matrix was converted into the two meaningful values, which are density of team members and degree centralities of each team safety culture competency. Density of tem members and degree centrality of each team safety culture competency represent the team safety culture index and the priority of team safety culture competency to be improved

  16. Development of an Evaluation Method for Team Safety Culture Competencies using Social Network Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sang Min; Kim, Ar Ryum; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2016-05-15

    In this study, team safety culture competency of a team was estimated through SNA, as a team safety culture index. To overcome the limit of existing safety culture evaluation methods, the concept of competency and SNA were adopted. To estimate team safety culture competency, we defined the definition, range and goal of team safety culture competencies. Derivation of core team safety culture competencies is performed and its behavioral characteristics were derived for each safety culture competency, from the procedures used in NPPs and existing criteria to assess safety culture. Then observation was chosen as a method to provide the input data for the SNA matrix of team members versus insufficient team safety culture competencies. Then through matrix operation, the matrix was converted into the two meaningful values, which are density of team members and degree centralities of each team safety culture competency. Density of tem members and degree centrality of each team safety culture competency represent the team safety culture index and the priority of team safety culture competency to be improved.

  17. The Relationship Between Team Psychological Safety and Team Effectiveness in Management Teams: The Mediating Effect of Dialogue.

    OpenAIRE

    Bilstad, Julie Brat

    2016-01-01

    This study is a response to the research and request presented by Bang and Midelfart (2010), to further investigate the effect dialogue can have on management team s effectiveness. The purpose of the study was to investigate and explain the effect of team psychological safety on task performance and team member satisfaction, with dialogue as a mediator in this relationship. 215 Norwegian and Danish management teams in the private and public sector were studied. As expected, team psychological...

  18. Behavioral integrity for safety, priority of safety, psychological safety, and patient safety : a team-level study

    NARCIS (Netherlands)

    Leroy, H.; Dierynck, B.; Anseel, F.; Simons, T.; Halbesleben, J.R.; McCaughey, D.; Savage, G.T.; Sels, L.

    2012-01-01

    This article clarifies how leader behavioral integrity for safety helps solve follower's double bind between adhering to safety protocols and speaking up about mistakes against protocols. Path modeling of survey data in 54 nursing teams showed that head nurse behavioral integrity for safety

  19. Republished: Building a culture of safety through team training and engagement.

    Science.gov (United States)

    Thomas, Lily; Galla, Catherine

    2013-07-01

    Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.

  20. Human factors and safety in emergency medicine

    Science.gov (United States)

    Schaefer, H. G.; Helmreich, R. L.; Scheidegger, D.

    1994-01-01

    A model based on an input process and outcome conceptualisation is suggested to address safety-relevant factors in emergency medicine. As shown in other dynamic and demanding environments, human factors play a decisive role in attaining high quality service. Attitudes held by health-care providers, organisational shells and work-cultural parameters determine communication, conflict resolution and workload distribution within and between teams. These factors should be taken into account to improve outcomes such as operational integrity, job satisfaction and morale.

  1. [Team Care for Patient Safety, TeamSTEPPS to Improve Nontechnical Skills and Teamwork--Actions to Become an HRO].

    Science.gov (United States)

    Kaito, Ken

    2015-07-01

    It is important to develop safer medical systems and follow manuals of medical procedures for patient safety. However, these approaches do not always result in satisfactory results because of many human factors. It is known that defects of nontechnical skills are more important than those of technical skills regarding medical accidents and incidents. So, it is necessary to improve personal nontechnical skills and compensate for each other's defects based on a team approach. For such purposes, we have implemented TeamSTEPPS to enhance performance and patient safety in our hospital. TeamSTEPPS (team strategies and tools to enhance performance and patient safety) is a useful method to improve the nontechnical skills of each member and the team. In TeamSTEPPS, leadership to share mental models among the team, continuous monitoring and awareness for team activities, mutual support for workload and knowledge, and approaches to complete communication are summarized to enhance teamwork and patient safety. Other than improving nontechnical skills and teamwork, TeamSTEPPS is also very important as a High Reliability Organization (HRO). TeamSTEPPS is worth implementing in every hospital to decrease medical errors and improve patient outcomes and satisfaction.

  2. Developing Expert Teams with a Strong Safety Culture

    Science.gov (United States)

    Rogers, David G.

    2010-01-01

    Would you like to lead a world renowned team that draws out all the talents and expertise of its members and consistently out performs all others in the industry? Ever wonder why so many organizations fail to truly learn from past mistakes only to repeat the same ones at a later date? Are you a program/project manager or team member in a high-risk organization where the decisions made often carry the highest of consequences? Leadership, communication, team building, critical decision-making and continuous team improvement skills and behaviors are mere talking points without the attitudes, commitment and strategies necessary to make them the very fabric of a team. Developing Expert Teams with a Strong Safety Culture, will provide you with proven knowledge and strategies to take your team soaring to heights you may have not thought possible. A myriad of teams have applied these strategies and techniques within their organization team environments: military and commercial aviation, astronaut flight crews, Shuttle flight controllers, members of the Space Shuttle Program Mission Management Team, air traffic controllers, nuclear power control teams, surgical teams, and the fire service report having spectacular success. Many industry leaders are beginning to realize that although the circumstances and environments of these teams may differ greatly to their own, the core elements, governing principles and dynamics involved in managing and building a stellar safety conscious team remain identical.

  3. Safety Training and Awareness: a team at your service

    CERN Multimedia

    HSE Unit

    2014-01-01

    Ever wondered who is on the other end of the safety-training@cern.ch e-mail address? If so, you might like to know that all the activities relating to safety training and awareness (“Safety Training" for short) are managed by a team dedicated to ensuring the smooth running of CERN’s safety training courses.    Photo: Christoph Balle. This team currently consists of five people: the manager in charge of coordinating all the projects, two administrative assistants who provide logistical support and two technicians who manage the training centre. This team, which has seen its workload and the number of challenges it faces increase considerably with LS1, is responsible for organising classroom training sessions (in partnership with some 15 training bodies) and for the management of online e-learning courses in partnership with the GS-AIS Group. The members of the team don't just deal with enrolment on the courses: they also help with the development...

  4. Identifying and training non-technical skills of nuclear emergency response teams

    International Nuclear Information System (INIS)

    Crichton, M.T.; Flin, R.

    2004-01-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams

  5. Identifying and training non-technical skills of nuclear emergency response teams

    Energy Technology Data Exchange (ETDEWEB)

    Crichton, M.T. E-mail: m.crichton@abdn.ac.uk; Flin, R

    2004-08-01

    Training of the non-technical (social and cognitive) skills that are crucial to safe and effective management by teams in emergency situations is an issue that is receiving increasing emphasis in many organisations, particularly in the nuclear power industry. As teams play a major role in emergency response organisations (ERO), effective functioning and interactions within, between and across teams is crucial, particularly as the management of an emergency situation often requires that teams are extended by members from various other sections and strategic groups throughout the company, as well as members of external agencies. A series of interviews was recently conducted with members of a UK nuclear emergency response organisation to identify the non-technical skills required by team members that would be required for managing an emergency. Critical skills have been identified as decision making and situation assessment, as well as communication, teamwork, and stress management. A number of training strategies are discussed which can be tailored to the roles and responsibilities of the team members and the team leader, based on the roles within the team being defined as either Decision Maker, Evaluator, or Implementor, according to Nuclear Energy Institute (NEI) classifications. It is anticipated that enhanced learning of the necessary non-technical skills, through experience and directed practice, will improve the skills of members of emergency response teams.

  6. International Expert Team Concludes IAEA Peer Review of Slovakia's Regulatory Framework for Nuclear Safety

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: An international team of senior nuclear safety and radiation protection experts today concluded an 11-day mission to review the regulatory framework for nuclear safety in Slovakia. At the request of the Slovak Government, the IAEA assembled a team of 12 senior regulatory experts from 12 nations to conduct the Integrated Regulatory Review Service (IRRS) mission involving the Nuclear Regulatory Authority of the Slovak Republic (UJD SR). The international experts also met officials from the Public Health Authority of the Slovak Republic (UVZ SR) regarding the regulation of occupational radiation protection in nuclear facilities. The mission is a peer review based on the IAEA Safety Standards. Marta Ziakova, Chairperson of the Nuclear Regulatory Authority of Slovak Republic, declared that ''The IRRS mission has a great value for the future development and orientation of the UJD SR.'' ''Slovakia has established a regulatory framework for nuclear safety which is in line with international standards and practice,'' said Mission Team Leader Andrej Stritar, Director of the Slovenian Nuclear Safety Administration. The main observations of the IRRS Review team included: UJD SR operates with independence and transparency; UJD SR has developed and implemented a systematic training approach to meet its competence needs; and in response to the accident at TEPCO's Fukushima Daiichi Nuclear Power Station, UJD SR has reacted and communicated to interested parties, including the public. The good practices identified by the IRRS Review Team include: UJD SR has a comprehensive and well-formalized strategic approach to informing and consulting interested parties; UJD SR has developed and implemented a structured approach to training and developing its staff; and Detailed legal requirements provide a solid basis for on-site and off-site response in nuclear emergencies coordinated with local authorities. The IRRS Review team identified areas for further improvement and believes

  7. The work of the Operational Safety Review Team (OSART)

    International Nuclear Information System (INIS)

    Hide, K.W.

    1996-01-01

    The Operational Safety Review Team (OSART) programme was set up by the IAEA in 1982 to assist Member States to enhance the operational safety of nuclear power plants. Each team is staffed by senior experts in the relevant fields. The review team discusses with plant staff the existing operational programmes for plant which may be under construction, being commissioned or already operating. Following a detailed examination of a safety programme, the OSART team lists strengths and weaknesses and makes recommendations on how to overcome the latter. Since their conclusions are based on the best prevailing international practice, they may be more stringent than those based on national criteria. The results of the 77 missions conducted at 62 plants in 28 countries by the end of 1994 are summarised. (UK)

  8. Team communication patterns in emergency resuscitation: a mixed methods qualitative analysis.

    Science.gov (United States)

    Calder, Lisa Anne; Mastoras, George; Rahimpour, Mitra; Sohmer, Benjamin; Weitzman, Brian; Cwinn, A Adam; Hobin, Tara; Parush, Avi

    2017-12-01

    In order to enhance patient safety during resuscitation of critically ill patients, we need to optimize team communication and enhance team situational awareness but little is known about resuscitation team communication patterns. The objective of this study is to understand how teams communicate during resuscitation; specifically to assess for a shared mental model (organized understanding of a team's relationships) and information needs. We triangulated 3 methods to evaluate resuscitation team communication at a tertiary care academic trauma center: (1) interviews; (2) simulated resuscitation observations; (3) live resuscitation observations. We interviewed 18 resuscitation team members about shared mental models, roles and goals of team members and procedural expectations. We observed 30 simulated resuscitation video recordings and documented the timing, source and destination of communication and the information category. We observed 12 live resuscitations in the emergency department and recorded baseline characteristics of the type of resuscitations, nature of teams present and type and content of information exchanges. The data were analyzed using a qualitative communication analysis method. We found that resuscitation team members described a shared mental model. Respondents understood the roles and goals of each team member in order to provide rapid, efficient and life-saving care with an overall need for situational awareness. The information flow described in the interviews was reflected during the simulated and live resuscitations with the most responsible physician and charting nurse being central to team communication. We consolidated communicated information into six categories: (1) time; (2) patient status; (3) patient history; (4) interventions; (5) assistance and consultations; 6) team members present. Resuscitation team members expressed a shared mental model and prioritized situational awareness. Our findings support a need for cognitive aids to

  9. Job satisfaction among mental healthcare professionals: The respective contributions of professional characteristics, team attributes, team processes, and team emergent states

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2017-01-01

    Objectives: The aim of this study was to determine the respective contribution of professional characteristics, team attributes, team processes, and team emergent states on the job satisfaction of 315 mental health professionals from Quebec (Canada). Methods: Job satisfaction was measured with the Job Satisfaction Survey. Independent variables were organized into four categories according to a conceptual framework inspired from the Input-Mediator-Outcomes-Input Model. The contribution of each category of variables was assessed using hierarchical regression analysis. Results: Variations in job satisfaction were mostly explained by team processes, with minimal contribution from the other three categories. Among the six variables significantly associated with job satisfaction in the final model, four were team processes: stronger team support, less team conflict, deeper involvement in the decision-making process, and more team collaboration. Job satisfaction was also associated with nursing and, marginally, male gender (professional characteristics) as well as with a stronger affective commitment toward the team (team emergent states). Discussion and Conclusion: Results confirm the importance for health managers of offering adequate support to mental health professionals, and creating an environment favorable to collaboration and decision-sharing, and likely to reduce conflicts between team members. PMID:29276591

  10. Job satisfaction among mental healthcare professionals: The respective contributions of professional characteristics, team attributes, team processes, and team emergent states.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie

    2017-01-01

    The aim of this study was to determine the respective contribution of professional characteristics, team attributes, team processes, and team emergent states on the job satisfaction of 315 mental health professionals from Quebec (Canada). Job satisfaction was measured with the Job Satisfaction Survey. Independent variables were organized into four categories according to a conceptual framework inspired from the Input-Mediator-Outcomes-Input Model. The contribution of each category of variables was assessed using hierarchical regression analysis. Variations in job satisfaction were mostly explained by team processes, with minimal contribution from the other three categories. Among the six variables significantly associated with job satisfaction in the final model, four were team processes: stronger team support, less team conflict, deeper involvement in the decision-making process, and more team collaboration. Job satisfaction was also associated with nursing and, marginally, male gender (professional characteristics) as well as with a stronger affective commitment toward the team (team emergent states). Results confirm the importance for health managers of offering adequate support to mental health professionals, and creating an environment favorable to collaboration and decision-sharing, and likely to reduce conflicts between team members.

  11. Team safety and innovation by learning from errors in long-term care settings.

    Science.gov (United States)

    Buljac-Samardžić, Martina; van Woerkom, Marianne; Paauwe, Jaap

    2012-01-01

    Team safety and team innovation are underexplored in the context of long-term care. Understanding the issues requires attention to how teams cope with error. Team managers could have an important role in developing a team's error orientation and managing team membership instabilities. The aim of this study was to examine the impact of team member stability, team coaching, and a team's error orientation on team safety and innovation. A cross-sectional survey method was employed within 2 long-term care organizations. Team members and team managers received a survey that measured safety and innovation. Team members assessed member stability, team coaching, and team error orientation (i.e., problem-solving and blaming approach). The final sample included 933 respondents from 152 teams. Stable teams and teams with managers who take on the role of coach are more likely to adopt a problem-solving approach and less likely to adopt a blaming approach toward errors. Both error orientations are related to team member ratings of safety and innovation, but only the blaming approach is (negatively) related to manager ratings of innovation. Differences between members' and managers' ratings of safety are greater in teams with relatively high scores for the blaming approach and relatively low scores for the problem-solving approach. Team coaching was found to be positively related to innovation, especially in unstable teams. Long-term care organizations that wish to enhance team safety and innovation should encourage a problem-solving approach and discourage a blaming approach. Team managers can play a crucial role in this by coaching team members to see errors as sources of learning and improvement and ensuring that individuals will not be blamed for errors.

  12. Difficult Airway Response Team: A Novel Quality Improvement Program for Managing Hospital-Wide Airway Emergencies

    Science.gov (United States)

    Mark, Lynette J.; Herzer, Kurt R.; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I.; Berkow, Lauren C.; Haut, Elliott R.; Hillel, Alexander T.; Miller, Christina R.; Feller-Kopman, David J.; Schiavi, Adam J.; Xie, Yanjun J.; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W.; Mirski, Marek A.

    2015-01-01

    Background Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. Methods We developed a quality improvement program—the Difficult Airway Response Team (DART)—to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had three core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Results Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index > 40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous

  13. Difficult airway response team: a novel quality improvement program for managing hospital-wide airway emergencies.

    Science.gov (United States)

    Mark, Lynette J; Herzer, Kurt R; Cover, Renee; Pandian, Vinciya; Bhatti, Nasir I; Berkow, Lauren C; Haut, Elliott R; Hillel, Alexander T; Miller, Christina R; Feller-Kopman, David J; Schiavi, Adam J; Xie, Yanjun J; Lim, Christine; Holzmueller, Christine; Ahmad, Mueen; Thomas, Pradeep; Flint, Paul W; Mirski, Marek A

    2015-07-01

    Difficult airway cases can quickly become emergencies, increasing the risk of life-threatening complications or death. Emergency airway management outside the operating room is particularly challenging. We developed a quality improvement program-the Difficult Airway Response Team (DART)-to improve emergency airway management outside the operating room. DART was implemented by a team of anesthesiologists, otolaryngologists, trauma surgeons, emergency medicine physicians, and risk managers in 2005 at The Johns Hopkins Hospital in Baltimore, Maryland. The DART program had 3 core components: operations, safety, and education. The operations component focused on developing a multidisciplinary difficult airway response team, standardizing the emergency response process, and deploying difficult airway equipment carts throughout the hospital. The safety component focused on real-time monitoring of DART activations and learning from past DART events to continuously improve system-level performance. This objective entailed monitoring the paging system, reporting difficult airway events and DART activations to a Web-based registry, and using in situ simulations to identify and mitigate defects in the emergency airway management process. The educational component included development of a multispecialty difficult airway curriculum encompassing case-based lectures, simulation, and team building/communication to ensure consistency of care. Educational materials were also developed for non-DART staff and patients to inform them about the needs of patients with difficult airways and ensure continuity of care with other providers after discharge. Between July 2008 and June 2013, DART managed 360 adult difficult airway events comprising 8% of all code activations. Predisposing patient factors included body mass index >40, history of head and neck tumor, prior difficult intubation, cervical spine injury, airway edema, airway bleeding, and previous or current tracheostomy. Twenty

  14. High-reliability emergency response teams in the hospital: improving quality and safety using in situ simulation training.

    Science.gov (United States)

    Wheeler, Derek S; Geis, Gary; Mack, Elizabeth H; LeMaster, Tom; Patterson, Mary D

    2013-06-01

    In situ simulation training is a team-based training technique conducted on actual patient care units using equipment and resources from that unit, and involving actual members of the healthcare team. We describe our experience with in situ simulation training in a major children's medical centre. In situ simulations were conducted using standardised scenarios approximately twice per month on inpatient hospital units on a rotating basis. Simulations were scheduled so that each unit participated in at least two in situ simulations per year. Simulations were conducted on a revolving schedule alternating on the day and night shifts and were unannounced. Scenarios were preselected to maximise the educational experience, and frequently involved clinical deterioration to cardiopulmonary arrest. We performed 64 of the scheduled 112 (57%) in situ simulations on all shifts and all units over 21 months. We identified 134 latent safety threats and knowledge gaps during these in situ simulations, which we categorised as medication, equipment, and/or resource/system threats. Identification of these errors resulted in modification of systems to reduce the risk of error. In situ simulations also provided a method to reinforce teamwork behaviours, such as the use of assertive statements, role clarity, performance of frequent updating, development of a shared mental model, performance of independent double checks of high-risk medicines, and overcoming authority gradients between team members. Participants stated that the training programme was effective and did not disrupt patient care. In situ simulations can identify latent safety threats, identify knowledge gaps, and reinforce teamwork behaviours when used as part of an organisation-wide safety programme.

  15. Building patient safety in intensive care nursing : Patient safety culture, team performance and simulation-based training

    OpenAIRE

    Ballangrud, Randi

    2013-01-01

    Aim: The overall aim of the thesis was to investigate patient safety culture, team performance and the use of simulation-based team training for building patient safety in intensive care nursing. Methods: Quantitative and qualitative methods were used. In Study I, 220 RNs from ten ICUs responded to a patient safety culture questionnaire analysed with statistics. Studies II-IV were based on an evaluation of a simulation-based team training programme. Studies II-III included 53 RNs from seven I...

  16. Team Performance in Emergency Medicine (MedTeams), Draft 3, Instructor Guide

    National Research Council Canada - National Science Library

    1997-01-01

    .... Unlike traditional team development which focuses more on improving group dynamics and interpersonal relationships, this program focuses on a concrete set of understandings and behavioral skills applicable in the emergency care environment.

  17. Characteristics of the safety climate in teams with world-class safety ...

    African Journals Online (AJOL)

    interact to deliver a project successfully in terms of cost .... small-scale accidents occurring at high frequency and from diverse ... the team dynamics of role players in a construction project and .... modified safety pyramid to measure the impact of the safety climate ...... Methodological Centre for Vocational Education and.

  18. Designing and Developing an Effective Safety Program for a Student Project Team

    Directory of Open Access Journals (Sweden)

    John Catton

    2018-05-01

    Full Text Available In the workplace, safety must be the first priority of all employers and employees alike. In order to maintain the safety and well-being of their employees, employers must demonstrate due diligence and provide the appropriate safety training to familiarize employees with the hazards within the workplace. Although, a student “project team” is not a business, the work done by students for their respective teams is synonymous with the work done in a place of business and thus requires that similar safety precautions and training be administered to students by their team leads and faculty advisors. They take on the role of supervisors within the team dynamic. Student teams often utilize the guidelines and policies that their universities or colleges have developed in order to build a set of standard operating procedures and safety training modules. These guidelines aid in providing a base for training for the team, however, they are no substitute for training specific to the safety risks associated with the work the team is doing. In order to comply with these requirements, a full analysis of the workplace is required to be completed. A variety of safety analysis techniques need to be applied to define the hazards within the workplace and institute appropriate measures to mitigate them. In this work, a process is developed for establishing a safety training program for a student project team, utilizing systems safety management techniques and the aspect of gamification to produce incentives for students to continue developing their skills. Although, systems safety management is typically applied to the design of active safety components or systems, the techniques for identifying and mitigating hazards can be applied in the same fashion to the workplace. They allow one to analyze their workplace and determine the hazards their employees might encounter, assign appropriate hazard ratings and segregate each respective hazard by their risks. In so

  19. Organization of the French emergency teams in the event of a radiological accident

    Energy Technology Data Exchange (ETDEWEB)

    Dumon, F. [Faculte de Pharmacie, 13 - Marseille (France); Pizzocaro, Y. [CSP, Risques Technologiques, 83 - Toulon (France)

    2001-07-01

    Nowadays, the intervention in ionizing environment is increasingly probable. It is still rare, but with the development of the nuclear programme of electricity production which was held in the french past and the significant rise in the use of the radioelements, as well in the medical field as industrial, the radioactive risk cannot be neglected. Technical and human resources, brought by mobile emergency teams called CMIR, were thus implemented to ensure either the safety of only hard-working exposed to the ionizing radiations, but also that of the population. In France, the organization of the public authorities in the event of nuclear accident, fixed by Directives of the Prime Minister which relate to nuclear safety, protection against radiation, the law and order and the civil safety, is described in Particular Plan for Intervention (PPI). (author)

  20. Organization of the French emergency teams in the event of a radiological accident

    International Nuclear Information System (INIS)

    Dumon, F.; Pizzocaro, Y.

    2001-01-01

    Nowadays, the intervention in ionizing environment is increasingly probable. It is still rare, but with the development of the nuclear programme of electricity production which was held in the french past and the significant rise in the use of the radioelements, as well in the medical field as industrial, the radioactive risk cannot be neglected. Technical and human resources, brought by mobile emergency teams called CMIR, were thus implemented to ensure either the safety of only hard-working exposed to the ionizing radiations, but also that of the population. In France, the organization of the public authorities in the event of nuclear accident, fixed by Directives of the Prime Minister which relate to nuclear safety, protection against radiation, the law and order and the civil safety, is described in Particular Plan for Intervention (PPI). (author)

  1. Summary of Tiger Team Assessment and Technical Safety Appraisal recurring concerns in the Operations Area

    International Nuclear Information System (INIS)

    1993-01-01

    Fourteen Tiger Team Assessment and eight Technical Safety Appraisal (TSA) final reports have been received and reviewed by the DOE Training Coordination Program during Fiscal Year 1992. These assessments and appraisals included both reactor and non-reactor nuclear facilities in their reports. The Tiger Team Assessments and TSA reports both used TSA performance objectives, and list ''concerns'' as a result of their findings. However, the TSA reports categorized concerns into the following functional areas: (1) Organization and Administration, (2) Radiation Protection, (3) Nuclear Criticality Safety, (4) Occupational Safety, (5) Engineering/Technical Support, (6) Emergency Preparedness, (7) Safety Assessments, (8) Quality Verification, (9) Fire Protection, (10) Environmental Protection, and (11) Energetic Materials Safety. Although these functional areas match most of the TSA performance objectives, not all of the TSA performance objectives are addressed. For example, the TSA reports did not include Training, Maintenance, and Operations as functional areas. Rather, they included concerns that related to these topics throughout the 11 functional areas identified above. For consistency, the Operations concerns that were identified in each of the TSA report functional areas have been included in this summary with the corresponding TSA performance objective

  2. Use of a Surgical Safety Checklist to Improve Team Communication.

    Science.gov (United States)

    Cabral, Richard A; Eggenberger, Terry; Keller, Kathryn; Gallison, Barry S; Newman, David

    2016-09-01

    To improve surgical team communication, a team at Broward Health Imperial Point Hospital, Ft Lauderdale, Florida, implemented a program for process improvement using a locally adapted World Health Organization Surgical Safety Checklist. This program included a standardized, comprehensive time out and a briefing/debriefing process. Postimplementation responses to the Safety Attitudes Questionnaire revealed a significant increase in the surgical team's perception of communication compared with that reported on the pretest (6% improvement resulting in t79 = -1.72, P improved surgical teamwork behaviors and an enhanced culture of safety in the OR. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  3. Online Food Safety Information System for Nuclear or Radiological Emergencies

    International Nuclear Information System (INIS)

    Albinet, Franck; Adjigogov, Lazar; Dercon, Gerd

    2016-01-01

    Over the last year, the protocol with regards to data management and visualization requirements for food safety decision-making, developed under CRP D1.50.15 on R esponse to Nuclear Emergency Affecting Food and Agriculture , was further implemented. The development team moved away from early series of disconnected prototypes to a more advanced Information System integrating both data management and visualization components outlined in the agreed protocol

  4. Clinical efficiency in a simulated emergency and relationship to team behaviours: a multisite cross-sectional study.

    Science.gov (United States)

    Siassakos, D; Bristowe, K; Draycott, T J; Angouri, J; Hambly, H; Winter, C; Crofts, J F; Hunt, L P; Fox, R

    2011-04-01

    To identify specific aspects of teamworking associated with greater clinical efficiency in simulated obstetric emergencies. Cross-sectional secondary analysis of video recordings from the Simulation & Fire-drill Evaluation (SaFE) randomised controlled trial. Six secondary and tertiary maternity units. A total of 114 randomly selected healthcare professionals, in 19 teams of six members. Two independent assessors, a clinician and a language communication specialist identified specific teamwork behaviours using a grid derived from the safety literature. Relationship between teamwork behaviours and the time to administration of magnesium sulfate, a validated measure of clinical efficiency, was calculated. More efficient teams were likely to (1) have stated (recognised and verbally declared) the emergency (eclampsia) earlier (Kendall's rank correlation coefficient τ(b) = -0.53, 95% CI from -0.74 to -0.32, P=0.004); and (2) have managed the critical task using closed-loop communication (task clearly and loudly delegated, accepted, executed and completion acknowledged) (τ(b) = 0.46, 95% CI 0.17-0.74, P=0.022). Teams that administered magnesium sulfate within the allocated time (10 minutes) had significantly fewer exits from the labour room compared with teams who did not: a median of three (IQR 2-5) versus six exits (IQR 5-6) (P=0.03, Mann-Whitney U-test). Using administration of an essential drug as a valid surrogate of team efficiency and patient outcome after a simulated emergency, we found that more efficient teams were more likely to exhibit certain team behaviours relating to better handover and task allocation. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

  5. Planning and Preparing for Emergency Response to Transport Accidents Involving Radioactive Material. Safety Guide

    International Nuclear Information System (INIS)

    2009-01-01

    This Safety Guide provides guidance on various aspects of emergency planning and preparedness for dealing effectively and safely with transport accidents involving radioactive material, including the assignment of responsibilities. It reflects the requirements specified in Safety Standards Series No. TS-R-1, Regulations for the Safe Transport of Radioactive Material, and those of Safety Series No. 115, International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources. Contents: 1. Introduction; 2. Framework for planning and preparing for response to accidents in the transport of radioactive material; 3. Responsibilities for planning and preparing for response to accidents in the transport of radioactive material; 4. Planning for response to accidents in the transport of radioactive material; 5. Preparing for response to accidents in the transport of radioactive material; Appendix I: Features of the transport regulations influencing emergency response to transport accidents; Appendix II: Preliminary emergency response reference matrix; Appendix III: Guide to suitable instrumentation; Appendix IV: Overview of emergency management for a transport accident involving radioactive material; Appendix V: Examples of response to transport accidents; Appendix VI: Example equipment kit for a radiation protection team; Annex I: Example of guidance on emergency response to carriers; Annex II: Emergency response guide.

  6. Communication between anesthesiologists, patients and the anesthesia team: a descriptive study of induction and emergence.

    Science.gov (United States)

    Smith, Andrew F; Pope, Catherine; Goodwin, Dawn; Mort, Maggie

    2005-11-01

    Although the importance of communication skills in anesthetic practice is increasingly recognized, formal communication skills training has hitherto dealt only with limited aspects of this professional activity. We aimed to document and analyze the informally-learned communication that takes place between anesthesia personnel and patients at induction of and emergence from general anesthesia. We adopted an ethnographic approach based principally on observation of anesthesia personnel at work in the operating theatres with subsequent analysis of observation transcripts. We noted three main styles of communication on induction, commonly combined in a single induction. In order of frequency, these were: (1) descriptive, where the anesthesiologists explained to the patient what he/she might expect to feel; (2) functional, which seemed designed to help anesthesiologists maintain physiological stability or assess the changing depth of anesthesia and (3) evocative, which referred to images or metaphors. Although the talk we have described is nominally directed at the patient, it also signifies to other members of the anesthetic team how induction is progressing. The team may also contribute to the communication behaviour depending on the context. Communication on emergence usually focused on establishing that the patient was awake. Communication at induction and emergence tends to fall into specific patterns with different emphases but similar functions. This communication work is shared across the anesthetic team. Further work could usefully explore the relationship between communication styles and team performance or indicators of patient safety or well-being.

  7. Study on team characteristics influencing on nuclear safety culture in Korea based on Bayesian networks

    International Nuclear Information System (INIS)

    Young-gab, K.; Chan-ho, S.; Jeong-jin, P.

    2014-01-01

    The safety culture of Korean nuclear power plants has been settled down as an organizational culture since the Chernobyl accident in 1986. Reason (1997) proposed that safety culture is a sub-culture of corporate culture and sub-culture is a term that can be used interchangeably to a sub-group of people (i.e., department, workgroup). Therefore, the safety culture of organization comprised of various teams can be told as a culture to reflect team characteristics and interact with each other. Team characteristics have something to do with a successful task performance and task efficiency. However, the team characteristics in nuclear power plant have to consider safety preferentially rather than performance. Team characteristics for a safety are necessary to ensure and enhance the safety of safety-critical system. This paper proposed team characteristics for a safety which influence on the strong and vulnerable area of safety culture. These characteristics were analyzed on the basis of the safety culture evaluation which was performed to measure the level of plant workers' safety culture in 2013. The model of team characteristics was constructed considering Bayesian inference and the result was proposed according to workers' awareness. Safety team characteristics have a direct or indirect effect on the safety of nuclear power plants. Therefore, if they are improved and trained continuously, the safety of nuclear power plants might be enhanced. (author)

  8. Study on team characteristics influencing on nuclear safety culture in Korea based on Bayesian networks

    Energy Technology Data Exchange (ETDEWEB)

    Young-gab, K.; Chan-ho, S.; Jeong-jin, P., E-mail: iamkyg@khnp.co.kr, E-mail: chsung@khnp.co.kr, E-mail: jjpark82@khnp.co.kr [Korea Hydro & Nuclear Power Co., Central Research Inst., Yuseong-gu, Daejeon (Korea, Republic of)

    2014-07-01

    The safety culture of Korean nuclear power plants has been settled down as an organizational culture since the Chernobyl accident in 1986. Reason (1997) proposed that safety culture is a sub-culture of corporate culture and sub-culture is a term that can be used interchangeably to a sub-group of people (i.e., department, workgroup). Therefore, the safety culture of organization comprised of various teams can be told as a culture to reflect team characteristics and interact with each other. Team characteristics have something to do with a successful task performance and task efficiency. However, the team characteristics in nuclear power plant have to consider safety preferentially rather than performance. Team characteristics for a safety are necessary to ensure and enhance the safety of safety-critical system. This paper proposed team characteristics for a safety which influence on the strong and vulnerable area of safety culture. These characteristics were analyzed on the basis of the safety culture evaluation which was performed to measure the level of plant workers' safety culture in 2013. The model of team characteristics was constructed considering Bayesian inference and the result was proposed according to workers' awareness. Safety team characteristics have a direct or indirect effect on the safety of nuclear power plants. Therefore, if they are improved and trained continuously, the safety of nuclear power plants might be enhanced. (author)

  9. Intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care: a descriptive qualitative study.

    Science.gov (United States)

    Ballangrud, Randi; Hall-Lord, Marie Louise; Persenius, Mona; Hedelin, Birgitta

    2014-08-01

    To describe intensive care nurses' perceptions of simulation-based team training for building patient safety in intensive care. Failures in team processes are found to be contributory factors to incidents in an intensive care environment. Simulation-based training is recommended as a method to make health-care personnel aware of the importance of team working and to improve their competencies. The study uses a qualitative descriptive design. Individual qualitative interviews were conducted with 18 intensive care nurses from May to December 2009, all of which had attended a simulation-based team training programme. The interviews were analysed by qualitative content analysis. One main category emerged to illuminate the intensive care nurse perception: "training increases awareness of clinical practice and acknowledges the importance of structured work in teams". Three generic categories were found: "realistic training contributes to safe care", "reflection and openness motivates learning" and "finding a common understanding of team performance". Simulation-based team training makes intensive care nurses more prepared to care for severely ill patients. Team training creates a common understanding of how to work in teams with regard to patient safety. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. On-call emergency workload of a general surgical team.

    Science.gov (United States)

    Jawaid, Masood; Raza, Syed Muhammad; Alam, Shams Nadeem; Manzar, S

    2009-01-01

    To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E) and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Total 456 patients (326 males and 130 females) were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9%) were received from 8 am to 5 pm. 224 (49.1%) calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0%) patients. Total 73 (16.0%) calls were received for trauma. Total 131 (28.7%) patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5%) patients were discharged from A and E. 92 (20.1%) patients were referred to other units with medical referral accounts for 45 (9.8%) patients. Total 104 (22.8%) emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7%) patients. Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

  11. IAEA Sets Up Team to Drive Nuclear Safety Action Plan

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: The International Atomic Energy Agency is setting up a Nuclear Safety Action Team to oversee prompt implementation of the IAEA Action Plan on Nuclear Safety and ensure proper coordination among all stakeholders. The 12-point Action Plan, drawn up in the wake of the Fukushima Daiichi accident, was approved by the Agency's Board of Governors on 13 September and endorsed by all 151 Member States at its General Conference last week. The team will work within the Agency's Department of Nuclear Safety and Security, headed by Deputy Director General Denis Flory, and will coordinate closely with the Director General's Office for Policy. ''The Action Plan requires immediate follow-up,'' Director General Yukiya Amano said. ''This compact, dedicated team will assist Deputy Director General Flory in implementing the measures agreed in the Action Plan.'' Gustavo Caruso, Head of the Regulatory Activities Section in the IAEA's Division of Installation Safety, has been designated as the team's Special Coordinator for the implementation of the Action Plan. The IAEA has already started implementing its responsibilities under the Action Plan, including development of an IAEA methodology for stress tests for nuclear power plants. The methodology will be ready in October. (IAEA)

  12. UPSAT guidelines. 1996 edition. Reference document for IAEA Uranium Productions Safety Assessment Teams (UPSATs)

    International Nuclear Information System (INIS)

    1996-05-01

    The IAEA Uranium Production Safety Assessment Team (UPSAT) programme provides advice and assistance to Member States to enhance the safety and environmental performance of uranium production facilities during construction, commissioning and operation. Sound design and construction are prerequisite for the safe and environmentally responsible operation of uranium mines and mills. However, the safety of the facility depends ultimately on sound policies, procedures and practices; on the capability and reliability of the construction, commissioning and operating personnel; on comprehensive instructions; and on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. The UPSAT guidelines have been developed in the following areas: (1) management, organization and administration; (2) training and qualification; (3) operation (4) maintenance; (5) safety, fire protection, emergency planning, and preparedness; (6) radiation protection; (7) environmental monitoring programme; (8) construction management; (9) commissioning and decommissioning

  13. A case for safety leadership team training of hospital managers.

    Science.gov (United States)

    Singer, Sara J; Hayes, Jennifer; Cooper, Jeffrey B; Vogt, Jay W; Sales, Michael; Aristidou, Angela; Gray, Garry C; Kiang, Mathew V; Meyer, Gregg S

    2011-01-01

    Delivering safe patient care remains an elusive goal. Resolving problems in complex organizations like hospitals requires managers to work together. Safety leadership training that encourages managers to exercise learning-oriented, team-based leadership behaviors could promote systemic problem solving and enhance patient safety. Despite the need for such training, few programs teach multidisciplinary groups of managers about specific behaviors that can enhance their role as leadership teams in the realm of patient safety. The aims of this study were to describe a learning-oriented, team-based, safety leadership training program composed of reinforcing exercises and to provide evidence confirming the need for such training and demonstrating behavior change among management groups after training. Twelve groups of managers from an academic medical center based in the Northeast United States were randomly selected to participate in the program and exposed to its customized, experience-based, integrated, multimodal curriculum. We extracted data from transcripts of four training sessions over 15 months with groups of managers about the need for the training in these groups and change in participants' awareness, professional behaviors, and group activity. Training transcripts confirmed the need for safety leadership team training and provided evidence of the potential for training to increase targeted behaviors. The training increased awareness and use of leadership behaviors among many managers and led to new routines and coordinated effort among most management groups. Enhanced learning-oriented leadership often helped promote a learning orientation in managers' work areas. Team-based training that promotes specific learning-oriented leader behaviors can promote behavioral change among multidisciplinary groups of hospital managers.

  14. Protecting front-line survey and rescue teams during emergencies

    International Nuclear Information System (INIS)

    Tresise, H.

    1980-01-01

    Means of protecting front-line survey and rescue teams during emergencies are described. The team composition, their apparatus, the selection of the incident control point, the use of guidelines and breathing apparatus and control point trolley and equipment are discussed. (H.K.)

  15. Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum.

    Science.gov (United States)

    Wong, Ambrose H; Wing, Lisa; Weiss, Brenda; Gang, Maureen

    2015-11-01

    While treating potentially violent patients in the emergency department (ED), both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a team-based approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1) to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2) to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs) and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS) consisting of 30 Likert-scale questions grouped into four themed constructs. One hundred sixty-two ED staff members completed the course with >95% staff participation, generating a total of 106 paired surveys

  16. On-call emergency workload of a general surgical team

    Directory of Open Access Journals (Sweden)

    Jawaid Masood

    2009-01-01

    Full Text Available Background: To examine the on-call emergency workload of a general surgical team at a tertiary care teaching hospital to guide planning and provision of better surgical services. Patients and Methods: During six months period from August to January 2007; all emergency calls attended by general surgical team of Surgical Unit II in Accident and Emergency department (A and E and in other units of Civil, Hospital Karachi, Pakistan were prospectively recorded. Data recorded includes timing of call, diagnosis, operation performed and outcome apart from demography. Results: Total 456 patients (326 males and 130 females were attended by on-call general surgery team during 30 emergency days. Most of the calls, 191 (41.9% were received from 8 am to 5 pm. 224 (49.1% calls were of abdominal pain, with acute appendicitis being the most common specific pathology in 41 (9.0% patients. Total 73 (16.0% calls were received for trauma. Total 131 (28.7% patients were admitted in the surgical unit for urgent operation or observation while 212 (46.5% patients were discharged from A and E. 92 (20.1% patients were referred to other units with medical referral accounts for 45 (9.8% patients. Total 104 (22.8% emergency surgeries were done and the most common procedure performed was appendicectomy in 34 (32.7% patients. Conclusion: Major workload of on-call surgical emergency team is dealing with the acute conditions of abdomen. However, significant proportion of patients are suffering from other conditions including trauma that require a holistic approach to care and a wide range of skills and experience. These results have important implications in future healthcare planning and for the better training of general surgical residents.

  17. Code Blue Emergencies: A Team Task Analysis and Educational Initiative.

    Science.gov (United States)

    Price, James W; Applegarth, Oliver; Vu, Mark; Price, John R

    2012-01-01

    The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR) and post-operative recovery unit (PAR) at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH) were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Both nursing staff (n = 49) and anesthesiologists (n = 19) supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

  18. Code Blue Emergencies: A Team Task Analysis and Educational Initiative

    Directory of Open Access Journals (Sweden)

    James W. Price

    2012-04-01

    Full Text Available Introduction: The objective of this study was to identify factors that have a positive or negative influence on resuscitation team performance during emergencies in the operating room (OR and post-operative recovery unit (PAR at a major Canadian teaching hospital. This information was then used to implement a team training program for code blue emergencies. Methods: In 2009/10, all OR and PAR nurses and 19 anesthesiologists at Vancouver General Hospital (VGH were invited to complete an anonymous, 10 minute written questionnaire regarding their code blue experience. Survey questions were devised by 10 recovery room and operation room nurses as well as 5 anesthesiologists representing 4 different hospitals in British Columbia. Three iterations of the survey were reviewed by a pilot group of nurses and anesthesiologists and their feedback was integrated into the final version of the survey. Results: Both nursing staff (n = 49 and anesthesiologists (n = 19 supported code blue training and believed that team training would improve patient outcome. Nurses noted that it was often difficult to identify the leader of the resuscitation team. Both nursing staff and anesthesiologists strongly agreed that too many people attending the code blue with no assigned role hindered team performance. Conclusion: Identifiable leadership and clear communication of roles were identified as keys to resuscitation team functioning. Decreasing the number of people attending code blue emergencies with no specific role, increased access to mock code blue training, and debriefing after crises were all identified as areas requiring improvement. Initial team training exercises have been well received by staff.

  19. Team knowledge research: emerging trends and critical needs.

    Science.gov (United States)

    Wildman, Jessica L; Thayer, Amanda L; Pavlas, Davin; Salas, Eduardo; Stewart, John E; Howse, William R

    2012-02-01

    This article provides a systematic review of the team knowledge literature and guidance for further research. Recent research has called attention to the need for the improved study and understanding of team knowledge. Team knowledge refers to the higher level knowledge structures that emerge from the interactions of individual team members. We conducted a systematic review of the team knowledge literature, focusing on empirical work that involves the measurement of team knowledge constructs. For each study, we extracted author degree area, study design type, study setting, participant type, task type, construct type, elicitation method, aggregation method, measurement timeline, and criterion domain. Our analyses demonstrate that many of the methodological characteristics of team knowledge research can be linked back to the academic training of the primary author and that there are considerable gaps in our knowledge with regard to the relationships between team knowledge constructs, the mediating mechanisms between team knowledge and performance, and relationships with criteria outside of team performance, among others. We also identify categories of team knowledge not yet examined based on an organizing framework derived from a synthesis of the literature. There are clear opportunities for expansion in the study of team knowledge; the science of team knowledge would benefit from a more holistic theoretical approach. Human factors researchers are increasingly involved in the study of teams. This review and the resulting organizing framework provide researchers with a summary of team knowledge research over the past 10 years and directions for improving further research.

  20. Team Training and Institutional Protocols to Prevent Shoulder Dystocia Complications.

    Science.gov (United States)

    Smith, Samuel

    2016-12-01

    Shoulder dystocia is an obstetrical emergency that may result in significant neonatal complications. It requires rapid recognition and a coordinated response. Standardization of care, teamwork and communication, and clinical simulation are the key components of patient safety programs in obstetrics. Simulation-based team training and institutional protocols for the management of shoulder dystocia are emerging as integral components of many labor and delivery safety initiatives because of their impact on technical skills and team performance.

  1. Effects of a team-based assessment and intervention on patient safety culture in general practice

    DEFF Research Database (Denmark)

    Hoffmann, B; Müller, V; Rochon, J

    2014-01-01

    Background: The measurement of safety culture in healthcare is generally regarded as a first step towards improvement. Based on a self-assessment of safety culture, the Frankfurt Patient Safety Matrix (FraTrix) aims to enable healthcare teams to improve safety culture in their organisations....... In this study we assessed the effects of FraTrix on safety culture in general practice. Methods: We conducted an open randomised controlled trial in 60 general practices. FraTrix was applied over a period of 9 months during three facilitated team sessions in intervention practices. At baseline and after 12...... months, scores were allocated for safety culture as expressed in practice structure and processes (indicators), in safety climate and in patient safety incident reporting. The primary outcome was the indicator error management. Results: During the team sessions, practice teams reflected on their safety...

  2. Quality of care using a multidisciplinary team in the emergency room

    DEFF Research Database (Denmark)

    Christensen, Dorthea; Maaløe, Rikke; Jensen, Nanna Martin

    2011-01-01

    Bispebjerg Hospital has implemented a multidisciplinary team reception of critically ill and severely injured patients at the Emergency Department (ED), termed emergency call (EC) and trauma call (TC). The aim of this study was to describe the course, medical treatment and outcome for patients re...... received by this multidisciplinary team and to evaluate the quality of acute medical treatment of these patients....

  3. What makes maternity teams effective and safe? Lessons from a series of research on teamwork, leadership and team training.

    Science.gov (United States)

    Siassakos, Dimitrios; Fox, Robert; Bristowe, Katherine; Angouri, Jo; Hambly, Helen; Robson, Lauren; Draycott, Timothy J

    2013-11-01

    We describe lessons for safety from a synthesis of seven studies of teamwork, leadership and team training across a healthcare region. Two studies identified successes and challenges in a unit with embedded team training: a staff survey demonstrated a positive culture but a perceived need for greater senior presence; training improved actual emergency care, but wide variation in team performance remained. Analysis of multicenter simulation records showed that variation in patient safety and team efficiency correlated with their teamwork but not individual knowledge, skills or attitudes. Safe teams tended to declare the emergency earlier, hand over in a more structured way, and use closed-loop communication. Focused and directed communication was also associated with better patient-actor perception of care. Focus groups corroborated these findings, proposed that the capability and experience of the leader is more important than seniority, and identified teamwork and leadership issues that require further research. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  4. Interprofessional education in team communication: working together to improve patient safety.

    Science.gov (United States)

    Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

    2013-05-01

    Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (pskills included, team structure (p=0.002), situation monitoring (pcommunication (p=0.002). Significant shifts were reported for knowledge of TeamSTEPPS (pcommunicating in interprofessional teams (pcommunication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

  5. An overview of the Environmental Response Team's air surveillance procedures at emergency response activities

    Energy Technology Data Exchange (ETDEWEB)

    Turpin, R.D.; Campagna, P.R. (U.S. Environmental Protection Agency, Edison, NJ (USA))

    The Safety and Air Surveillance Section of the United States Environmental Protection Agency's Environmental Response Team responds to emergency air releases such as tire fires and explosions. The air surveillance equipment and procedures used by the organization are described, and case studies demonstrating the various emergency response activities are presented. Air response activities include emergency air responses, occupational and human health air responses and remedial air responses. Monitoring and sampling equipment includes photoionization detectors, combustible gas meters, real-time aerosol monitors, personal sampling pumps, and high flow pumps. Case histories presented include disposal of dioxane from a cotton plant, response to oil well fires in Kuwait, disposal of high pressure cylinders in American Samoa, and response to hurricane Hugo. 3 refs., 1 tab.

  6. Interprofessional education in team communication: working together to improve patient safety.

    Science.gov (United States)

    Brock, Douglas; Abu-Rish, Erin; Chiu, Chia-Ru; Hammer, Dana; Wilson, Sharon; Vorvick, Linda; Blondon, Katherine; Schaad, Douglas; Liner, Debra; Zierler, Brenda

    2013-11-01

    Communication failures in healthcare teams are associated with medical errors and negative health outcomes. These findings have increased emphasis on training future health professionals to work effectively within teams. The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) communication training model, widely employed to train healthcare teams, has been less commonly used to train student interprofessional teams. The present study reports the effectiveness of a simulation-based interprofessional TeamSTEPPS training in impacting student attitudes, knowledge and skills around interprofessional communication. Three hundred and six fourth-year medical, third-year nursing, second-year pharmacy and second-year physician assistant students took part in a 4 h training that included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback sessions. Students worked in groups balanced by a professional programme in a self-selected focal area (adult acute, paediatric, obstetrics). Preassessments and postassessments were used for examining attitudes, beliefs and reported opportunities to observe or participate in team communication behaviours. One hundred and forty-nine students (48.7%) completed the preassessments and postassessments. Significant differences were found for attitudes toward team communication (pteam structure (p=0.002), situation monitoring (pteams (pteam communication is important in patient safety. We demonstrate positive attitudinal and knowledge effects in a large-scale interprofessional TeamSTEPPS-based training involving four student professions.

  7. IAEA Operational Safety Team (OSART) Reviews Progress at Fessenheim Nuclear Power Plant, France

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: An international team of nuclear installation safety experts, led by the International Atomic Energy Agency (IAEA), has evaluated the French Nuclear Power Plant (NPP) at Fessenheim to assess how the facility has followed up on an Operational Safety Review Team (OSART) mission undertaken in 2009. The IAEA assembled a team of experts at the request of the Government of France to conduct the mission. Follow-up missions are standard components of the OSART programme and are conducted 18-24 months after the initial OSART mission. Under the leadership of the IAEA's Division of Nuclear Installation Safety, the team performed its review from 7 to 11 February 2011. The team assessed how the Fessenheim NPP has addressed the recommendations and suggestions made during the 2009 OSART mission. The team was made up of experts from Slovakia, Switzerland and the IAEA. The review covered the areas of Management, Organization and Administration; Training and Qualifications; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry and Emergency Planning and Preparedness. The conclusions of the follow-up review are based on the IAEA's Safety Standards and proven good international practices. There were 21 issues raised by the 2009 mission. During the follow-up mission, the team assessed that six issues had been resolved, thirteen had made satisfactory progress to date and two had made insufficient progress to date. 'Resolved' describes action plans for improvement that have been fully implemented; 'satisfactory progress to date' describes action plans that have been developed but are not yet fully implemented; and 'insufficient progress to date' describes situations where additional consideration or strengthening of improvement plans is necessary. Examples of issues falling into different resolution categories include: The plant has resolved the suggestion to establish a process to review initial training materials on a regular basis

  8. Preparedness of Operation Teams' Non-technical Skills in a Main Control Room of Nuclear Power Plants to Manage Emergency Situations

    International Nuclear Information System (INIS)

    Yim, Ho Bin; Kim, Ar Ryum; Seong, Poong Hyun

    2012-01-01

    Human reliability is one of the important determinants for the system safety. Nuclear Energy Agency reported that approximately half of events reported by foreign nuclear industry were related with inappropriate human actions. The human error problems can be viewed in two ways: the person approach and the system approach. Other terms to represent each approach are active failures and latent conditions. Active failures are unsafe acts committed by people who are in direct contact with systems whereas latent conditions are the inevitable 'resident pathogens' within the system. To identify what kinds of non-technical skills were needed to cope with emergency conditions, a method to evaluate preparedness of task management in emergency conditions based on monitoring patterns was presented. Five characteristics were suggested to evaluate emergency task management and communication: latent mistake resistibility, latent violation resistibility, thoroughness, communication, and assertiveness. Case study was done by analyzing emergency training of 9 different real operation teams in the reference plant. The result showed that the 9 teams had their own emergency task management skills which resulted in good and bad performances

  9. Evaluation of aviation-based safety team training in a hospital in The Netherlands.

    Science.gov (United States)

    De Korne, Dirk F; Van Wijngaarden, Jeroen D H; Van Dyck, Cathy; Hiddema, U Francis; Klazinga, Niek S

    2014-01-01

    The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient safety, but little is known about how it affects safety culture. Pre- and post-assessments of the hospitals' safety culture was based on interviews with ophthalmologists, anesthesiologists, residents, nurses, and support staff. Interim observations were made at training sessions and in daily hospital practice. The program consisted of safety audits of processes and (team) activities, interactive classroom training sessions by aviation experts, a flight simulator session, and video recording of team activities with subsequent feedback. Medical professionals considered aviation experts inspiring role models and respected their non-hierarchical external perspective and focus on medical-technical issues. The post-assessment showed that ophthalmologists and other hospital staff had become increasingly aware of safety issues. The multidisciplinary approach promoted social (team) orientation that replaced the former functionally-oriented culture. The number of reported near-incidents greatly increased; the number of wrong-side surgeries stabilized to a minimum after an initial substantial reduction. The study was observational and the hospital's variety of efforts to improve safety culture prevented us from establishing a causal relation between improvement and any one specific intervention. Aviation-based TRM training can be a useful to stimulate safety culture in hospitals. Safety and quality improvements are not single treatment interventions but complex socio-technical interventions. A multidisciplinary system approach and focus on "team" instead of "profession" seems both necessary and difficult in hospital care.

  10. Challenges to effective crisis management: using information and communication technologies to coordinate emergency medical services and emergency department teams.

    Science.gov (United States)

    Reddy, Madhu C; Paul, Sharoda A; Abraham, Joanna; McNeese, Michael; DeFlitch, Christopher; Yen, John

    2009-04-01

    The purpose of this study is to identify the major challenges to coordination between emergency department (ED) teams and emergency medical services (EMS) teams. We conducted a series of focus groups involving both ED and EMS team members using a crisis scenario as the basis of the focus group discussion. We also collected organizational workflow data. We identified three major challenges to coordination between ED and EMS teams including ineffectiveness of current information and communication technologies, lack of common ground, and breakdowns in information flow. The three challenges highlight the importance of designing systems from socio-technical perspective. In particular, these inter-team coordination systems must support socio-technical issues such as awareness, context, and workflow between the two teams.

  11. Characteristics of the safety climate in teams with world-class safety ...

    African Journals Online (AJOL)

    Accidents and incidents in the construction environment are not reduced or eliminated effectively, despite numerous efforts made to improve health and safety in the industry. An extensive field of research has been conducted on how teams in the construction environment interact to deliver a project successfully in terms of ...

  12. Constructing Common Information Space across Distributed Emergency Medical Teams

    DEFF Research Database (Denmark)

    Zhang, Zhan; Sarcevic, Aleksandra; Bossen, Claus

    2017-01-01

    This paper examines coordination and real-time information sharing across four emergency medical teams in a high-risk and distributed setting as they provide care to critically injured patients within the first hour after injury. Through multiple field studies we explored how common understanding...... of critical patient data is established across these heterogeneous teams and what coordination mechanisms are being used to support information sharing and interpretation. To analyze the data, we drew on the concept of Common Information Spaces (CIS). Our results showed that teams faced many challenges...... in achieving efficient information sharing and coordination, including difficulties in locating and assembling team members, communicating and interpreting information from the field, and accommodating differences in team goals and information needs, all while having minimal technology support. We reflect...

  13. Study on the action guidelines for medical support team for nuclear and radiological emergency

    International Nuclear Information System (INIS)

    Liu Chang'an; Liu Ying; Geng Xiusheng

    2006-01-01

    Objective: To study the action guidelines for medical support team for nuclear and radiological emergency. Methods: It is based on the experience and lessons learned in the course of meeting the emergencies preparedness and response of nuclear and radiological emergencies in China and abroad with the reference of the relevant reports of International Atomic Energy Agency. Results: Essential requirements and practical recommendations for the roles, responsibilities, emergency preparedness, principles and procedures of medical assistance at the scene, as well as the radiological protection of medical support team were provided. Conclusion: The document mentioned above can be applied to direct the establishment, effective medical preparedness and response of the medical support team for nuclear and radiological emergency. (authors)

  14. Training and exercises of the Emergency Response Team at the Los Alamos Plutonium Facility

    International Nuclear Information System (INIS)

    Yearwood, D.D.

    1988-01-01

    The Los Alamos National Laboratory Plutonium Facility has an active Emergency Response Team. The Emergency Response Team is composed of members of the operating and support groups within the Plutonium Facility. In addition to their initial indoctrination, the members are trained and certified in first-aid, CPR, fire and rescue, and the use of self-contained-breathing-apparatus. Training exercises, drills, are conducted once a month. The drills consist of scenarios which require the Emergency Response Team to apply CPR and/or first aid. The drills are performed in the Plutonium Facility, they are video taped, then reviewed and critiqued by site personnel. Through training and effective drills and the Emergency Response Team can efficiently respond to any credible accident which may occur at the Plutonium Facility. 3 tabs

  15. Preparedness of Operation Teams' Non-technical Skills in a Main Control Room of Nuclear Power Plants to Manage Emergency Situations

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Ho Bin; Kim, Ar Ryum; Seong, Poong Hyun [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of)

    2012-05-15

    Human reliability is one of the important determinants for the system safety. Nuclear Energy Agency reported that approximately half of events reported by foreign nuclear industry were related with inappropriate human actions. The human error problems can be viewed in two ways: the person approach and the system approach. Other terms to represent each approach are active failures and latent conditions. Active failures are unsafe acts committed by people who are in direct contact with systems whereas latent conditions are the inevitable 'resident pathogens' within the system. To identify what kinds of non-technical skills were needed to cope with emergency conditions, a method to evaluate preparedness of task management in emergency conditions based on monitoring patterns was presented. Five characteristics were suggested to evaluate emergency task management and communication: latent mistake resistibility, latent violation resistibility, thoroughness, communication, and assertiveness. Case study was done by analyzing emergency training of 9 different real operation teams in the reference plant. The result showed that the 9 teams had their own emergency task management skills which resulted in good and bad performances

  16. International Expert Team Concludes IAEA Peer Review of Bulgaria's Regulatory Framework for Nuclear and Radiation Safety

    International Nuclear Information System (INIS)

    2013-01-01

    the notification of nuclear and radiation safety-related events; Provisions established by the BNRA to manage its technical support organisations provide a good basis to use them effectively; The process to establish and keep updated regulations and guidelines is well structured and involves, as necessary, relevant interested parties; The BNRA has a policy of transparency and openness with the public, which covers in an effective manner the provision of information on safety-related events and protective actions during emergencies; and There is a complete national dose registry system that includes provision for comprehensive information gathering, which allows for thorough cause-effect analyses to be performed. The IRRS team identified the following areas where the overall performance of the regulatory system could be enhanced: Demarcation of the respective roles of state authorities in the area of radiation protection safety, and establishment of formal coordination and cooperation of their regulatory functions; BNRA's resources and competence for oversight of future facilities and activities; BNRA's establishment of an integrated management system that contributes to meeting its goals in an efficient manner; BNRA procedures used for the review and assessment process for all facilities and activities; and Inspection processes, including the development and implementation of planned and systematic inspection programmes that cover all facilities and activities, and coordination among different regulatory organisations. A final report will be submitted to the Government of Bulgaria in about three months. The BNRA announced to the mission that the report will be made publicly available. The IAEA encourages nations to invite a follow-up IRRS mission about two years after the initial mission has been completed. Background The team reviewed the legal and regulatory framework for nuclear and radiation safety, addressing all facilities and activities regulated by BNRA

  17. Emergency and backup power supplies at Department of Energy facilities: Augmented Evaluation Team -- Final report

    Energy Technology Data Exchange (ETDEWEB)

    1993-11-01

    This report documents the results of the Defense Programs (DP) Augmented Evaluation Team (AET) review of emergency and backup power supplies (i.e., generator, uninterruptible power supply, and battery systems) at DP facilities. The review was conducted in response to concerns expressed by former Secretary of Energy James D. Watkins over the number of incidents where backup power sources failed to provide electrical power during tests or actual demands. The AET conducted a series of on-site reviews for the purpose of understanding the design, operation, maintenance, and safety significance of emergency and backup power (E&BP) supplies. The AET found that the quality of programs related to maintenance of backup power systems varies greatly among the sites visited, and often among facilities at the same site. No major safety issues were identified. However, there are areas where the AET believes the reliability of emergency and backup power systems can and should be improved. Recommendations for improving the performance of E&BP systems are provided in this report. The report also discusses progress made by Management and Operating (M&O) contractors to improve the reliability of backup sources used in safety significant applications. One area that requires further attention is the analysis and understanding of the safety implications of backup power equipment. This understanding is needed for proper graded-approach implementation of Department of Energy (DOE) Orders, and to help ensure that equipment important to the safety of DOE workers, the public, and the environment is identified, classified, recognized, and treated as such by designers, users, and maintainers. Another area considered important for improving E&BP system performance is the assignment of overall ownership responsibility and authority for ensuring that E&BP equipment performs adequately and that reliability and availability are maintained at acceptable levels.

  18. Modifications of Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany based upon new version of Emergency Operating Procedures

    International Nuclear Information System (INIS)

    Aldorf, R.

    1997-01-01

    In the frame of 'living Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany Project' being performed by Nuclear Research Institute Rez during 1997 is planned to reflect on Probabilistic Safety Assessment-1 basis on impact of Emergency Response Guidelines (as one particular event from the list of other modifications) on Plant Safety. Following highlights help to orient the reader in main general aspects, findings and issues of the work that currently continues on. Older results of Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany have revealed that human behaviour during accident progression scenarios represent one of the most important aspects in plant safety. Current effort of Nuclear Power Plants Dukovany (Czech Republic) and Bohunice (Slovak Republic) is focussed on development of qualitatively new symptom-based Emergency Operating Procedures called Emergency Response Guidelines Supplier - Westinghouse Energy Systems Europe, Brussels works in cooperation with teams of specialist from both Nuclear Power Plants. In the frame of 'living Probabilistic Safety Assessment-1 Nuclear Power Plant Dukovany Project' being performed by Nuclear Research Institute Rez during 1997 is planned to prove on Probabilistic Safety Assessment -1 basis an expected - positive impact of Emergency Response Guidelines on Plant Safety, Since this contract is currently still in progress, it is possible to release only preliminary conclusions and observations. Emergency Response Guidelines compare to original Emergency Operating Procedures substantially reduce uncertainty of general human behaviour during plant response to an accident process. It is possible to conclude that from the current scope Probabilistic Safety Assessment Dukovany point of view (until core damage), Emergency Response Guidelines represent adequately wide basis for mitigating any initiating event

  19. Quality of prescription of high-alert medication and patient safety in pediatric emergency

    Directory of Open Access Journals (Sweden)

    V. Vieira de Melo

    2014-01-01

    Full Text Available Objective: Verify the importance of compliance by prescribed doses of high-alert medications in unit of pediatric emergency in patient safety. Method: This was a cross-sectional descriptive study conducted in a unit of pediatric emergency, for March to April of 2012. This study included all prescriptions that contained at least one high-alert medication, excluding all of others. The data were analyzed using Microsoft Office Excel® version 2007, and the study was approved by the Research Ethics Committee of the Hospital. Results: This study included prescriptions for 100 patients with a mean age of 5.2 ± 4.2 years. Were identified 983 (40.1% high-alert medications (21 different, with predominance of injectable solutions (834, 84,8%, and of these 727 (73.95% were electrolytes. The analysis of the dose was possible for 641 electrolytes and 104 non-electrolytes, being the dose inadequacies observed for some medications. Was observed concentration absent to 189 (18.9% prescribed medications, these with liquid pharmaceutical form or aerosol. Was observed also the absence of maximum dose for 8 (36.3% prescribed drugs “if necessary”. Conclusión: The inadequacies of doses of high-alert medications identified in this study may compromise patient safety, demonstrating the importance of knowledge of multidisciplinary health care team by this subject, in this context, it is noteworthy that the acting of a clinical pharmacist together with the health multidisciplined team can contributes with the review of drug prescriptions, reducing potential errors and collaborating with patient safety.

  20. Video conferencing versus telephone calls for team work across hospitals: a qualitative study on simulated emergencies

    Directory of Open Access Journals (Sweden)

    Hagen Oddvar

    2009-11-01

    Full Text Available Abstract Background Teamwork is important for patient care and outcome in emergencies. In rural areas, efficient communication between rural hospitals and regional trauma centers optimise decisions and treatment of trauma patients. Little is known on potentials and effects of virtual team to team cooperation between rural and regional trauma teams. Methods We adapted a video conferencing (VC system to the work process between multidisciplinary teams responsible for trauma as well as medical emergencies between one rural and one regional (university hospital. We studied how the teams cooperated during simulated critical scenarios, and compared VC with standard telephone communication. We used qualitative observations and interviews to evaluate results. Results The team members found VC to be a useful tool during emergencies and for building "virtual emergency teams" across distant hospitals. Visual communication combined with visual patient information is superior to information gained during ordinary telephone calls, but VC may also cause interruptions in the local teamwork. Conclusion VC can improve clinical cooperation and decision processes in virtual teams during critical patient care. Such team interaction requires thoughtful organisation, training, and new rules for communication.

  1. Factors influencing mine rescue team behaviors.

    Science.gov (United States)

    Jansky, Jacqueline H; Kowalski-Trakofler, K M; Brnich, M J; Vaught, C

    2016-01-01

    A focus group study of the first moments in an underground mine emergency response was conducted by the National Institute for Occupational Safety and Health (NIOSH), Office for Mine Safety and Health Research. Participants in the study included mine rescue team members, team trainers, mine officials, state mining personnel, and individual mine managers. A subset of the data consists of responses from participants with mine rescue backgrounds. These responses were noticeably different from those given by on-site emergency personnel who were at the mine and involved with decisions made during the first moments of an event. As a result, mine rescue team behavior data were separated in the analysis and are reported in this article. By considering the responses from mine rescue team members and trainers, it was possible to sort the data and identify seven key areas of importance to them. On the basis of the responses from the focus group participants with a mine rescue background, the authors concluded that accurate and complete information and a unity of purpose among all command center personnel are two of the key conditions needed for an effective mine rescue operation.

  2. Tiger Team assessment of the Idaho National Engineering Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    McKenzie, Barbara J.; West, Stephanie G.; Jones, Olga G.; Kerr, Dorothy A.; Bieri, Rita A.; Sanderson, Nancy L.

    1991-08-01

    The purpose of the Safety and Health (S H) Subteam assessment was to determine the effectiveness of representative safety and health programs at the Idaho National Engineering Laboratory (INEL) site. Four Technical Safety Appraisal (TSA) Teams were assembled for this purpose by the US Department of Energy (DOE), Deputy Assistant Secretary for Safety and Quality Assurance, Office of Safety Appraisals (OSA). Team No. 1 reviewed EG G Idaho, Inc. (EG G Idaho) and the Department of Energy Field Office, Idaho (ID) Fire Department. Team No. 2 reviewed Argonne National Laboratory-West (ANL-W). Team No. 3 reviewed selected contractors at the INEL; specifically, Morrison Knudsen-Ferguson of Idaho Company (MK-FIC), Protection Technology of Idaho, Inc. (PTI), Radiological and Environmental Sciences Laboratory (RESL), and Rockwell-INEL. Team No. 4 provided an Occupational Safety and Health Act (OSHA)-type compliance sitewide assessment of INEL. The S H Subteam assessment was performed concurrently with assessments conducted by Environmental and Management Subteams. Performance was appraised in the following technical areas: Organization and Administration, Quality Verification, Operations, Maintenance, Training and Certification, Auxiliary Systems, Emergency Preparedness, Technical Support, Packaging and Transportation, Nuclear Criticality Safety, Security/Safety Interface, Experimental Activities, Site/Facility Safety Review, Radiological Protection, Personnel Protection, Worker Safety and Health (OSHA) Compliance, Fire Protection, Aviation Safety, Medical Services, and Firearms Safety.

  3. Tiger Team assessment of the Idaho National Engineering Laboratory

    International Nuclear Information System (INIS)

    1991-08-01

    The purpose of the Safety and Health (S ampersand H) Subteam assessment was to determine the effectiveness of representative safety and health programs at the Idaho National Engineering Laboratory (INEL) site. Four Technical Safety Appraisal (TSA) Teams were assembled for this purpose by the US Department of Energy (DOE), Deputy Assistant Secretary for Safety and Quality Assurance, Office of Safety Appraisals (OSA). Team No. 1 reviewed EG ampersand G Idaho, Inc. (EG ampersand G Idaho) and the Department of Energy Field Office, Idaho (ID) Fire Department. Team No. 2 reviewed Argonne National Laboratory-West (ANL-W). Team No. 3 reviewed selected contractors at the INEL; specifically, Morrison Knudsen-Ferguson of Idaho Company (MK-FIC), Protection Technology of Idaho, Inc. (PTI), Radiological and Environmental Sciences Laboratory (RESL), and Rockwell-INEL. Team No. 4 provided an Occupational Safety and Health Act (OSHA)-type compliance sitewide assessment of INEL. The S ampersand H Subteam assessment was performed concurrently with assessments conducted by Environmental and Management Subteams. Performance was appraised in the following technical areas: Organization and Administration, Quality Verification, Operations, Maintenance, Training and Certification, Auxiliary Systems, Emergency Preparedness, Technical Support, Packaging and Transportation, Nuclear Criticality Safety, Security/Safety Interface, Experimental Activities, Site/Facility Safety Review, Radiological Protection, Personnel Protection, Worker Safety and Health (OSHA) Compliance, Fire Protection, Aviation Safety, Medical Services, and Firearms Safety

  4. Safety/security interface assessments at commercial nuclear power plants

    International Nuclear Information System (INIS)

    Byers, K.R.; Brown, P.J.; Norderhaug, L.R.

    1985-01-01

    The findings of the Haynes Task Force Committee (NUREG-0992) are used as the basis for defining safety/security assessment team activities at commercial nuclear power plants in NRC Region V. A safety/security interface assessment outline and the approach used for making the assessments are presented along with the composition of team members. As a result of observing simulated plant emergency conditions during scheduled emergency preparedness exercises, examining security and operational response procedures, and interviewing plant personnel, the team has identified instances where safety/security conflicts can occur

  5. Safety/security interface assessments at commercial nuclear power plants

    International Nuclear Information System (INIS)

    Byers, K.R.; Brown, P.J.; Norderhaug, L.R.

    1985-07-01

    The findings of the Haynes Task Force Committee (NUREG-0992) are used as the basis for defining safety/security assessment team activities at commercial nuclear power plants in NRC Region V. A safety/security interface assessment outline and the approach used for making the assessments are presented along with the composition of team members. As a result of observing simulated plant emergency conditions during scheduled emergency preparedness exercises, examining security and operational response procedures, and interviewing plant personnel, the team has identified instances where safety/security conflicts can occur. 2 refs

  6. Leading teams during simulated pediatric emergencies: a pilot study

    Directory of Open Access Journals (Sweden)

    Coolen EH

    2015-01-01

    Full Text Available Ester H Coolen,1 Jos M Draaisma,2 Sabien den Hamer,3 Jan L Loeffen2 1Department of Pediatric Surgery, Amalia Children’s Hospital, Radboud University Medical Center, 2Department of Pediatrics, Amalia Children’s Hospital, Radboud University Medical Center, 3Department of Communication Science, Radboud University, Nijmegen, the Netherlands Purpose: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods: We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results: The coaching style (mean 54.5%, SD 7.8 is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1. This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion: The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. Keywords

  7. A Simulation-based Approach to Measuring Team Situational Awareness in Emergency Medicine: A Multicenter, Observational Study.

    Science.gov (United States)

    Rosenman, Elizabeth D; Dixon, Aurora J; Webb, Jessica M; Brolliar, Sarah; Golden, Simon J; Jones, Kerin A; Shah, Sachita; Grand, James A; Kozlowski, Steve W J; Chao, Georgia T; Fernandez, Rosemarie

    2018-02-01

    Team situational awareness (TSA) is critical for effective teamwork and supports dynamic decision making in unpredictable, time-pressured situations. Simulation provides a platform for developing and assessing TSA, but these efforts are limited by suboptimal measurement approaches. The objective of this study was to develop and evaluate a novel approach to TSA measurement in interprofessional emergency medicine (EM) teams. We performed a multicenter, prospective, simulation-based observational study to evaluate an approach to TSA measurement. Interprofessional emergency medical teams, consisting of EM resident physicians, nurses, and medical students, were recruited from the University of Washington (Seattle, WA) and Wayne State University (Detroit, MI). Each team completed a simulated emergency resuscitation scenario. Immediately following the simulation, team members completed a TSA measure, a team perception of shared understanding measure, and a team leader effectiveness measure. Subject matter expert reviews and pilot testing of the TSA measure provided evidence of content and response process validity. Simulations were recorded and independently coded for team performance using a previously validated measure. The relationships between the TSA measure and other variables (team clinical performance, team perception of shared understanding, team leader effectiveness, and team experience) were explored. The TSA agreement metric was indexed by averaging the pairwise agreement for each dyad on a team and then averaging across dyads to yield agreement at the team level. For the team perception of shared understanding and team leadership effectiveness measures, individual team member scores were aggregated within a team to create a single team score. We computed descriptive statistics for all outcomes. We calculated Pearson's product-moment correlations to determine bivariate correlations between outcome variables with two-tailed significance testing (p teams (n = 41

  8. What is the value and impact of quality and safety teams? A scoping review

    Directory of Open Access Journals (Sweden)

    Norris Jill M

    2011-08-01

    Full Text Available Abstract Background The purpose of this study was to conduct a scoping review of the literature about the establishment and impact of quality and safety team initiatives in acute care. Methods Studies were identified through electronic searches of Medline, Embase, CINAHL, PsycINFO, ABI Inform, Cochrane databases. Grey literature and bibliographies were also searched. Qualitative or quantitative studies that occurred in acute care, describing how quality and safety teams were established or implemented, the impact of teams, or the barriers and/or facilitators of teams were included. Two reviewers independently extracted data on study design, sample, interventions, and outcomes. Quality assessment of full text articles was done independently by two reviewers. Studies were categorized according to dimensions of quality. Results Of 6,674 articles identified, 99 were included in the study. The heterogeneity of studies and results reported precluded quantitative data analyses. Findings revealed limited information about attributes of successful and unsuccessful team initiatives, barriers and facilitators to team initiatives, unique or combined contribution of selected interventions, or how to effectively establish these teams. Conclusions Not unlike systematic reviews of quality improvement collaboratives, this broad review revealed that while teams reported a number of positive results, there are many methodological issues. This study is unique in utilizing traditional quality assessment and more novel methods of quality assessment and reporting of results (SQUIRE to appraise studies. Rigorous design, evaluation, and reporting of quality and safety team initiatives are required.

  9. A theory-driven, longitudinal evaluation of the impact of team training on safety culture in 24 hospitals.

    Science.gov (United States)

    Jones, Katherine J; Skinner, Anne M; High, Robin; Reiter-Palmon, Roni

    2013-05-01

    Effective teamwork facilitates collective learning, which is integral to safety culture. There are no rigorous evaluations of the impact of team training on the four components of safety culture-reporting, just, flexible and learning cultures. We evaluated the impact of a year-long team training programme on safety culture in 24 hospitals using two theoretical frameworks. We used two quasi-experimental designs: a cross-sectional comparison of hospital survey on patient safety culture (HSOPS) results from an intervention group of 24 hospitals to a static group of 13 hospitals and a pre-post comparison of HSOPS results within intervention hospitals. Dependent variables were HSOPS items representing the four components of safety culture; independent variables were derived from items added to the HSOPS that measured the extent of team training, learning and transfer. We used a generalised linear mixed model approach to account for the correlated nature of the data. 59% of 2137 respondents from the intervention group reported receiving team training. Intervention group HSOPS scores were significantly higher than static group scores in three dimensions assessing the flexible and learning components of safety culture. The distribution of the adoption of team behaviours (transfer) varied in the intervention group from 2.8% to 31.0%. Adoption of team behaviours was significantly associated with odds of an individual reacting more positively at reassessment than baseline to nine items reflecting all four components of safety culture. Team training can result in transformational change in safety culture when the work environment supports the transfer of learning to new behaviour.

  10. Development of a quantitative evaluation method for non-technical skills preparedness of operation teams in nuclear power plants to deal with emergency conditions

    International Nuclear Information System (INIS)

    Yim, Ho Bin; Kim, Ar Ryum; Seong, Poong Hyun

    2013-01-01

    Highlights: ► We selected important non-technical skills for emergency conditions in NPPs. ► We proposed an evaluation method for the selected non-technical skills. ► We conducted two sets of training, 9 experiments each, with real plant operators. ► Teams showed consistent non-technical skills preparedness with changing scenarios. ► Non-technical skills preparedness gives plausible explanations why teams fail tasks. -- Abstract: Many statistical results from safety reports tell that human related errors are the dominant influencing factor on the safe operation of power plants. Fortunately, training operators for the technical and non-technical skills can prevent many types of human errors. In this study, four important non-technical skills in safety critical industries – medical, aviation, and nuclear – were selected to describe behaviors of operation teams in emergency conditions of nuclear power plants (NPPs): communication, leadership, situation awareness, and decision-making skills. Also, preparedness of the non-technical skills was defined, and a quantification method of those skills called NoT-SkiP (Non-Technical Skills Preparedness) was developed to represent ‘how well operation teams are prepared to deal with emergency conditions’ in the non-technical skills aspect by analyzing monitoring-control patterns and a verbal protocol. Two case studies were conducted to validate the method. The first case was applied to Loss of Coolant Accident (LOCA) and Steam Generator Tube Rupture (SGTR) training. Independent variables were scenario, training repetition, and members. Relative values of the NoT-SkiP showed a consistent trend with changing scenarios. However, when training was repeated with the same scenario, NoT-SkiP values of some team were changed. It was supposed that leaders of some teams exerted their knowledge acquired from the previous training and gave up thoroughness of using procedures. When members especially who play a dominant role

  11. Development of a quantitative evaluation method for non-technical skills preparedness of operation teams in nuclear power plants to deal with emergency conditions

    Energy Technology Data Exchange (ETDEWEB)

    Yim, Ho Bin; Kim, Ar Ryum [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon 305-701 (Korea, Republic of); Seong, Poong Hyun, E-mail: phseong@kaist.ac.kr [Department of Nuclear and Quantum Engineering, Korea Advanced Institute of Science and Technology, 373-1, Guseong-dong, Yuseong-gu, Daejeon 305-701 (Korea, Republic of)

    2013-02-15

    Highlights: ► We selected important non-technical skills for emergency conditions in NPPs. ► We proposed an evaluation method for the selected non-technical skills. ► We conducted two sets of training, 9 experiments each, with real plant operators. ► Teams showed consistent non-technical skills preparedness with changing scenarios. ► Non-technical skills preparedness gives plausible explanations why teams fail tasks. -- Abstract: Many statistical results from safety reports tell that human related errors are the dominant influencing factor on the safe operation of power plants. Fortunately, training operators for the technical and non-technical skills can prevent many types of human errors. In this study, four important non-technical skills in safety critical industries – medical, aviation, and nuclear – were selected to describe behaviors of operation teams in emergency conditions of nuclear power plants (NPPs): communication, leadership, situation awareness, and decision-making skills. Also, preparedness of the non-technical skills was defined, and a quantification method of those skills called NoT-SkiP (Non-Technical Skills Preparedness) was developed to represent ‘how well operation teams are prepared to deal with emergency conditions’ in the non-technical skills aspect by analyzing monitoring-control patterns and a verbal protocol. Two case studies were conducted to validate the method. The first case was applied to Loss of Coolant Accident (LOCA) and Steam Generator Tube Rupture (SGTR) training. Independent variables were scenario, training repetition, and members. Relative values of the NoT-SkiP showed a consistent trend with changing scenarios. However, when training was repeated with the same scenario, NoT-SkiP values of some team were changed. It was supposed that leaders of some teams exerted their knowledge acquired from the previous training and gave up thoroughness of using procedures. When members especially who play a dominant role

  12. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

    Science.gov (United States)

    2011-11-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety Foundation AGENCY: Agency for... notification of voluntary relinquishment from Emergency Medicine Patient Safety Foundation of its status as a...

  13. Report on the emergency evacuation review team on emergency response plans for the Perry and Davis-Besse nuclear power plants

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    This book is a report by Ohio's Emergency Evacuation Review Team, at the request of Governor Richard Celeste. The Team concludes that the current emergency response plan for Ohio's reactors is inadequate to protect the public and recommends changes in the current emergency plant requirements. The report also includes a summary of the litigation that has occurred since Celeste withdrew his support for the plans, a list of experts consulted, and sources used to prepare the report. An important document, and a study which every state should undertake

  14. 78 FR 79010 - Criteria to Certify Coal Mine Rescue Teams

    Science.gov (United States)

    2013-12-27

    ... coal requires more heat to combust; (3) anthracite dust does not propagate an explosion; and (4) there... to Certify Coal Mine Rescue Teams AGENCY: Mine Safety and Health Administration, Labor. ACTION... updated the coal mine rescue team certification criteria. The Mine Improvement and New Emergency Response...

  15. Neutron detector suitcase for the Nuclear Emergency Search Team

    International Nuclear Information System (INIS)

    Dowdy, E.J.; Henry, C.N.; Hastings, R.D.; France, S.W.

    1978-02-01

    A portable high-efficiency neutron detection system has been constructed for the Nuclear Emergency Search Team. It includes an alarm system based on time interval measurements of the incoming neutron detection pulses. The system is designed for transportation by vehicle in searching for neutron-emitting radioactive materials

  16. Coordinating a Team Response to Behavioral Emergencies in the Emergency Department: A Simulation-Enhanced Interprofessional Curriculum

    Directory of Open Access Journals (Sweden)

    Ambrose H. Wong

    2015-10-01

    Full Text Available Introduction: While treating potentially violent patients in the emergency department (ED, both patients and staff may be subject to unintentional injury. Emergency healthcare providers are at the greatest risk of experiencing physical and verbal assault from patients. Preliminary studies have shown that a teambased approach with targeted staff training has significant positive outcomes in mitigating violence in healthcare settings. Staff attitudes toward patient aggression have also been linked to workplace safety, but current literature suggests that providers experience fear and anxiety while caring for potentially violent patients. The objectives of the study were (1 to develop an interprofessional curriculum focusing on improving teamwork and staff attitudes toward patient violence using simulation-enhanced education for ED staff, and (2 to assess attitudes towards patient aggression both at pre- and post-curriculum implementation stages using a survey-based study design. Methods: Formal roles and responsibilities for each member of the care team, including positioning during restraint placement, were predefined in conjunction with ED leadership. Emergency medicine residents, nurses and hospital police officers were assigned to interprofessional teams. The curriculum started with an introductory lecture discussing de-escalation techniques and restraint placement as well as core tenets of interprofessional collaboration. Next, we conducted two simulation scenarios using standardized participants (SPs and structured debriefing. The study consisted of a survey-based design comparing pre- and post-intervention responses via a paired Student t-test to assess changes in staff attitudes. We used the validated Management of Aggression and Violence Attitude Scale (MAVAS consisting of 30 Likert-scale questions grouped into four themed constructs. Results: One hundred sixty-two ED staff members completed the course with >95% staff participation

  17. Just allocation and team loyalty: a new virtue ethic for emergency medicine

    Science.gov (United States)

    Girod, J; Beckman, A

    2005-01-01

    When traditional virtue ethics is applied to clinical medicine, it often claims as its goal the good of the individual patient, and focuses on the dyadic relationship between one physician and one patient. An alternative model of virtue ethics, more appropriate to the practice of emergency medicine, will be outlined by this paper. This alternative model is based on the assumption that the appropriate goal of the practice of emergency medicine is a team approach to the medical wellbeing of individual patients, constrained by the wellbeing of the patient population served by a particular emergency department. By defining boundaries and using the key virtues of justice and team loyalty, this model fits emergency practice well and gives care givers the conceptual clarity to apply this model to various conflicts both within the department and with those outside the department. PMID:16199595

  18. Leading teams during simulated pediatric emergencies: a pilot study

    Science.gov (United States)

    Coolen, Ester H; Draaisma, Jos M; den Hamer, Sabien; Loeffen, Jan L

    2015-01-01

    Purpose Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often report having little opportunity to perform in the role of team leader during residency. In order to gain more insight into leadership skills and behaviors, we classified leadership styles of pediatric residents during simulated emergencies. Methods We conducted a prospective quantitative study to investigate leadership styles used by pediatric residents during simulated emergencies with clinical deterioration of a child at a pediatric ward. Using videotaped scenarios of 48 simulated critical events among 12 residents, we were able to classify verbal and nonverbal communication into different leadership styles according to the situational leadership theory. Results The coaching style (mean 54.5%, SD 7.8) is the most frequently applied by residents, followed by the directing style (mean 35.6%, SD 4.1). This pattern conforms to the task- and role-related requirements in our scenarios and it also conforms to the concept of situational leadership. We did not find any significant differences in leadership style according to the postgraduate year or scenario content. Conclusion The model used in this pilot study helps us to gain a better understanding of the development of effective leadership behavior and supports the applicability of situational leadership theory in training leadership skills during residency. PMID:25610010

  19. Critical care clinician perceptions of factors leading to Medical Emergency Team review.

    Science.gov (United States)

    Currey, Judy; Allen, Josh; Jones, Daryl

    2018-03-01

    The introduction of rapid response systems has reduced the incidence of in-hospital cardiac arrest; however, many instances of clinical deterioration are unrecognised. Afferent limb failure is common and may be associated with unplanned intensive care admissions, heightened mortality and prolonged length of stay. Patients reviewed by a Medical Emergency Team are inherently vulnerable with a high in-hospital mortality. To explore perceptions of intensive care unit (ICU) staff who attend deteriorating acute care ward patients regarding current problems, barriers and potential solutions to recognising and responding to clinical deterioration that culminates in a Medical Emergency Team review. A descriptive exploratory design was used. Registered intensive care nurses and medical staff (N=207) were recruited during a professional conference using purposive sampling for experience in attending deteriorating patients. Written response surveys were used to address the study aim. Data were analysed using content analysis. Four major themes were identified: Governance, Teamwork, Clinical Care Delivery and End of Life Care. Participants perceived there was a lack of sufficient and senior staff with the required theoretical knowledge; and inadequate assessment and critical thinking skills for anticipating, recognising and responding to clinical deterioration. Senior doctors were perceived to inappropriately manage End of Life Care issues and displayed Teamwork behaviours rendering ward clinicians feeling fearful and intimidated. A lack of System and Clinical Governance hindered identification of clinical deterioration. To improve patient safety related to recognising and responding to clinical deterioration, suboptimal care due to professionals' knowledge, skills and behaviours need addressing, along with End of Life Care and Governance. Copyright © 2017 Australian College of Critical Care Nurses Ltd. All rights reserved.

  20. Transformational leadership as a moderator of the relationship between psychological safety and learning behaviour in work teams in Ghana

    Directory of Open Access Journals (Sweden)

    Stephen K. Kumako

    2013-07-01

    Research purpose: The study was aimed at investigating the relationship between psychological safety and learning behaviour in teams, as well as the moderating role of transformational team leadership in this relationship. Motivation for the study: For a team to be effective, adaptive and innovative and engage in learning behaviours, the transformational team leader must set the right climate in the team, where he or she welcomes the team members’ opinions, questions and feedback at no risk to their image. An understanding of this will be important in team leader selection and training. Research design, approach and method: Using a cross-sectional survey design, 57 work teams comprising 456 respondents in teams of 7–9 members were purposively sampled from five financial institutions in Accra, Ghana. Hierarchical regression and moderation analyses were run on the data at the team level. Main findings: Results indicated a positive relationship between team psychological safety and team learning behaviour, with transformational team leadership moderating this relationship. Practical/managerial implication: Transformational team leadership is important in creating a climate of psychological safety that will enable team members to engage in learning behaviours. Contribution/value-add: The study provided theoretical and empirical evidence that, in organisational contexts, transformational team leadership is an important variable that can facilitate psychological safety and learning behaviour in teams.

  1. Team Emergency Assessment Measure (TEAM) for the assessment of non-technical skills during resuscitation: Validation of the French version.

    Science.gov (United States)

    Maignan, Maxime; Koch, François-Xavier; Chaix, Jordane; Phellouzat, Pierre; Binauld, Gery; Collomb Muret, Roselyne; Cooper, Simon J; Labarère, José; Danel, Vincent; Viglino, Damien; Debaty, Guillaume

    2016-04-01

    Evaluation of team performances during medical simulation must rely on validated and reproducible tools. Our aim was to build and validate a French version of the Team Emergency Assessment Measure (TEAM) score, which was developed for the assessment of team performance and non-technical skills during resuscitation. A forward and backward translation of the initial TEAM score was made, with the agreement and the final validation by the original author. Ten medical teams were recruited and performed a standardized cardiac arrest simulation scenario. Teams were videotaped and nine raters evaluate non-technical skills for each team thanks to the French TEAM Score. Psychometric properties of the score were then evaluated. French TEAM score showed an excellent reliability with a Cronbach coefficient of 0.95. Mean correlation coefficient between each item and the global score range was 0.78. The inter-rater reliability measured by intraclass correlation coefficient of the global score was 0.93. Finally, expert teams had higher French TEAM score than intermediate and novice teams. The French TEAM score shows good psychometric properties to evaluate team performance during cardiac arrest simulation. Its utilization could help in the assessment of non-technical skills during simulation. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. How can leaders foster team learning? Effects of leader-assigned mastery and performance goals and psychological safety.

    Science.gov (United States)

    Ashauer, Shirley A; Macan, Therese

    2013-01-01

    Learning and adapting to change are imperative as teams today face unprecedented change. Yet, an important part of learning involves challenging assumptions and addressing differences of opinion openly within a group--the kind of behaviors that pose the potential for embarrassment or threat. How can leaders foster an environment in which team members feel it is safe to take interpersonal risks in order to learn? In a study of 71 teams, we found that psychological safety and learning behavior were higher for teams with mastery than performance goal instructions or no goal instructions. Team psychological safety mediated the relationship between mastery and performance goal instructions and learning behavior. Findings contribute to our understanding of how leader-assigned goals are related to psychological safety and learning behavior in a team context, and suggest approaches to foster such processes.

  3. Reducing health care hazards: lessons from the commercial aviation safety team.

    Science.gov (United States)

    Pronovost, Peter J; Goeschel, Christine A; Olsen, Kyle L; Pham, Julius C; Miller, Marlene R; Berenholtz, Sean M; Sexton, J Bryan; Marsteller, Jill A; Morlock, Laura L; Wu, Albert W; Loeb, Jerod M; Clancy, Carolyn M

    2009-01-01

    The movement to improve quality of care and patient safety has grown, but examples of measurable and sustained progress are rare. The slow progress made in health care contrasts with the success of aviation safety. After a tragic 1995 plane crash, the aviation industry and government created the Commercial Aviation Safety Team to reduce fatal accidents. This public-private partnership of safety officials and technical experts is responsible for the decreased average rate of fatal aviation accidents. We propose a similar partnership in the health care community to coordinate national efforts and move patient safety and quality forward.

  4. Utility and assessment of non-technical skills for rapid response systems and medical emergency teams.

    Science.gov (United States)

    Chalwin, R P; Flabouris, A

    2013-09-01

    Efforts are ongoing to improve outcomes from cardiac arrest and medical emergencies. A promising quality improvement modality is use of non-technical skills (NTS) that aim to address human factors through improvements in performance of leadership, communication, situational awareness and decision-making. Originating in the airline industry, NTS training has been successfully introduced into anaesthesia, surgery, emergency medicine and other acute medical specialities. Some aspects of NTS have already achieved acceptance for cardiac arrest teams. Leadership skills are emphasised in advanced life support training and have shown favourable results when employed in simulated and clinical resuscitation scenarios. The application of NTS in medical emergency teams as part of a rapid response system attending medical emergencies is less certain; however, observations of simulations have also shown promise. This review highlights the potential benefits of NTS competency for cardiac arrest teams and, more importantly, medical emergency teams because of the diversity of clinical scenarios encountered. Discussion covers methods to assess and refine NTS and NTS training to optimise performance in the clinical environment. Increasing attention should be applied to yielding meaningful patient and organisational outcomes from use of NTS. Similarly, implementation of any training course should receive appropriate scrutiny to refine team and institutional performance. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  5. [Nurses and social care workers in emergency teams in Norway].

    Science.gov (United States)

    Hilpüsch, Frank; Parschat, Petra; Fenes, Sissel; Aaraas, Ivar J; Gilbert, Mads

    2011-01-07

    The Norwegian counties Troms and Finnmark are dominated by large areas with widespread habitation and rather long response times for ambulances and doctors. We wished to investigate the extent to which the municipal preparedness in these counties use employees from the municipal nursing and social care services and if these are part of local emergency teams. In the autumn of 2008, we sent a questionnaire to the district medical officers and the leaders for municipal nursing and social care services in all 44 municipalities in Troms and Finnmark. The answers were analyzed manually. 41 municipalities responded. In 34 of these the municipal nurses and social care workers practice emergency medicine procedures. The content in these training sessions is much more comprehensive than that in a typical first aid course. In three of four municipalities ambulance personnel do not participate in this training. In 31 municipalities the inhabitants contact nurses and social care workers directly if they are acutely ill. In only 10 of the municipalities the nurses and social care workers are organized in local teams including a doctor and an ambulance. In the districts, nursing and social care services are a resource in an emergency medicine context. The potential within these professions can be exploited better and be an important supplement in emergencies. In emergencies, cooperation across disciplines requires a clear organizational and economical structure, local basis and leadership.

  6. A mixed methods observational simulation-based study of interprofessional team communication

    DEFF Research Database (Denmark)

    Paltved, Charlotte; Nielsen, Kurt; Musaeus, Peter

    2013-01-01

    Interprofessional team communication has been identified as an important focus for safety in medical emergency care. However, in-depth insight into the complexity of team communication is limited. Video observational studies might fill a gap in terms of understanding the meaning of specific commu...

  7. The evolving story of medical emergency teams in quality improvement.

    Science.gov (United States)

    Amaral, André Carlos Kajdacsy-Balla; Shojania, Kaveh G

    2009-01-01

    Adverse events affect approximately 3% to 12% of hospitalized patients. At least a third, but as many as half, of such events are considered preventable. Detection of these events requires investments of time and money. A report in a recent issue of Critical Care used the medical emergency team activation as a trigger to perform a prospective standardized evaluation of charts. The authors observed that roughly one fourth of calls were related to a preventable adverse event, which is comparable to the previous literature. However, while previous studies relied on retrospective chart reviews, this study introduced the novel element of real-time characterization of events by the team at the moment of consultation. This methodology captures important opportunities for improvements in local care at a rate far higher than routine incident-reporting systems, but without requiring substantial investments of additional resources. Academic centers are increasingly recognizing engagement in quality improvement as a distinct career pathway. Involving such physicians in medical emergency teams will likely facilitate the dual roles of these as a clinical outreach arm of the intensive care unit and in identifying problems in care and leading to strategies to reduce them.

  8. Ensuring the safety of surgical teams when managing casualties of a radiological dirty bomb.

    Science.gov (United States)

    Williams, Geraint; O'Malley, Michael; Nocera, Antony

    2010-09-01

    The capacity for surgical teams to ensure their own safety when dealing with the consequences caused by the detonation of a radiological dirty bomb is primarily determined by prior knowledge, familiarity and training for this type of event. This review article defines the associated radiological terminology with an emphasis on the personal safety of surgical team members in respect to the principles of radiological protection. The article also describes a technique for use of hand held radiation monitors and will discuss the identification and management of radiologically contaminated patients who may pose a significant danger to the surgical team. 2010 Elsevier Ltd. All rights reserved.

  9. UAVs Use for the Support of Emergency Response Teams Specific Missions

    Directory of Open Access Journals (Sweden)

    Sorin-Gabriel CONSTANTINESCU

    2013-03-01

    Full Text Available This article presents various methods of implementation for a new technology concerning the assessment and coordination of emergency situations, which is based upon the usage of Unmanned Aerial Vehicles (UAVs. The UAV platform is equipped with optical electronic sensors and other types of sensors, being an aerial surveillance device as efficient as any other classically piloted platform. While currently being in service as military operations support for various operation theaters, they can also be used for assisting emergency response teams, providing full national coverage. For these special response teams, the ability to carry out overview, surveillance or information gathering activities and locating fixed or mobile targets are key components for the successful accomplishment of their missions, which have the purpose of saving lives and properties and of limiting the damage done to the surrounding environment. More concretely, the presented scenarios are: response in emergency situations, extinguishing of large-scale fires, testing of chemically, biologically or radioactively polluted areas and assessment of natural disasters.

  10. Composition of emergency medical services teams and the problem of specialisation of emergency medical services physicians in the opinions of occupationally active paramedics

    Directory of Open Access Journals (Sweden)

    Dorota Rębak

    2015-01-01

    Full Text Available Introduction: Emergency medicine includes prevention, prehospital care, specialised treatment, rehabilitation, and education. Aim of the research: The objective of the analysis was to determine the opinions of paramedics concerning the problem of the composition of emergency medical services (EMS teams and specialisation of EMS system physicians according to their education level and sense of coherence. Material and methods: The study was conducted among 336 occupationally active paramedics working in EMS teams delivering prehospital care in selected units in Poland. The study was conducted at Ambulance Stations and in Hospital Emergency Departments, which within their structure had an out-of-hospital EMS team. The study was conducted by the method of a diagnostic survey, and the research instrument was the Orientation to Life Questionnaire SOC-29 and a questionnaire designed by the author. Results: The respondents who had licentiate education relatively more frequently indicated paramedics with licentiate education level as persons most suitable to undertake medical actions (26.32% rather than physicians (21.05%. Paramedics with 2-year post-secondary school education relatively more often mentioned physicians (33.07% than those with licentiate education (17.32%. As many as 89.58% of the paramedics reported the need for a physician in the composition of the EMS team delivering prehospital care, while only 10.42% of them expressed an opinion that there should be teams composed of paramedics only. According to 30.65% of respondents, EMS team delivering prehospital care should include a physician with the specialty in emergency medicine, whereas 8.04% of respondents reported the need for a physician, irrespective of specialisation. However, 42.56% of the paramedics expressed an opinion that a physician is needed only in a specialist team with a specialisation in emergency medicine. The opinions of the paramedics concerning the need for a

  11. Radiological Emergency Response Health and Safety Manual

    Energy Technology Data Exchange (ETDEWEB)

    D. R. Bowman

    2001-05-01

    This manual was created to provide health and safety (H&S) guidance for emergency response operations. The manual is organized in sections that define each aspect of H and S Management for emergency responses. The sections are as follows: Responsibilities; Health Physics; Industrial Hygiene; Safety; Environmental Compliance; Medical; and Record Maintenance. Each section gives guidance on the types of training expected for managers and responders, safety processes and procedures to be followed when performing work, and what is expected of managers and participants. Also included are generic forms that will be used to facilitate or document activities during an emergency response. These ensure consistency in creating useful real-time and archival records and help to prevent the loss or omission of information.

  12. Information delivery in team communication of MCR operators for an emergency task

    Energy Technology Data Exchange (ETDEWEB)

    Jeong, Kwang Sub; Park, Jin Kyun; Jung, Won Dae

    2005-01-01

    Team performance is a major measure to evaluate the ability of team when a lot of people perform a task of common purpose such as the main control room operators in the nuclear power plant. A team performance is affected the collaboration and communication among operators under dynamic situation as well as by the cognitive process of each team member. Specially, under the emergency situation, more clear and apparent communication in a team is a critical key for the appropriate response to emergency situation. As a general human factor analysis accesses the operator's behavior, it leads to a resulting action of planning, decision, problem-solving. In order to access the internal information and background information of his/her behavior, the verbal protocol analysis is applied. The impact factors on the team performance are derived from the state of the art for team performance, and it is found that the communication is a common key for all impact factors. And, in turn, the impact factors for the communication are accesses and the more detailed analysis is performed. The recorded data for the operator training for emergency situation of nuclear power plant training center are analyzed according to the verbal protocol analysis that are being generally utilized in cognitive psychology, educational psychology, and cognitive science. Two aspects, external (syntax) and internal (symantic) aspects of communication are reviewed. From the syntax analysis, it is found that the task of each step in EOP is separated according to each corresponding operator and the ordinary training is important, and the weak-points for a sentence presentation can be found team-by-team. And, from the symantic analysis for the diagnostic procedure of EOP is performed and the communication errors due to different situation awareness by operators could be found, and it lead to a diagnosis failure. The factors for different symantic cognition for a situation are analyzed and the affecting

  13. IAEA Fact-Finding Team Completes Visit to Japan

    International Nuclear Information System (INIS)

    2011-01-01

    Full text: A team of international nuclear safety experts today completed a preliminary assessment of the safety issues linked with TEPCO's Fukushima Daiichi Nuclear Power Station accident following the Great East Japan Earthquake and Tsunami. The team - created by an agreement of the International Atomic Energy Agency (IAEA) and the Government of Japan - sought to identify lessons learned from the accident that can help improve nuclear safety around the world. To conduct its work, the team held extensive discussions with officials from the full range of Japanese nuclear-related agencies and visited three nuclear sites, including the nuclear power plant at TEPCO's Fukushima Daiichi. These visits gave the team a first-hand appreciation of the scale of devastation wreaked by the earthquake and tsunami on 11 March and of the extraordinary efforts Japanese workers have been applying ever since to stabilize the situation. ''Our entire team was humbled by the enormous damage inflicted by the tsunami on Japan. We are also profoundly impressed by the dedication of Japanese workers working to resolve this unprecedented nuclear accident,'' said team leader Mike Weightman, the United Kingdom's Chief Inspector of Nuclear Installations. The team was comprised of international experts with experience across a range of nuclear specialties. They came from 12 countries: Argentina, China, France, Hungary, India, Indonesia, Russia, South Korea, Spain, Turkey, United Kingdom and the United States. In a draft report summary delivered to Japanese authorities today, the team prepared a set of preliminary conclusions and identified lessons learned in three broad areas: external hazards, severe accident management and emergency preparedness. The final report will be delivered to the Ministerial Conference on Nuclear Safety at IAEA headquarters in Vienna from 20 to 24 June. The expert team made several preliminary findings and lessons learned, including: Japan's response to the nuclear

  14. Thick as Thieves: The Effects of Ethical Orientation and Psychological Safety on Unethical Team Behavior

    Science.gov (United States)

    Pearsall, Matthew J.; Ellis, Aleksander P. J.

    2011-01-01

    The purpose of this study was to uncover compositional and emergent influences on unethical behavior by teams. Results from 126 teams indicated that the presence of a formalistic orientation within the team was negatively related to collective unethical decisions. Conversely, the presence of a utilitarian orientation within the team was positively…

  15. The safety of available and emerging options for emergency contraception.

    Science.gov (United States)

    Lee, Jessica K; Schwarz, Eleanor Bimla

    2017-10-01

    Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expertopinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown. The copper IUD has the highest efficacy of EC methods. Given the excellent safety profiles of mifepristone and the levonorgestrel IUD, research is ongoing related to use of these products for EC.

  16. Resilience and Brittleness in a Nuclear Emergency Response Simulation: Focusing on Team Coordination Activity

    International Nuclear Information System (INIS)

    Costa, Wagner Schenkel; Buarque, Lia; Voshell, Martin; Branlat, Matthieu; Woods, David D.; Gomes, Jose Orlando

    2008-01-01

    The current work presents results from a cognitive task analysis (CTA) of a nuclear disaster simulation. Audio-visual records were collected from an emergency room team composed of individuals from 26 different agencies as they responded to multiple scenarios in a simulated nuclear disaster. This simulation was part of a national emergency response training activity for a nuclear power plant located in a developing country. The objectives of this paper are to describe sources of resilience and brittleness in these activities, identify cues of potential improvements for future emergency simulations, and leveraging the resilience of the emergency response System in case of a real disaster. Multiple CTA techniques were used to gain a better understanding of the cognitive dimensions of the activity and to identify team coordination and crisis management patterns that emerged from the simulation training. (authors)

  17. [An emergency team working closely with the patient].

    Science.gov (United States)

    Selma, Toufik; Chermak, Mustapha; Limani, Mohammed; Rochard, Jacques; Wendlandt, Jérôme; Hernandez, Angélique

    2015-01-01

    ERIC 77 is a rapid response team for emergency psychiatric situations. This cross-sector service based at Marne-la-Vallée general hospital represents a supplementary network in psychiatric patient care. The analysis of the professionals receiving calls as well as the link with the sector are critical in determining the success of patient care. Each risk is measured in order to provide adapted and personalised care. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. International Expert Team Concludes IAEA Peer Review of Poland's Regulatory Framework for Nuclear and Radiation Safety

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: International safety experts last week concluded a two-week International Atomic Energy Agency (IAEA) mission to review the regulatory framework for nuclear and radiation safety in Poland. In its preliminary report, the Integrated Regulatory Review Service (IRRS) mission team found that Poland's nuclear regulator, Panstwowa Agencja Atomistyki (PAA), has a clear commitment to safety, a high level of transparency, competent staff and leadership, and a good recognition of challenges ahead related to Poland's efforts to develop nuclear power. ''Poland's regulatory framework and the work of PAA give high confidence of strong radiation protection for the Polish people. Further, there has been significant progress in the development of Poland's regulatory framework in preparation for the challenge of regulating nuclear power,'' said team leader Robert Lewis, a senior executive in the US Nuclear Regulatory Commission. The mission was conducted at the request of the Government of Poland from 15-25 April. The team was made up of 11 regulatory experts from Belgium, the Czech Republic, Finland, France, the Republic of Korea, Slovakia, Slovenia, Sweden, the United Arab Emirates, the United Kingdom and the United States, as well as five IAEA staff members. The IRRS review team was very thorough in its review, and we welcome its advice on how to continue to improve our programmes to protect people and the environment , said Janusz Wlodarski, President of PAA. The team interviewed members of PAA and officials from various ministries, as well as key players in the Polish safety framework. Such IRRS missions are peer reviews based on IAEA Safety Standards, not inspections or audits. Among its main observations the IRRS review team identified the following good practices: Applying the considerable experience of PAA's senior management to regulatory issues; The introduction of changes to Poland's laws and regulations following broad public consultation at an early stage in

  19. Tiger Team Assessment of the Savannah River Site

    International Nuclear Information System (INIS)

    1990-06-01

    This draft document contains findings identified during the Tiger Team Compliance Assessment of the US Department of Energy Savannah River Site (SRS), located in three counties (Aiken, Barnwell and Allendale), South Carolina. The Assessment was directed by the Department's Office of the Assistant Secretary for Environment, Safety, and Health (ES ampersand H) and was conducted from January 29 to March 23, 1990. The Savannah River Site Tiger Team Compliance Assessment was broad in scope covering the Environment, Safety and Health, and Management areas and was designed to determine the site's compliance with applicable Federal (including DOE), state, and local regulations and requirements. The scope of the Environmental assessment was sitewide while the Safety and Health assessments included site operating facilities (except reactors), and the sitewide elements of Aviation Safety, Emergency Preparedness, Medical Services, and Packaging and Transportation

  20. Trauma team leaders' non-verbal communication: video registration during trauma team training.

    Science.gov (United States)

    Härgestam, Maria; Hultin, Magnus; Brulin, Christine; Jacobsson, Maritha

    2016-03-25

    There is widespread consensus on the importance of safe and secure communication in healthcare, especially in trauma care where time is a limiting factor. Although non-verbal communication has an impact on communication between individuals, there is only limited knowledge of how trauma team leaders communicate. The purpose of this study was to investigate how trauma team members are positioned in the emergency room, and how leaders communicate in terms of gaze direction, vocal nuances, and gestures during trauma team training. Eighteen trauma teams were audio and video recorded during trauma team training in the emergency department of a hospital in northern Sweden. Quantitative content analysis was used to categorize the team members' positions and the leaders' non-verbal communication: gaze direction, vocal nuances, and gestures. The quantitative data were interpreted in relation to the specific context. Time sequences of the leaders' gaze direction, speech time, and gestures were identified separately and registered as time (seconds) and proportions (%) of the total training time. The team leaders who gained control over the most important area in the emergency room, the "inner circle", positioned themselves as heads over the team, using gaze direction, gestures, vocal nuances, and verbal commands that solidified their verbal message. Changes in position required both attention and collaboration. Leaders who spoke in a hesitant voice, or were silent, expressed ambiguity in their non-verbal communication: and other team members took over the leader's tasks. In teams where the leader had control over the inner circle, the members seemed to have an awareness of each other's roles and tasks, knowing when in time and where in space these tasks needed to be executed. Deviations in the leaders' communication increased the ambiguity in the communication, which had consequences for the teamwork. Communication cannot be taken for granted; it needs to be practiced

  1. Teammate Familiarity, Teamwork, and Risk of Workplace Injury in Emergency Medical Services Teams.

    Science.gov (United States)

    Hughes, Ashley M; Patterson, P Daniel; Weaver, Matthew D; Gregory, Megan E; Sonesh, Shirley C; Landsittel, Douglas P; Krackhardt, David; Hostler, David; Lazzara, Elizabeth H; Wang, Xiao; Vena, John E; Salas, Eduardo; Yealy, Donald M

    2017-07-01

    Increased teammate familiarity in emergency medical services (EMS) promotes development of positive teamwork and protects against workplace injury. Measures were collected using archival shift records, workplace injury data, and cross-sectional surveys from a nationally representative sample of 14 EMS agencies employing paramedics, prehospital nurses, and other EMS clinicians. One thousand EMS clinicians were selected at random to complete a teamwork survey for each of their recent partnerships and tested the hypothesized role of teamwork as a mediator in the relationship between teammate familiarity and injury with the PROCESS macro. We received 2566 completed surveys from 333 clinicians, of which 297 were retained. Mean participation was 40.5% (standard deviation [SD] = 20.5%) across EMS agencies. Survey respondents were primarily white (93.8%), male (67.3%), and ranged between 21-62 years of age (M = 37.4, SD = 9.7). Seventeen percent were prehospital nurses. Respondents worked a mean of 3 shifts with recent teammates in the 8 weeks preceding the survey (M = 3.06, SD = 4.4). We examined data at the team level, which suggest positive views of teamwork (M = 5.92, SD = 0.69). Our hypothesis that increased teammate familiarity protects against adverse safety outcomes through development of positive teamwork was not supported. Teamwork factor Partner Adaptability and Backup Behavior is a likely mediator (odds ratio = 1.03, P = .05). When dyad familiarity is high and there are high levels of backup behavior, the likelihood of injury is increased. The relationship between teammate familiarity and outcomes is complex. Teammate adaptation and backup behavior is a likely mediator of this relationship in EMS teams with greater familiarity. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  2. Barsebaeck power plant - safety and emergency measures

    International Nuclear Information System (INIS)

    Anon.

    1981-01-01

    A Swedish-Danish Committee on safety at the Swedish nuclear power plant Barsebaeck was established in 1979 in order to evaluate the nuclear safety at Barsebaeck with a view to the reactor accident at the Three-Mile-Island nuclear power plant March 28, 1979. According to the committees mandate the investigations of the Kemeny Commission, the Rogouin investigation, investigations of the American Nuclear Regulatory Commission, and the Swedish report ''Safe nuclear power'' have been taken into consideration by the Committee. Furthermore, it has formed the basis for the Committees work that the authority responsibility for the safety at Barsebaeck lies with the Swedish authorities, and that these authorities have evaluated the safety aspects before the permissions for operation of the Barsebaeck power plant were given and hereafter currently in connection with the inspection of the power plant. The report prepared by the Commission treats aspects as: a) Nuclear safety at the Barsebaeck power plant, b) reactor safety and emergency provisions, c) common elements in the emergency provision situation in Sweden and Denmark, d) ongoing investigations on course of events during accidents and release limiting safety systems. (BP)

  3. Operative team communication during simulated emergencies: Too busy to respond?

    Science.gov (United States)

    Davis, W Austin; Jones, Seth; Crowell-Kuhnberg, Adrianna M; O'Keeffe, Dara; Boyle, Kelly M; Klainer, Suzanne B; Smink, Douglas S; Yule, Steven

    2017-05-01

    Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status. We used the closed loop communication framework to code retrospectively the communication behavior of 7 operative teams (each comprising 2 surgeons, anesthesiologists, and nurses) during response to a simulated, postanesthesia care unit "code blue." We identified call outs, check backs, and closed loop episodes and applied descriptive statistics and a mixed-effects negative binomial regression to describe characteristics of communication in individuals and in different specialties. We coded a total of 662 call outs. The frequency and type of initiation and receipt of communication events varied between clinical specialties (P communication events than anesthesiologists. For the average participant, directed communication increased the likelihood of check back by at least 50% (P = .021) in periods preceding acute changes in the clinical setting, and exerted no significant effect in periods after acute changes in the clinical situation. Communication patterns vary by specialty during a simulated operative emergency, and the effect of directed communication in eliciting a response depends on the clinical status of the patient. Operative training programs should emphasize the importance of quality communication in the period immediately after an acute change in the clinical setting of a patient and recognize that communication patterns and needs vary between members of multidisciplinary operative teams. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Moving Toward Improved Teamwork in Cancer Care: The Role of Psychological Safety in Team Communication.

    Science.gov (United States)

    Jain, Anshu K; Fennell, Mary L; Chagpar, Anees B; Connolly, Hannah K; Nembhard, Ingrid M

    2016-11-01

    Effective communication is a requirement in the teamwork necessary for improved coordination to deliver patient-centered, value-based cancer care. Communication is particularly important when care providers are geographically distributed or work across organizations. We review organizational and teams research on communication to highlight psychological safety as a key determinant of high-quality communication within teams. We first present the concept of psychological safety, findings about its communication effects for teamwork, and factors that affect it. We focus on five factors applicable to cancer care delivery: familiarity, clinical hierarchy-related status differences, geographic dispersion, boundary spanning, and leader behavior. To illustrate how these factors facilitate or hinder psychologically safe communication and teamwork in cancer care, we review the case of a patient as she experiences the treatment-planning process for early-stage breast cancer in a community setting. Our analysis is summarized in a key principle: Teamwork in cancer care requires high-quality communication, which depends on psychological safety for all team members, clinicians and patients alike. We conclude with a discussion of the implications of psychological safety in clinical care and suggestions for future research.

  5. Safety measurement and monitoring in healthcare: a framework to guide clinical teams and healthcare organisations in maintaining safety

    Science.gov (United States)

    Vincent, Charles; Burnett, Susan; Carthey, Jane

    2014-01-01

    Patients, clinicians and managers all want to be reassured that their healthcare organisation is safe. But there is no consensus about what we mean when we ask whether a healthcare organisation is safe or how this is achieved. In the UK, the measurement of harm, so important in the evolution of patient safety, has been neglected in favour of incident reporting. The use of softer intelligence for monitoring and anticipation of problems receives little mention in official policy. The Francis Inquiry report into patient treatment at the Mid Staffordshire NHS Foundation Trust set out 29 recommendations on measurement, more than on any other topic, and set the measurement of safety an absolute priority for healthcare organisations. The Berwick review found that most healthcare organisations at present have very little capacity to analyse, monitor or learn from safety and quality information. This paper summarises the findings of a more extensive report and proposes a framework which can guide clinical teams and healthcare organisations in the measurement and monitoring of safety and in reviewing progress against safety objectives. The framework has been used so far to promote self-reflection at both board and clinical team level, to stimulate an organisational check or analysis in the gaps of information and to promote discussion of ‘what could we do differently’. PMID:24764136

  6. Recent Experiences of the NASA Engineering and Safety Center (NESC) GN and C Technical Discipline Team (TDT)

    Science.gov (United States)

    Dennehy, Cornelius J.

    2010-01-01

    The NASA Engineering and Safety Center (NESC), initially formed in 2003, is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. The GN&C Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA projects. This paper will then describe selected recent experiences, over the period 2007 to present, of the GN&C TDT in which they directly performed or supported a wide variety of NESC assessments and consultations.

  7. Asymptotic safety, emergence and minimal length

    International Nuclear Information System (INIS)

    Percacci, Roberto; Vacca, Gian Paolo

    2010-01-01

    There seems to be a common prejudice that asymptotic safety is either incompatible with, or at best unrelated to, the other topics in the title. This is not the case. In fact, we show that (1) the existence of a fixed point with suitable properties is a promising way of deriving emergent properties of gravity, and (2) there is a sense in which asymptotic safety implies a minimal length. In doing so we also discuss possible signatures of asymptotic safety in scattering experiments.

  8. Are there any differences in medical emergency team interventions between rural and urban areas? A single-centre cohort study.

    Science.gov (United States)

    Aftyka, Anna; Rybojad, Beata; Rudnicka-Drozak, Ewa

    2014-10-01

    To compare interventions of medical emergency teams in urban and rural areas with particular emphasis on response time and on-site medical rescue activities. A retrospective analysis of ambulance call reports from two emergency medical service substations: one in the city and the other in a rural area. Two emergency medical service substations: one in the city and the other in a rural area. Medical emergency teams. Interventions in the city were associated with a substantially shorter response time in comparison to rural areas. In the city, the distances were generally less than 10 km. In the rural area, however, such short distances accounted for only 7.2% of events, while 33.8% were over 30 km. Medical emergency teams more often acted exclusively on-site or ceased any interventions in rural areas. Compared with the city, actions in the rural setting were associated with significantly increased use of cervical collars and decreased use of intravenous access. The presence of a physician in the team raised the probability of pharmacotherapy. The relationship between medical emergency teams activities and the location of intervention shows the real diversity of the functioning of emergency medical service within a city and rural areas. Further research should aim to improve the generalisability of these findings. © 2014 National Rural Health Alliance Inc.

  9. Team behaviors in emergency care: a qualitative study using behavior analysis of what makes team work.

    Science.gov (United States)

    Mazzocato, Pamela; Forsberg, Helena Hvitfeldt; Schwarz, Ulrica von Thiele

    2011-11-15

    Teamwork has been suggested as a promising approach to improving care processes in emergency departments (ED). However, for teamwork to yield expected results, implementation must involve behavior changes. The aim of this study is to use behavior analysis to qualitatively examine how teamwork plays out in practice and to understand eventual discrepancies between planned and actual behaviors. The study was set in a Swedish university hospital ED during the initial phase of implementation of teamwork. The intervention focused on changing the environment and redesigning the work process to enable teamwork. Each team was responsible for entire care episodes, i.e. from patient arrival to discharge from the ED. Data was collected through 3 days of observations structured around an observation scheme. Behavior analysis was used to pinpoint key teamwork behaviors for consistent implementation of teamwork and to analyze the contingencies that decreased or increased the likelihood of these behaviors. We found a great discrepancy between the planned and the observed teamwork processes. 60% of the 44 team patients observed were handled solely by the appointed team members. Only 36% of the observed patient care processes started according to the description in the planned teamwork process, that is, with taking patient history together. Beside this behavior, meeting in a defined team room and communicating with team members were shown to be essential for the consistent implementation of teamwork. Factors that decreased the likelihood of these key behaviors included waiting for other team members or having trouble locating each other. Getting work done without delay and having an overview of the patient care process increased team behaviors. Moreover, explicit instructions on when team members should interact and communicate increased adherence to the planned process. This study illustrates how behavior analysis can be used to understand discrepancies between planned and observed

  10. OSART Guidelines. 2015 Edition. Reference Report for IAEA Operational Safety Review Teams (OSARTs)

    International Nuclear Information System (INIS)

    2016-01-01

    The IAEA works to provide a global nuclear safety and security framework for the protection of people and the environment from the effects of ionizing radiation, the minimization of the likelihood of accidents that could endanger life and property, and effective mitigation of the effects of any such events, should they occur. The strategic approach to achieving such a framework involves continual improvement in four areas: national and international safety infrastructures; the establishment and global acceptance of IAEA safety standards; an integrated approach to the provision for the application of the safety standards; and a global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. Conservative design, careful manufacture and sound construction are all prerequisites for the safe operation of nuclear power plants. However, the safety of the plant also depends ultimately on: sound management, policies, procedures, processes and practices; the capability and reliability of commissioning and operating personnel; comprehensive instructions; sound accident management and emergency preparedness; and adequate resources. Finally, a positive attitude and conscientiousness on the part of all staff in discharging their responsibilities is important to safety. The OSART programme is based on the safety standards applicable to nuclear power plants. IAEA safety standards reflect the consensus of Member States on nuclear safety matters. The reports of the International Nuclear Safety Group identify important current nuclear safety issues and also serve as references during an OSART review. The publication OSART Guidelines provides overall guidance on the conduct of OSART

  11. Development of a Novel Nuclear Safety Culture Evaluation Method for an Operating Team Using Probabilistic Safety Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Han, Sangmin; Lee, Seung Min; Seong, Poong Hyun [KAIST, Daejeon (Korea, Republic of)

    2015-05-15

    IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea.

  12. Development of a Novel Nuclear Safety Culture Evaluation Method for an Operating Team Using Probabilistic Safety Analysis

    International Nuclear Information System (INIS)

    Han, Sangmin; Lee, Seung Min; Seong, Poong Hyun

    2015-01-01

    IAEA defined safety culture as follows: 'Safety Culture is that assembly of characteristics and attitudes in organizations and individuals which establishes that, as an overriding priority, nuclear plant safety issues receive the attention warranted by their significance'. Also, celebrated behavioral scientist, Cooper, defined safety culture as,'safety culture is that observable degree of effort by which all organizational members direct their attention and actions toward improving safety on a daily basis' with his internal psychological, situational, and behavioral context model. With these various definitions and criteria of safety culture, several safety culture assessment methods have been developed to improve and manage safety culture. To develop a new quantitative safety culture evaluation method for an operating team, we unified and redefined safety culture assessment items. Then we modeled a new safety culture evaluation by adopting level 1 PSA concept. Finally, we suggested the criteria to obtain nominal success probabilities of assessment items by using 'operational definition'. To validate the suggested evaluation method, we analyzed the collected audio-visual recording data collected from a full scope main control room simulator of a NPP in Korea

  13. Examining the Role of School Resource Officers on School Safety and Crisis Response Teams

    Science.gov (United States)

    Eklund, Katie; Meyer, Lauren; Bosworth, Kris

    2018-01-01

    School resource officers (SROs) are being increasingly employed in schools to respond to incidents of school violence and to help address safety concerns among students and staff. While previous research on school safety and crisis teams has examined the role of school mental health professionals' and administrators, fewer studies have evaluated…

  14. The Role of Interpersonal Relations in Healthcare Team Communication and Patient Safety: A Proposed Model of Interpersonal Process in Teamwork.

    Science.gov (United States)

    Lee, Charlotte Tsz-Sum; Doran, Diane Marie

    2017-06-01

    Patient safety is compromised by medical errors and adverse events related to miscommunications among healthcare providers. Communication among healthcare providers is affected by human factors, such as interpersonal relations. Yet, discussions of interpersonal relations and communication are lacking in healthcare team literature. This paper proposes a theoretical framework that explains how interpersonal relations among healthcare team members affect communication and team performance, such as patient safety. We synthesized studies from health and social science disciplines to construct a theoretical framework that explicates the links among these constructs. From our synthesis, we identified two relevant theories: framework on interpersonal processes based on social relation model and the theory of relational coordination. The former involves three steps: perception, evaluation, and feedback; and the latter captures relational communicative behavior. We propose that manifestations of provider relations are embedded in the third step of the framework on interpersonal processes: feedback. Thus, varying team-member relationships lead to varying collaborative behavior, which affects patient-safety outcomes via a change in team communication. The proposed framework offers new perspectives for understanding how workplace relations affect healthcare team performance. The framework can be used by nurses, administrators, and educators to improve patient safety, team communication, or to resolve conflicts.

  15. Emergency team and action plan; Brigada de emergencia y plan de accion de emergencia

    Energy Technology Data Exchange (ETDEWEB)

    Jimenez Gorgerino, Ruben Dario [Central Hidroelectrica Itaipu, Hernandarias (Paraguay)]. E-mail: jimenez@itaipu.gov.br

    1998-07-01

    This work reports the various activities developed by a commission designated for the investigation of the fire occurred in the excitation panel of the generator unit 16, for the execution of two tasks: short term creation of plant emergency team, and a long term implementation of emergency action plan.

  16. Tiger Team Assessment of the Savannah River Site: Appendices

    International Nuclear Information System (INIS)

    1990-06-01

    This draft document contains findings identified during the Tiger Team Compliance Assessment of the US Department of Energy Savannah River Site (SRS), located in three countries (Aiken, Barnwell and Allendale), South Carolina. The Assessment was directed by the Department's Office of the Assistant Secretary for Environment, Safety, and Health (ES ampersand H) and was conducted from January 29 to March 23, 1990. The Savannah River Site Tiger Team Compliance Assessment was broad in scope covering the Environment, Safety and Health, and Management areas and was designed to determine the site's compliance with applicable Federal (including DOE), state, and local regulations and requirements. The scope of the Environmental assessment was sitewide while the Safety and Health assessments included site operating facilities (except reactors), and the sitewide elements of Aviation Safety, Emergency Preparedness, Medical Services, and Packaging and Transportation. This report contains the appendices to the assessment

  17. Dedication increases productivity: an analysis of the implementation of a dedicated medical team in the emergency department.

    Science.gov (United States)

    Ramos, Pedro; Paiva, José Artur

    2017-12-01

    In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED. Our study assesses the effect of an intervention in a large academic hospital ED in Portugal in 2002, and it is the first to test the hypothesis that implementing a dedicated team of doctors with EM expertise increases the productivity and reduces costs in the ED, maintaining the quality of care provided to patients. A pre-post design was used for comparing the change on the organisational model of delivering care in our medical ED. All emergency medical admissions were tracked in 2002 (classic model with 12-h shift in the ED) and 2005/2006 (dedicated team with full-time EM physicians), and productivity, costs with medical human resources and quality of care measures were compared. We found that medical productivity (number of patients treated per hour of medical work) increased dramatically after the creation of the dedicated team (X 2 KW = 31.135; N = 36; p work reduced both in regular hours and overtime. Moreover, hospitalisation rates decreased and the length of stay in the ED increased significantly after the creation of the dedicated team. Implementing a dedicated team of doctors increased the medical productivity and reduced costs in our ED. Our findings have straightforward implication for Portuguese policymakers aiming at reducing hospital costs while coping with increased ED demand.

  18. An Anesthesia Preinduction Checklist to Improve Information Exchange, Knowledge of Critical Information, Perception of Safety, and Possibly Perception of Teamwork in Anesthesia Teams.

    Science.gov (United States)

    Tscholl, David W; Weiss, Mona; Kolbe, Michaela; Staender, Sven; Seifert, Burkhardt; Landert, Daniel; Grande, Bastian; Spahn, Donat R; Noethiger, Christoph B

    2015-10-01

    An anesthesia preinduction checklist (APIC) to be performed before anesthesia induction was introduced and evaluated with respect to 5 team-level outcomes, each being a surrogate end point for patient safety: information exchange (the percentage of checklist items exchanged by a team, out of 12 total items); knowledge of critical information (the percentage of critical information items out of 5 total items such as allergies, reported as known by the members of a team); team members' perceptions of safety (the median scores given by the members of a team on a continuous rating scale); their perception of teamwork (the median scores given by the members of a team on a continuous rating scale); and clinical performance (the percentage of completed items out of 14 required tasks, e.g., suction device checked). A prospective interventional study comparing anesthesia teams using the APIC with a control group not using the APIC was performed using a multimethod design. Trained observers rated information exchange and clinical performance during on-site observations of anesthesia inductions. After the observations, each team member indicated the critical information items they knew and their perceptions of safety and teamwork. One hundred five teams using the APIC were compared with 100 teams not doing so. The medians of the team-level outcome scores in the APIC group versus the control group were as follows: information exchange: 100% vs 33% (P safety: 91% vs 84% (P improves information exchange, knowledge of critical information, and perception of safety in anesthesia teams-all parameters contributing to patient safety. There was a trend indicating improved perception of teamwork.

  19. Emergency Preparedness and Response: A Safety Net

    Energy Technology Data Exchange (ETDEWEB)

    Aaltonen, H., E-mail: hannele.aaltonen@stuk.fi [Radiation and Nuclear Safety Authority (STUK), Helsinki (Finland)

    2014-10-15

    Full text: The objective of nuclear regulatory work is to prevent accidents. Nevertheless, possibility of a severe accident cannot be totally excluded, which makes a safety net, efficient emergency preparedness and response, necessary. Should the possibility of accidents be rejected, the result would be in the worst case inadequate protection of population, functions of society, and environment from harmful effects of radiation. Adequate resources for maintenance and development of emergency arrangement are crucial. However, they need to be balanced taking into account risks assessments, justified expectations of society, and international requirements. To successfully respond to an emergency, effective emergency preparedness, such as up-to-date plans and procedures, robust arrangements and knowledgeable and regularly trained staff are required. These, however, are not enough without willingness and proactive attitude to • communicate in a timely manner; • co-operate and coordinate actions; • provide and receive assistance; and • evaluate and improve emergency arrangements. In the establishment and development of emergency arrangements, redundant and diverse means or tools used are needed in, for example, communication and assessment of hazard. Any severe nuclear emergency would affect all countries either directly or indirectly. Thus, national emergency arrangements have to be compatible to the extent practicable with international emergency arrangements. It is important to all countries that the safety nets of emergency arrangements are reliable - and operate efficiently in a coordinated manner when needed - on national, regional and international level. (author)

  20. International Expert Team Concludes IAEA Peer Review of Finland's Regulatory Framework for Nuclear and Radiation Safety

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: International safety experts today concluded a two-week International Atomic Energy Agency (IAEA) mission to review the regulatory framework for nuclear and radiation safety in Finland. In its preliminary report, the Integrated Regulatory Review Service (IRRS) mission team found that the Radiation and Nuclear Safety Authority of Finland (STUK) is a competent and highly credible regulator that is open and transparent and derives great strength from the technical competence of its staff. ''Finland's comprehensive regulatory framework allows STUK to operate in practice as an independent regulatory body,'' said team leader Philippe Jamet, a commissioner of the French regulatory body ASN. The mission was conducted at the request of the Government of Finland from 15-26 October. The team interviewed members of STUK and officials from various ministries, as well as key players in the Finnish safety framework. Such IRRS missions are peer reviews based on IAEA Safety Standards, not inspections or audits. The team was made up of 18 members from Bulgaria, Canada, the Czech Republic, France, Germany, Iceland, Ireland, Romania, the Russian Federation, South Africa, Slovakia, Slovenia, Spain, Sweden, the United Arab Emirates, the United Kingdom and the United States, as well as six IAEA staff members. 'The IRRS mission and preparation for it was a unique occasion that involved the whole organization, provided motivation for improvement of the safety framework in Finland and assists STUK review its mission', said Tero Varjoranta, Director General of STUK. The IRRS team identified a number of good practices and achievements, including: - STUK's excellence in its safety assessment of nuclear power plants and waste repositories, in particular its demonstration that long-term political commitment is a necessity to sustain the creation of a waste repository as well as its regulatory oversight of medical applications of radiation sources; and - STUK's excellent record in

  1. Flexible knowledge repertoires: communication by leaders in trauma teams

    Directory of Open Access Journals (Sweden)

    Jacobsson Maritha

    2012-07-01

    Full Text Available Abstract Background In emergency situations, it is important for the trauma team to efficiently communicate their observations and assessments. One common communication strategy is “closed-loop communication”, which can be described as a transmission model in which feedback is of great importance. The role of the leader is to create a shared goal in order to achieve consensus in the work for the safety of the patient. The purpose of this study was to analyze how formal leaders communicate knowledge, create consensus, and position themselves in relation to others in the team. Methods Sixteen trauma teams were audio- and video-recorded during high fidelity training in an emergency department. Each team consisted of six members: one surgeon or emergency physician (the designated team leader, one anaesthesiologist, one nurse anaesthetist, one enrolled nurse from the theatre ward, one registered nurse and one enrolled nurse from the emergency department (ED. The communication was transcribed and analyzed, inspired by discourse psychology and Strauss’ concept of “negotiated order”. The data were organized and coded in NVivo 9. Results The findings suggest that leaders use coercive, educational, discussing and negotiating strategies to work things through. The leaders in this study used different repertoires to convey their knowledge to the team, in order to create a common goal of the priorities of the work. Changes in repertoires were dependent on the urgency of the situation and the interaction between team members. When using these repertoires, the leaders positioned themselves in different ways, either on an authoritarian or a more egalitarian level. Conclusion This study indicates that communication in trauma teams is complex and consists of more than just transferring messages quickly. It also concerns what the leaders express, and even more importantly, how they speak to and involve other team members.

  2. Flexible knowledge repertoires: communication by leaders in trauma teams

    Science.gov (United States)

    2012-01-01

    Background In emergency situations, it is important for the trauma team to efficiently communicate their observations and assessments. One common communication strategy is “closed-loop communication”, which can be described as a transmission model in which feedback is of great importance. The role of the leader is to create a shared goal in order to achieve consensus in the work for the safety of the patient. The purpose of this study was to analyze how formal leaders communicate knowledge, create consensus, and position themselves in relation to others in the team. Methods Sixteen trauma teams were audio- and video-recorded during high fidelity training in an emergency department. Each team consisted of six members: one surgeon or emergency physician (the designated team leader), one anaesthesiologist, one nurse anaesthetist, one enrolled nurse from the theatre ward, one registered nurse and one enrolled nurse from the emergency department (ED). The communication was transcribed and analyzed, inspired by discourse psychology and Strauss’ concept of “negotiated order”. The data were organized and coded in NVivo 9. Results The findings suggest that leaders use coercive, educational, discussing and negotiating strategies to work things through. The leaders in this study used different repertoires to convey their knowledge to the team, in order to create a common goal of the priorities of the work. Changes in repertoires were dependent on the urgency of the situation and the interaction between team members. When using these repertoires, the leaders positioned themselves in different ways, either on an authoritarian or a more egalitarian level. Conclusion This study indicates that communication in trauma teams is complex and consists of more than just transferring messages quickly. It also concerns what the leaders express, and even more importantly, how they speak to and involve other team members. PMID:22747848

  3. Flexible knowledge repertoires: communication by leaders in trauma teams.

    Science.gov (United States)

    Jacobsson, Maritha; Hargestam, Maria; Hultin, Magnus; Brulin, Christine

    2012-07-02

    In emergency situations, it is important for the trauma team to efficiently communicate their observations and assessments. One common communication strategy is "closed-loop communication", which can be described as a transmission model in which feedback is of great importance. The role of the leader is to create a shared goal in order to achieve consensus in the work for the safety of the patient. The purpose of this study was to analyze how formal leaders communicate knowledge, create consensus, and position themselves in relation to others in the team. Sixteen trauma teams were audio- and video-recorded during high fidelity training in an emergency department. Each team consisted of six members: one surgeon or emergency physician (the designated team leader), one anaesthesiologist, one nurse anaesthetist, one enrolled nurse from the theatre ward, one registered nurse and one enrolled nurse from the emergency department (ED). The communication was transcribed and analyzed, inspired by discourse psychology and Strauss' concept of "negotiated order". The data were organized and coded in NVivo 9. The findings suggest that leaders use coercive, educational, discussing and negotiating strategies to work things through. The leaders in this study used different repertoires to convey their knowledge to the team, in order to create a common goal of the priorities of the work. Changes in repertoires were dependent on the urgency of the situation and the interaction between team members. When using these repertoires, the leaders positioned themselves in different ways, either on an authoritarian or a more egalitarian level. This study indicates that communication in trauma teams is complex and consists of more than just transferring messages quickly. It also concerns what the leaders express, and even more importantly, how they speak to and involve other team members.

  4. Uranium Production Safety Assessment Team. UPSAT. An international peer review service for uranium production facilities

    International Nuclear Information System (INIS)

    1996-01-01

    The IAEA Uranium Production Safety Assessment Team (UPSAT) programme is designed to assist Member States to improve the safe operation of uranium production facilities. This programme facilitates the exchange of knowledge and experience between team members and industry personnel. An UPSAT mission is an international expert review, conducted outside of any regulatory framework. The programme is implemented in the spirit of voluntary co-operation to contribute to the enhancement of operational safety and practices where it is most effective, at the facility itself. An UPSAT review supplements other facility and regulatory efforts which may have the same objective

  5. Pre-Tiger Team Self-Assessment report

    International Nuclear Information System (INIS)

    1991-01-01

    The Sandia National Laboratories Pre-Tiger Team Self-Assessment Report contains an introduction that describes the three sites in Albuquerque, New Mexico, Kauai, Hawaii, and Tonopah, Nevada, and the activities associated therewith. The self-assessment was performed October 1990 through December 1990. The paper discusses key findings and root causes associated with problem areas; environmental protection assessment with respect to the Clean Air Act, Clean Water Act, Comprehensive Environmental Response, Compensation, and Liability Act and the Superfund amendments, Resource Conservation and Recovery Act; and other regulatory documents; safety and health assessment with respect to organization administration, quality assurance, maintenance, training, emergency preparedness, nuclear criticality safety, security/safety interface, transportation, radiation protection, occupational safety, and associated regulations; and management practices assessment. 5 figs

  6. Final Report of the NASA Office of Safety and Mission Assurance Agile Benchmarking Team

    Science.gov (United States)

    Wetherholt, Martha

    2016-01-01

    To ensure that the NASA Safety and Mission Assurance (SMA) community remains in a position to perform reliable Software Assurance (SA) on NASAs critical software (SW) systems with the software industry rapidly transitioning from waterfall to Agile processes, Terry Wilcutt, Chief, Safety and Mission Assurance, Office of Safety and Mission Assurance (OSMA) established the Agile Benchmarking Team (ABT). The Team's tasks were: 1. Research background literature on current Agile processes, 2. Perform benchmark activities with other organizations that are involved in software Agile processes to determine best practices, 3. Collect information on Agile-developed systems to enable improvements to the current NASA standards and processes to enhance their ability to perform reliable software assurance on NASA Agile-developed systems, 4. Suggest additional guidance and recommendations for updates to those standards and processes, as needed. The ABT's findings and recommendations for software management, engineering and software assurance are addressed herein.

  7. Employee Knowledge Sharing in Work Teams: Effects of Team Diversity, Emergent States, and Team Leadership

    Science.gov (United States)

    Noh, Jae Hang

    2013-01-01

    Knowledge sharing in work teams is one of the critical team processes. Without sharing of knowledge, work teams and organizations may not be able to fully utilize the diverse knowledge brought into work teams by their members. The purpose of this study was to investigate antecedents and underlying mechanisms influencing the extent to which team…

  8. Safety of emerging nuclear energy systems

    International Nuclear Information System (INIS)

    Novikov, V.M.; Slesarev, I.S.

    1989-01-01

    The first stage of world nuclear power development based on light water fission reactors has demonstrated not only rather high rate but at the same time too optimistic attitude to safety problems. Large accidents at Three Mile Island and Chernobyl essentially affects the concept of NP development. As a result the safety and social acceptance of NP became of absolute priority among other problems. That's why emerging nuclear power systems should be first of all estimated from this point of view. In the paper some quantitative criteria of safety derived from estimations of social risk and economic-ecological damage from hypothetical accidents are formulated. On the base of these criteria we define two stages of possible way to meet safety demands: first--development of high safety fission reactors and second--that of asymptotic high safety ENEs. The limits of tolorated expenses for safety are regarded. The basis physical factors determining hazards of NES accidents are considered. This permits to classify the ways of safety demands fulfillment due to physical principals used

  9. Initial activities of a radiation emergency medical assistance team to Fukushima from Nagasaki

    International Nuclear Information System (INIS)

    Matsuda, Naoki; Yoshida, Kouji; Nakashima, Kanami; Iwatake, Satoshi; Morita, Naoko; Ohba, Takashi; Yusa, Takeshi; Kumagai, Atsushi; Ohtsuru, Akira

    2013-01-01

    As an urgent response to serious radiological accidents in the Fukushima Daiichi nuclear power plant, the radiation emergency medical assistance team (REMAT) from Nagasaki University landed at Fukushima on March 14, 2011, two days after the initiation of radiation crisis by the hydrogen explosion at Unit-1 reactor. During a succession of unexpected disasters, REMAT members were involved in various activities for six days, such as setting the base for radiological triage at the Fukushima Medical University, considerations for administration of stable iodine, and risk communication with health care workers. This report briefly describes what happened around REMAT members and radiation doses measured during their activities. -- Highlights: ► The radiation emergency medical assistance team from Nagasaki was sent to Fukushima. ► The practical action level for body surface contamination was 100 kcpm. ► The ambient radiation dose in Fukushima drastically elevated on March 15, 2011. ► Higher than 10 kBq of I-131, Cs-134, and Cs-137 were detected in soil samples. ► The effective dose of the team members ranged between 51.7 and 127.8 μSv in 6 days

  10. Emergency team calls for critically ill non-trauma patients in the emergency department

    DEFF Research Database (Denmark)

    Jensen, Søren Marker; Do, Hien Quoc; Rasmussen, Søren W.

    2015-01-01

    BACKGROUND: Handling critically ill patients is a complex task for Emergency Department (ED) personnel. Initial treatment is of major importance and requires adequately experienced ED doctors to initiate and decide for the right medical or surgical treatment. Our aim was, with regard to clinical...... the study period. RESULTS: A total of 109 emergency team calls were triggered (79 orange and 30 red), comprising 66 (60.6 %) men and 43 women, with a median age of 64 years. Patients presented with: 4 Airway, 27 Breathing, 41 Circulation, 31 Disability, 2 Exposure and 4 Other problems. Overall, 58/109 (53.......2 %) patients were admitted to the ICU, while 20/109 (18.3 %) patients were deemed ineligible for ICU admission. 30-day mortality was 34/109 (31.2 %), and circulatory problems were the most frequent cause of death (61.8 %, p = 0.02). Patients who died were significantly older than those who survived (p = 0...

  11. SCART guidelines. Reference report for IAEA Safety Culture Assessment Review Team (SCART)

    International Nuclear Information System (INIS)

    2008-01-01

    The IAEA Director General stressed the role of safety culture in his concluding remarks at the Meeting of the Contracting Parties to the Convention on Nuclear Safety in 2002: 'As we have learned in other areas, it is not enough simply to have a structure; it is not enough to say that we have the necessary laws and the appropriate regulatory bodies. All these are important, but equally important is that we have in place a safety culture that gives effect to the structure that we have developed. To me, effectiveness and transparency are keys. So, it is an issue which I am pleased to see, you are giving the attention it deserves and we will continue to work with you in clarifying, developing and applying safety culture through our programmes and through our technical cooperation activities.' The concept of safety culture was initially developed by the International Nuclear Safety Advisory Group (INSAG) after the Chernobyl accident in 1986. Since then the IAEA's perspective of safety culture has expanded with time as its recognition of the complexities of the concept developed. Safety culture is considered to be specific organizational culture in all types of organizations with activities that give rise to radiation risks. The aim is to make safety culture strong and sustainable, so that safety becomes a primary focus for all activities in such organizations, even for those, which might not look safety-related at first. SCART (Safety Culture Assessment Review Team) is a safety review service, which reflects the expressed interest of Members States for methods and tools for safety culture assessment. It is a replacement for the earlier service ASCOT (Assessment of Safety Culture in Organizations Team). The IAEA Safety Fundamentals, Requirements and Guides (Safety Standards) are the basis for the SCART Safety Review Service. The reports of INSAG, identifying important current nuclear safety issues, serve also as references during a SCART mission. SCART missions are based

  12. Tethered Balloon Technology in Design Solutions for Rescue and Relief Team Emergency Communication Services.

    Science.gov (United States)

    Alsamhi, Saeed Hamood; Ansari, Mohd Samar; Ma, Ou; Almalki, Faris; Gupta, Sachin Kumar

    2018-05-23

    The actions taken at the initial times of a disaster are critical. Catastrophe occurs because of terrorist acts or natural hazards which have the potential to disrupt the infrastructure of wireless communication networks. Therefore, essential emergency functions such as search, rescue, and recovery operations during a catastrophic event will be disabled. We propose tethered balloon technology to provide efficient emergency communication services and reduce casualty mortality and morbidity for disaster recovery. The tethered balloon is an actively developed research area and a simple solution to support the performance, facilities, and services of emergency medical communication. The most critical requirement for rescue and relief teams is having a higher quality of communication services which enables them to save people's lives. Using our proposed technology, it has been reported that the performance of rescue and relief teams significantly improved. OPNET Modeler 14.5 is used for a network simulated with the help of ad hoc tools (Disaster Med Public Health Preparedness. 2018;page 1 of 8).

  13. Feasibility study for a computerized emergency preparedness simulation facility

    International Nuclear Information System (INIS)

    Gerhardstein, L.H.; Schroeder, J.O.; Sandusky, W.F.

    1979-11-01

    This report details the feasibility of a computerized Emergency Preparedness Simulation Facility (EPSF) for use by the Nuclear Regulatory Commission (NRC). The proposed facility would be designed to provide the NRC and other federal, state, and local government agencies with a capability to formulate, test, and evaluate the Emergency Preparedness Plans (EPP) which local and state agencies have/will establish for use during nuclear emergencies. In cases of any state emergency (including a nuclear emergency), high level state government officials will direct emergency procedures and insure that state and local emergency teams carry out tasks which have been established in their EPP. When an emergency exists, rapid mobilization of emergency teams, efficient communication, and effective coordination of individual team efforts is essential to safety, preservation of property, and overall public welfare. Current EPP evaluation procedures are qualitative in nature and while they do compare emergency drill performance with the EPP, the nature of the drills often does not provide enough realism to actual emergency conditions. Automated simulation of real emergency conditions using modern computer equipment and programming techniques will provide the NRC emergency evaluation teams a simulated environment which closely approximates conditions which would actually exist during a real emergency. In addition, the computer can be used to collect and log performance and event data which will aid the evaluation team in making assessments of the state or local area's EPP and their Emergency Preparedness Teams performance during emergency drills. Overall, a computerized EPSF can improve drill testing and evaluation efficiency, provide approximate emergency condition realism, and improve public awareness of local emergency procedures

  14. TOWARDS A FAST, LOW-COST INDOOR MAPPING AND POSITIONING SYSTEM FOR CIVIL PROTECTION AND EMERGENCY TEAMS

    Directory of Open Access Journals (Sweden)

    E. Angelats

    2017-11-01

    Full Text Available Civil protection and emergency teams work usually under very risky conditions that endanger their lives. One of the factors contributing to such risks is the lack of knowledge about their physical environment, especially when working indoors. Mapping and location indoor and outdoor technologies exist; for outdoors, very good levels of precision and accuracy may be obtained using offthe- shelf equipment; on the other side, and although good solutions for indoor environments are available, these require some extra pre-deployed infrastructure in the area to navigate, which is unacceptable in the case of emergency teams. It may be said, then, that no mature indoor + outdoor integrated solution providing the appropriate precision and accuracy for the purposes of emergency teams exist. In this paper, the assessment of a set of currently available sensors (IMUs, RGB-D cameras, GNSS receivers and algorithms is presented to show that it is already possible to build such a solution relying on them – providing that appropriate (indoor lightning and texture conditions exist.

  15. Team of experts concludes review of safety issues at Temelin

    International Nuclear Information System (INIS)

    2001-01-01

    Full text: At the request of the Czech Government, the International Atomic Energy Agency (IAEA) assembled a team of national experts from Bulgaria, France, Germany, Spain, and the United Kingdom, with an observer from Austria, to review safety issues at the Temelin power plant that were identified in 1996 as relevant to reactors of the generic Temelin design (WWER-1000/320 type). Following a detailed on-site review from 18 to 23 November 2001, the experts concluded that most identified issues had been addressed and resolved. Work is continuing on the few remaining issues. These issues, however, are not judged by them to be significant and would not from the experts' standpoint preclude the safe operation of the Temelin nuclear power plant. The final report of the team of experts will be available to the Czech Government in one month's time. (author)

  16. Understanding the value of mixed methods research: the Children’s Safety Initiative-Emergency Medical Services

    Science.gov (United States)

    Hansen, Matthew; O’Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

    2016-01-01

    Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children’s Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. PMID:26949970

  17. Assessing the similarity of mental models of operating room team members and implications for patient safety: a prospective, replicated study.

    Science.gov (United States)

    Nakarada-Kordic, Ivana; Weller, Jennifer M; Webster, Craig S; Cumin, David; Frampton, Christopher; Boyd, Matt; Merry, Alan F

    2016-08-31

    Patient safety depends on effective teamwork. The similarity of team members' mental models - or their shared understanding-regarding clinical tasks is likely to influence the effectiveness of teamwork. Mental models have not been measured in the complex, high-acuity environment of the operating room (OR), where professionals of different backgrounds must work together to achieve the best surgical outcome for each patient. Therefore, we aimed to explore the similarity of mental models of task sequence and of responsibility for task within multidisciplinary OR teams. We developed a computer-based card sorting tool (Momento) to capture the information on mental models in 20 six-person surgical teams, each comprised of three subteams (anaesthesia, surgery, and nursing) for two simulated laparotomies. Team members sorted 20 cards depicting key tasks according to when in the procedure each task should be performed, and which subteam was primarily responsible for each task. Within each OR team and subteam, we conducted pairwise comparisons of scores to arrive at mean similarity scores for each task. Mean similarity score for task sequence was 87 % (range 57-97 %). Mean score for responsibility for task was 70 % (range = 38-100 %), but for half of the tasks was only 51 % (range = 38-69 %). Participants believed their own subteam was primarily responsible for approximately half the tasks in each procedure. We found differences in the mental models of some OR team members about responsibility for and order of certain tasks in an emergency laparotomy. Momento is a tool that could help elucidate and better align the mental models of OR team members about surgical procedures and thereby improve teamwork and outcomes for patients.

  18. [Hospital-based acute care of emergency patients: the importance of interdisciplinary teamwork].

    Science.gov (United States)

    Gräff, I; Lenkeit, S

    2014-10-01

    The care of emergency patients with life-threatening injuries or diseases presents a special challenge to the treatment team. Good interdisciplinary cooperation is essential for fast, priority-oriented, and efficient emergency room management. Particularly in complex situations, such as trauma room care, so-called human factors largely determine the safety and performance of the individual as well as the team. Approximately 70 % of all adverse events stem from human factors rather than from a lack of medical expertise. It has been shown that 70-80 % of such incidents are preventable through special training. Established course concepts based on so-called ABCDE schemes are a good basis for creating algorithms for targeted therapy, yet they are not sufficient for the training of team-specific issues. For this, special course concepts are required, such as crew resource management, which is provided through simulator-based training scenarios. This includes task management, teamwork, decision-making, and communication. The knowledge of what needs to be done in a team under the adverse and complex conditions of a medical emergency must be gained by training based on realistic and effective measures. Course concepts that are geared toward interdisciplinary and interprofessional team training optimize patient safety and care by supporting the nontechnical abilities of team members.

  19. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare.

    Science.gov (United States)

    Weller, Jennifer; Boyd, Matt; Cumin, David

    2014-03-01

    Modern healthcare is delivered by multidisciplinary, distributed healthcare teams who rely on effective teamwork and communication to ensure effective and safe patient care. However, we know that there is an unacceptable rate of unintended patient harm, and much of this is attributed to failures in communication between health professionals. The extensive literature on teams has identified shared mental models, mutual respect and trust and closed-loop communication as the underpinning conditions required for effective teams. However, a number of challenges exist in the healthcare environment. We explore these in a framework of educational, psychological and organisational challenges to the development of effective healthcare teams. Educational interventions can promote a better understanding of the principles of teamwork, help staff understand each other's roles and perspectives, and help develop specific communication strategies, but may not be sufficient on their own. Psychological barriers, such as professional silos and hierarchies, and organisational barriers such as geographically distributed teams, can increase the chance of communication failures with the potential for patient harm. We propose a seven-step plan to overcome the barriers to effective team communication that incorporates education, psychological and organisational strategies. Recent evidence suggests that improvement in teamwork in healthcare can lead to significant gains in patient safety, measured against efficiency of care, complication rate and mortality. Interventions to improve teamwork in healthcare may be the next major advance in patient outcomes.

  20. S-TEAMS: A Truly Multiprofessional Course Focusing on Nontechnical Skills to Improve Patient Safety in the Operating Theater.

    Science.gov (United States)

    Stewart-Parker, Emma; Galloway, Robert; Vig, Stella

    Possessing adequate nontechnical skills (NTS) in operating theaters is of increasing interest to health care professionals, yet these are rarely formally taught. Teams make human errors despite technical expertise and knowledge, compromising patient safety. We designed a 1-day, multiprofessional, multidisciplinary course to teach, practice, and apply these skills through simulation. The course, "S-TEAMS," comprised a morning of lectures, case studies, and interactive teamworking exercises. The afternoon divided the group into multiprofessional teams to rotate around simulated scenarios. During the scenarios, teams were encouraged to focus on NTS, including communication strategies, situational awareness, and prompts such as checklists. A thorough debrief with experienced clinician observers followed. Data was collected through self-assessments, immediate and 6-month feedback to assess whether skills continued to be used and their effect on safety. In total, 68 health care professionals have completed the course thus far. All participants felt the course had a clear structure and that learning objectives were explicit. Overall, 95% felt the scenarios had good or excellent relevance to clinical practice. Self-assessments revealed a 55% increase in confidence for "speaking up" in difficult situations. Long-term data revealed 97% of the participants continued to use the skills, with 88% feeling the course had prevented them from making errors. Moreover, 94% felt the course had directly improved patient safety. There is a real demand and enthusiasm for developing NTS within the modern theater team. The simple and easily reproducible format of S-TEAMS is sustainable and inclusive, and crucially, the skills taught continue to be used in long term to improve patient safety and teamworking. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Criticality Safety Basics for INL Emergency Responders

    Energy Technology Data Exchange (ETDEWEB)

    Valerie L. Putman

    2012-08-01

    This document is a modular self-study guide about criticality safety principles for Idaho National Laboratory emergency responders. This guide provides basic criticality safety information for people who, in response to an emergency, might enter an area that contains much fissionable (or fissile) material. The information should help responders understand unique factors that might be important in responding to a criticality accident or in preventing a criticality accident while responding to a different emergency.

    This study guide specifically supplements web-based training for firefighters (0INL1226) and includes information for other Idaho National Laboratory first responders. However, the guide audience also includes other first responders such as radiological control personnel.

    For interested readers, this guide includes clearly marked additional information that will not be included on tests. The additional information includes historical examples (Been there. Done that.), as well as facts and more in-depth information (Did you know …).

    INL criticality safety personnel revise this guide as needed to reflect program changes, user requests, and better information. Revision 0, issued May 2007, established the basic text. Revision 1 incorporates operation, program, and training changes implemented since 2007. Revision 1 increases focus on first responders because later responders are more likely to have more assistance and guidance from facility personnel and subject matter experts. Revision 1 also completely reorganized the training to better emphasize physical concepts behind the criticality controls that help keep emergency responders safe. The changes are based on and consistent with changes made to course 0INL1226.

  2. The emergence of new organization designs. Evidences from self-managed team-based organizations

    NARCIS (Netherlands)

    Annosi, Maria Carmela; Giustiniano, Luca; Brunetta, Federica; Magnusson, Mats

    2017-01-01

    New organization designs emerge continuously in highly dynamic innovation context to improve readiness to change. The adoption of self-managing teams operating cross-functionally on a bulk of products, together with the reduction of vertical layers in the organization, seems to be a common strategy

  3. Authentic leadership, group cohesion and group identification in security and emergency teams.

    Science.gov (United States)

    García-Guiu López, Carlos; Molero Alonso, Fernando; Moya Morales, Miguel; Moriano León, Juan Antonio

    2015-01-01

    Authentic leadership (AL) is a kind of leadership that inspires and promotes positive psychological capacities, underlining the moral and ethical component of behavior. The proposed investigation studies the relations among AL, cohesion, and group identification in security and emergency teams. A cross-sectional research design was conducted in which participated 221 members from 26 fire departments and operative teams from the local police of three Spanish provinces. The following questionnaires were administered: Authentic Leadership (ALQ), Group Cohesion (GEQ), and Mael and Ashford's Group Identification Questionnaire. A direct and positive relation was found between AL, cohesion, and group identification. An indirect relation was also found between AL and group cohesion through group identification, indicating the existence of partial mediation. The utility of the proposed model based on AL is considered; this model can be employed by those in charge of the fire departments and operative groups in organizations to improve workteams' cohesion. Both AL and group identification help to explain group cohesion in organizations committed to security and emergencies.

  4. Physicians' and nurses' perceptions of patient safety risks in the emergency department.

    Science.gov (United States)

    Källberg, Ann-Sofie; Ehrenberg, Anna; Florin, Jan; Östergren, Jan; Göransson, Katarina E

    2017-07-01

    The emergency department has been described as a high-risk area for errors. It is also known that working conditions such as a high workload and shortage off staff in the healthcare field are common factors that negatively affect patient safety. A limited amount of research has been conducted with regard to patient safety in Swedish emergency departments. Additionally, there is a lack of knowledge about clinicians' perceptions of patient safety risks. Therefore, the purpose of this study was to describe emergency department clinicians' experiences with regard to patient safety risks. Semi-structured interviews were conducted with 10 physicians and 10 registered nurses from two emergency departments. Interviews were analysed by inductive content analysis. The experiences reflect the complexities involved in the daily operation of a professional practice, and the perception of risks due to a high workload, lack of control, communication and organizational failures. The results reflect a complex system in which high workload was perceived as a risk for patient safety and that, in a combination with other risks, was thought to further jeopardize patient safety. Emergency department staff should be involved in the development of patient safety procedures in order to increase knowledge regarding risk factors as well as identify strategies which can facilitate the maintenance of patient safety during periods in which the workload is high. Copyright © 2017 Elsevier Ltd. All rights reserved.

  5. The influence of individual and team cognitive ability on operators' task and safety performance: a multilevel field study in nuclear power plants.

    Directory of Open Access Journals (Sweden)

    Jingyu Zhang

    Full Text Available While much research has investigated the predictors of operators' performance such as personality, attitudes and motivation in high-risk industries, its cognitive antecedents and boundary conditions have not been fully investigated. Based on a multilevel investigation of 312 nuclear power plant main control room operators from 50 shift teams, the present study investigated how general mental ability (GMA at both individual and team level can influence task and safety performance. At the individual level, operators' GMA was predictive of their task and safety performance and this trend became more significant as they accumulated more experience. At the team level, we found team GMA had positive influences on all three performance criteria. However, we also found a "big-fish-little-pond" effect insofar as team GMA had a relatively smaller effect and inhibited the contribution of individual GMA to workers' extra-role behaviors (safety participation compared to its clear beneficial influence on in-role behaviors (task performance and safety compliance. The possible mechanisms related to learning and social comparison processes are discussed.

  6. The influence of individual and team cognitive ability on operators' task and safety performance: a multilevel field study in nuclear power plants.

    Science.gov (United States)

    Zhang, Jingyu; Li, Yongjuan; Wu, Changxu

    2013-01-01

    While much research has investigated the predictors of operators' performance such as personality, attitudes and motivation in high-risk industries, its cognitive antecedents and boundary conditions have not been fully investigated. Based on a multilevel investigation of 312 nuclear power plant main control room operators from 50 shift teams, the present study investigated how general mental ability (GMA) at both individual and team level can influence task and safety performance. At the individual level, operators' GMA was predictive of their task and safety performance and this trend became more significant as they accumulated more experience. At the team level, we found team GMA had positive influences on all three performance criteria. However, we also found a "big-fish-little-pond" effect insofar as team GMA had a relatively smaller effect and inhibited the contribution of individual GMA to workers' extra-role behaviors (safety participation) compared to its clear beneficial influence on in-role behaviors (task performance and safety compliance). The possible mechanisms related to learning and social comparison processes are discussed.

  7. Quality and safety implications of emergency department information systems.

    Science.gov (United States)

    Farley, Heather L; Baumlin, Kevin M; Hamedani, Azita G; Cheung, Dickson S; Edwards, Michael R; Fuller, Drew C; Genes, Nicholas; Griffey, Richard T; Kelly, John J; McClay, James C; Nielson, Jeff; Phelan, Michael P; Shapiro, Jason S; Stone-Griffith, Suzanne; Pines, Jesse M

    2013-10-01

    The Health Information Technology for Economic and Clinical Health Act of 2009 and the Centers for Medicare & Medicaid Services "meaningful use" incentive programs, in tandem with the boundless additional requirements for detailed reporting of quality metrics, have galvanized hospital efforts to implement hospital-based electronic health records. As such, emergency department information systems (EDISs) are an important and unique component of most hospitals' electronic health records. System functionality varies greatly and affects physician decisionmaking, clinician workflow, communication, and, ultimately, the overall quality of care and patient safety. This article is a joint effort by members of the Quality Improvement and Patient Safety Section and the Informatics Section of the American College of Emergency Physicians. The aim of this effort is to examine the benefits and potential threats to quality and patient safety that could result from the choice of a particular EDIS, its implementation and optimization, and the hospital's or physician group's approach to continuous improvement of the EDIS. Specifically, we explored the following areas of potential EDIS safety concerns: communication failure, wrong order-wrong patient errors, poor data display, and alert fatigue. Case studies are presented that illustrate the potential harm that could befall patients from an inferior EDIS product or suboptimal execution of such a product in the clinical environment. The authors have developed 7 recommendations to improve patient safety with respect to the deployment of EDISs. These include ensuring that emergency providers actively participate in selection of the EDIS product, in the design of processes related to EDIS implementation and optimization, and in the monitoring of the system's ongoing success or failure. Our recommendations apply to emergency departments using any type of EDIS: custom-developed systems, best-of-breed vendor systems, or enterprise systems

  8. Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams.

    Science.gov (United States)

    van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

    2017-04-01

    Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader's verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time.

  9. Team Leader Structuring for Team Effectiveness and Team Learning in Command-and-Control Teams

    Science.gov (United States)

    van der Haar, Selma; Koeslag-Kreunen, Mieke; Euwe, Eline; Segers, Mien

    2017-01-01

    Due to their crucial and highly consequential task, it is of utmost importance to understand the levers leading to effectiveness of multidisciplinary emergency management command-and-control (EMCC) teams. We argue that the formal EMCC team leader needs to initiate structure in the team meetings to support organizing the work as well as facilitate team learning, especially the team learning process of constructive conflict. In a sample of 17 EMCC teams performing a realistic EMCC exercise, including one or two team meetings (28 in sum), we coded the team leader’s verbal structuring behaviors (1,704 events), rated constructive conflict by external experts, and rated team effectiveness by field experts. Results show that leaders of effective teams use structuring behaviors more often (except asking procedural questions) but decreasingly over time. They support constructive conflict by clarifying and by making summaries that conclude in a command or decision in a decreasing frequency over time. PMID:28490856

  10. Staff Turnover in Assertive Community Treatment (Act) Teams: The Role of Team Climate.

    Science.gov (United States)

    Zhu, Xi; Wholey, Douglas R; Cain, Cindy; Natafgi, Nabil

    2017-03-01

    Staff turnover in Assertive Community Treatment (ACT) teams can result in interrupted services and diminished support for clients. This paper examines the effect of team climate, defined as team members' shared perceptions of their work environment, on turnover and individual outcomes that mediate the climate-turnover relationship. We focus on two climate dimensions: safety and quality climate and constructive conflict climate. Using survey data collected from 26 ACT teams, our analyses highlight the importance of safety and quality climate in reducing turnover, and job satisfaction as the main mediator linking team climate to turnover. The findings offer practical implications for team management.

  11. Evaluation of aviation-based safety team training in a hospital in The Netherlands

    NARCIS (Netherlands)

    de Korne, Dirk F.; van Wijngaarden, Jeroen D. H.; van Dyck, Cathy; Hiddema, U. Francis; Klazinga, Niek S.

    2014-01-01

    Purpose - The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program's content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient

  12. The One Plan Project: A cooperative effort of the National Response Team and the Region 6 Regional Response Team to simplify facility emergency response planning

    International Nuclear Information System (INIS)

    Staves, J.; McCormick, K.

    1997-01-01

    The National Response Team (NRT) in coordination with the Region 6 Response Team (RRT) have developed a facility contingency plan format which would integrate all existing regulatory requirements for contingency planning. This format was developed by a multi-agency team, chaired by the USEPA Region 6, in conjunction with various industry, labor, and public interest groups. The impetus for this project came through the USEPA Office of Chemical Emergency Preparedness and Prevention (CEPPO). The current national oil and hazardous material emergency preparedness and response system is an amalgam of federal, state, local, and industrial programs which are often poorly coordinated. In a cooperative effort with the NRT, the CEPPO conducted a Presidential Review of federal agency authorities and coordination responsibilities regarding release prevention, mitigation, and response. Review recommendations led to a Pilot Project in USEPA Region 6. The Region 6 Pilot Project targeted end users in the intensely industrialized Houston Ship Channel (HSC) area, which is comprised of petroleum and petrochemical companies

  13. Summary of Tiger Team Assessment and Technical Safety Appraisal recurring concerns in the Maintenance Area

    International Nuclear Information System (INIS)

    1993-01-01

    Tiger Team Assessments and Technical Safety Appraisals (TSA) were reviewed and evaluated for concerns in the Maintenance Area (MA). Two hundred and thirty one (231) maintenance concerns were identified by the Tiger Team Assessments and TSA reports. These recurring concerns appear below. A summary of the Noteworthy Practices that were identified and a compilation of the maintenance concerns for each performance objective that were not considered as recurring are also included. Where the Tiger Team Assessment and TSA identified the operating contractor or facility by name, the concern has been modified to remove the name while retaining the intent of the comment

  14. A 'mixed reality' simulator concept for future Medical Emergency Response Team training.

    Science.gov (United States)

    Stone, Robert J; Guest, R; Mahoney, P; Lamb, D; Gibson, C

    2017-08-01

    The UK Defence Medical Service's Pre-Hospital Emergency Care (PHEC) capability includes rapid-deployment Medical Emergency Response Teams (MERTs) comprising tri-service trauma consultants, paramedics and specialised nurses, all of whom are qualified to administer emergency care under extreme conditions to improve the survival prospects of combat casualties. The pre-deployment training of MERT personnel is designed to foster individual knowledge, skills and abilities in PHEC and in small team performance and cohesion in 'mission-specific' contexts. Until now, the provision of airborne pre-deployment MERT training had been dependent on either the availability of an operational aircraft (eg, the CH-47 Chinook helicopter) or access to one of only two ground-based facsimiles of the Chinook 's rear cargo/passenger cabin. Although MERT training has high priority, there will always be competition with other military taskings for access to helicopter assets (and for other platforms in other branches of the Armed Forces). This paper describes the development of an inexpensive, reconfigurable and transportable MERT training concept based on 'mixed reality' technologies-in effect the 'blending' of real-world objects of training relevance with virtual reality reconstructions of operational contexts. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Safety assessment of emergency electric power systems for nuclear power plants

    International Nuclear Information System (INIS)

    1986-09-01

    This paper is intended to assist the safety assessor within a regulatory body, or one working as a consultant, in assessing a given design of the Emergency Electrical Power System. Those non-electric power systems which may be used in a plant design to serve as emergency energy sources are addressed only in their general safety aspects. The paper thus relates closely to Safety Series 50-SG-D7 ''Emergency Power Systems at Nuclear Power Plants'' (1982), as far as it addresses emergency electric power systems. Several aspects are dealt with: the information the assessor may expect from the applicant to fulfill his task of safety review; the main questions the reviewer has to answer in order to determine the compliance with requirements of the NUSS documents; the national or international standards which give further guidance on a certain system or piece of equipment; comments and suggestions which may help to judge a variety of possible solutions

  16. Evaluation of aviation-based safety team training in a hospital in The Netherlands

    NARCIS (Netherlands)

    de Korne, D.F.; van Wijngaarden, J.D.H.; van Dyck, C.; Hiddema, F.; Klazinga, N.S.

    2014-01-01

    Purpose – The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program’s content and procedures. Aviation-based TRM training is recognized as a useful approach to increase patient

  17. Evaluation of aviation-based safety team training in a hospital in The Netherlands

    NARCIS (Netherlands)

    D.F. de Korne (Dirk); J.D.H. van Wijngaarden (Jeroen); C. van Dyck (Cathy); U.F. Hiddema (Frans); N.S. Klazinga (Niek)

    2014-01-01

    textabstractPurpose – The purpose of this paper is to evaluate the implementation of a broad-scale team resource management (TRM) program on safety culture in a Dutch eye hospital, detailing the program’s content and procedures. Aviation-based TRM training is recognized as a useful approach to

  18. Improving teamwork, trust and safety: an ethnographic study of an interprofessional initiative.

    Science.gov (United States)

    Jones, Aled; Jones, Delyth

    2011-05-01

    This study explored the perceptions of staff in an interprofessional team based on a medical rehabilitation ward for older people, following the introduction of a service improvement programme designed to promote better teamworking. The study aimed to address a lack of in-depth qualitative research that could explain the day-to-day realities of interprofessional teamworking in healthcare. All members of the team participated, (e.g. nurses, doctors, physiotherapists, social worker, occupational therapists), and findings suggest that interprofessional teamworking improved over the 12-month period. Four themes emerged from the data offering insights into the development and effects of better interprofessional teamworking: the emergence of collegial trust within the team, the importance of team meetings and participative safety, the role of shared objectives in conflict management and the value of autonomy within the team. Reductions in staff sickness/absence levels and catastrophic/major patient safety incidents were also detected following the introduction of the service improvement programme.

  19. Establishing research priorities for patient safety in emergency medicine: a multidisciplinary consensus panel.

    Science.gov (United States)

    Plint, Amy C; Stang, Antonia S; Calder, Lisa A

    2015-01-01

    Patient safety in the context of emergency medicine is a relatively new field of study. To date, no broad research agenda for patient safety in emergency medicine has been established. The objective of this study was to establish patient safety-related research priorities for emergency medicine. These priorities would provide a foundation for high-quality research, important direction to both researchers and health-care funders, and an essential step in improving health-care safety and patient outcomes in the high-risk emergency department (ED) setting. A four-phase consensus procedure with a multidisciplinary expert panel was organized to identify, assess, and agree on research priorities for patient safety in emergency medicine. The 19-member panel consisted of clinicians, administrators, and researchers from adult and pediatric emergency medicine, patient safety, pharmacy, and mental health; as well as representatives from patient safety organizations. In phase 1, we developed an initial list of potential research priorities by electronically surveying a purposeful and convenience sample of patient safety experts, ED clinicians, administrators, and researchers from across North America using contact lists from multiple organizations. We used simple content analysis to remove duplication and categorize the research priorities identified by survey respondents. Our expert panel reached consensus on a final list of research priorities through an in-person meeting (phase 3) and two rounds of a modified Delphi process (phases 2 and 4). After phases 1 and 2, 66 unique research priorities were identified for expert panel review. At the end of phase 4, consensus was reached for 15 research priorities. These priorities represent four themes: (1) methods to identify patient safety issues (five priorities), (2) understanding human and environmental factors related to patient safety (four priorities), (3) the patient perspective (one priority), and (4) interventions for

  20. Emergency preparedness

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, J. [Key Safety and Blowout Control Corp., Sylvan Lake, AB (Canada)

    2001-07-01

    This presentation included several slides depicting well control and emergency preparedness. It provided information to help in pre-emergency planning for potential well control situations. Key Safety and Blowout Control Corp has gained experience in the Canadian and International well control industry as well as from the fires of Kuwait. The president of the company lectures on the complications and concerns of managers, wellsite supervisors, service companies, the public sector, land owners, government agencies and the media. The slides presented scenarios based on actual blowout recovery assignments and described what types of resources are needed by a well control team. The presentation addressed issues such as the responsibility of a well control team and what they can be expected to do. The issue of how government agencies become involved was also discussed. The presentation combines important information and descriptive images of personal experiences in fire fighting and well control. The emergency situations presented here demonstrate the need for a thorough understanding of preplanning for emergencies and what to expect when a typical day in the oil patch turns into a high stress, volatile situation. tabs., figs.

  1. Emerging trends in PHWR safety - post Fukushima measures

    International Nuclear Information System (INIS)

    Nitheanandan, T.

    2015-01-01

    Nuclear power continues to be the choice for many countries that are seeking to enhance their energy security and reduce their carbon emissions. Nuclear power plants are complex systems which require multiple layers of protection. The fundamental principle of nuclear power safety technology is ‘Defence-in-Depth’ that underlies all safety activities - organizational, behavioural and technical. This provides layers of overlapping barrier protections so that, in the unlikely event that failure occurs, it would be compensated or corrected without causing harm to individuals or the public at large. Defence-in-depth encompasses prevention, control, protection, severe accident management and consequence mitigation, and offsite emergency response measures. Reactor Safety Science and Technology (S and T) has evolved over more than four decades in a number of PHWR countries. The PHWR operators, regulators and national research laboratories have dedicated S and T programs to continuously improve plant safety, operations and margins. The S and T is focused on finding simpler, less costly and more reliable safety system designs. These improvements are continuously incorporated in current units, refurbished units and proposed new builds. The Fukushima accident forced most nuclear nations to reassess and implement reactor design upgrades. The lessons learned from Fukushima have generated some nuclear safety enhancements such as: Design considerations for natural hazards, Diversity of heat sinks, Consideration of extended duration station blackout, Improvements to Severe Accident Management and SAM Operational aids, Accident instrumentation, Offsite management such as the use of predictive exposure tools, and Design considerations for Spent Fuel Pools. The plenary presentation will provide some of the emerging trends following the Fukushima accident. Examples of these emerging trends in Canada and on the international scene, will be presented. (author)

  2. Applying interprofessional Team-Based Learning in patient safety: a pilot evaluation study.

    Science.gov (United States)

    Lochner, Lukas; Girardi, Sandra; Pavcovich, Alessandra; Meier, Horand; Mantovan, Franco; Ausserhofer, Dietmar

    2018-03-27

    Interprofessional education (IPE) interventions are not always successful in achieving learning outcomes. Team-Based Learning (TBL) would appear to be a suitable pedagogical method for IPE, as it focuses on team performance; however, little is known about interprofessional TBL as an instructional framework for patient safety. In this pilot-study, we aimed to (1) describe participants' reactions to TBL, (2) observe their achievement with respect to interprofessional education learning objectives, and (3) document their attitudinal shifts with regard to patient safety behaviours. We developed and implemented a three-day course for pre-qualifying, non-medical healthcare students to give instruction on non-technical skills related to 'learning from errors'. The course consisted of three sequential modules: 'Recognizing Errors', 'Analysing Errors', and 'Reporting Errors'. The evaluation took place within a quasi-experimental pre-test-post-test study design. Participants completed self-assessments through valid and reliable instruments such as the Mennenga's TBL Student Assessment Instrument and the University of the West of England's Interprofessional Questionnaire. The mean scores of the individual readiness assurance tests were compared with the scores of the group readiness assurance test in order to explore if students learned from each other during group discussions. Data was analysed using descriptive (i.e. mean, standard deviation), parametric (i.e. paired t-test), and non-parametric (i.e. Wilcoxon signed-rank test) methods. Thirty-nine students from five different bachelor's programs attended the course. The participants positively rated TBL as an instructional approach. All teams outperformed the mean score of their individual members during the readiness assurance process. We observed significant improvements in 'communication and teamwork' and 'interprofessional learning' but not in 'interprofessional interaction' and 'interprofessional relationships

  3. Development of Nuclear Safety Culture evaluation method for an operation team based on the probabilistic approach

    International Nuclear Information System (INIS)

    Han, Sang Min; Lee, Seung Min; Yim, Ho Bin; Seong, Poong Hyun

    2018-01-01

    Highlights: •We proposed a Probabilistic Safety Culture Healthiness Evaluation Method. •Positive relationship between the ‘success’ states of NSC and performance was shown. •The state probability profile showed a unique ratio regardless of the scenarios. •Cutset analysis provided not only root causes but also the latent causes of failures. •Pro-SCHEMe was found to be applicable to Korea NPPs. -- Abstract: The aim of this study is to propose a new quantitative evaluation method for Nuclear Safety Culture (NSC) in Nuclear Power Plant (NPP) operation teams based on the probabilistic approach. Various NSC evaluation methods have been developed, and the Korea NPP utility company has conducted the NSC assessment according to international practice. However, most of methods are conducted by interviews, observations, and the self-assessment. Consequently, the results are often qualitative, subjective, and mainly dependent on evaluator’s judgement, so the assessment results can be interpreted from different perspectives. To resolve limitations of present evaluation methods, the concept of Safety Culture Healthiness was suggested to produce quantitative results and provide faster evaluation process. This paper presents Probabilistic Safety Culture Healthiness Evaluation Method (Pro-SCHEMe) to generate quantitative inputs for Human Reliability Assessment (HRA) in Probabilistic Safety Assessment (PSA). Evaluation items which correspond to a basic event in PSA are derived in the first part of the paper through the literature survey; mostly from nuclear-related organizations such as the International Atomic Energy Agency (IAEA), the United States Nuclear Regulatory Commission (U.S.NRC), and the Institute of Nuclear Power Operations (INPO). Event trees (ETs) and fault trees (FTs) are devised to apply evaluation items to PSA based on the relationships among such items. The Modeling Guidelines are also suggested to classify and calculate NSC characteristics of

  4. Validating Obstetric Emergency Checklists using Simulation: A Randomized Controlled Trial.

    Science.gov (United States)

    Bajaj, Komal; Rivera-Chiauzzi, Enid Y; Lee, Colleen; Shepard, Cynthia; Bernstein, Peter S; Moore-Murray, Tanya; Smith, Heather; Nathan, Lisa; Walker, Katie; Chazotte, Cynthia; Goffman, Dena

    2016-10-01

    Background The World Health Organization's Surgical Safety Checklist has demonstrated significant reduction in surgical morbidity. The American Congress of Obstetricians and Gynecologists District II Safe Motherhood Initiative (SMI) safety bundles include eclampsia and postpartum hemorrhage (PPH) checklists. Objective To determine whether use of the SMI checklists during simulated obstetric emergencies improved completion of critical actions and to elicit feedback to facilitate checklist revision. Study Design During this randomized controlled trial, teams were assigned to use a checklist during one of two emergencies: eclampsia and PPH. Raters scored teams on critical step completion. Feedback was elicited through structured debriefing. Results In total, 30 teams completed 60 scenarios. For eclampsia, trends toward higher completion were noted for blood pressure and airway management. For PPH, trends toward higher completion rates were noted for PPH stage assessment and fundal massage. Feedback resulted in substantial checklist revision. Participants were enthusiastic about using checklists in a clinical emergency. Conclusion Despite trends toward higher rates of completion of critical tasks, teams using checklists did not approach 100% task completion. Teams were interested in the application of checklists and provided feedback necessary to substantially revise the checklists. Intensive implementation planning and training in use of the revised checklists will result in improved patient outcomes. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Team Resilience as a Second-Order Emergent State: A Theoretical Model and Research Directions

    Directory of Open Access Journals (Sweden)

    Clint Bowers

    2017-08-01

    Full Text Available Resilience has been recognized as an important phenomenon for understanding how individuals overcome difficult situations. However, it is not only individuals who face difficulties; it is not uncommon for teams to experience adversity. When they do, they must be able to overcome these challenges without performance decrements.This manuscript represents a theoretical model that might be helpful in conceptualizing this important construct. Specifically, it describes team resilience as a second-order emergent state. We also include research propositions that follow from the model.

  6. An exploration of emergency nurses' perceptions, attitudes and experience of teamwork in the emergency department.

    Science.gov (United States)

    Grover, Elise; Porter, Joanne E; Morphet, Julia

    2017-05-01

    Teamwork may assist with increased levels of efficiency and safety of patient care in the emergency department (ED), with emergency nurses playing an indispensable role in this process. A descriptive, exploratory approach was used, drawing on principles from phenomenology and symbolic interactionism. Convenience, purposive sampling was used in a major metropolitan ED. Semi structured interviews were conducted, audio recorded, and transcribed verbatim. Transcripts were analysed using thematic analysis. Three major themes emerged from the data. The first theme 'when teamwork works' supported the notion that emergency nurses perceived teamwork as a positive and effective construct in four key areas; resuscitation, simulation training, patient outcomes and staff satisfaction. The second theme 'team support' revealed that back up behaviour and leadership were critical elements of team effectiveness within the study setting. The third theme 'no time for teamwork' centred around periods when teamwork practices failed due to various contributing factors including inadequate resources and skill mix. Outcomes of effective teamwork were valued by emergency nurses. Teamwork is about performance, and requires a certain skill set not necessarily naturally possessed among emergency nurses. Building a resilient team inclusive of strong leadership and communication skills is essential to being able to withstand the challenging demands of the ED. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  7. Teamwork Assessment Tools in Obstetric Emergencies: A Systematic Review.

    Science.gov (United States)

    Onwochei, Desire N; Halpern, Stephen; Balki, Mrinalini

    2017-06-01

    Team-based training and simulation can improve patient safety, by improving communication, decision making, and performance of team members. Currently, there is no general consensus on whether or not a specific assessment tool is better adapted to evaluate teamwork in obstetric emergencies. The purpose of this qualitative systematic review was to find the tools available to assess team effectiveness in obstetric emergencies. We searched Embase, Medline, PubMed, Web of Science, PsycINFO, CINAHL, and Google Scholar for prospective studies that evaluated nontechnical skills in multidisciplinary teams involving obstetric emergencies. The search included studies from 1944 until January 11, 2016. Data on reliability and validity measures were collected and used for interpretation. A descriptive analysis was performed on the data. Thirteen studies were included in the final qualitative synthesis. All the studies assessed teams in the context of obstetric simulation scenarios, but only six included anesthetists in the simulations. One study evaluated their teamwork tool using just validity measures, five using just reliability measures, and one used both. The most reliable tools identified were the Clinical Teamwork Scale, the Global Assessment of Obstetric Team Performance, and the Global Rating Scale of performance. However, they were still lacking in terms of quality and validity. More work needs to be conducted to establish the validity of teamwork tools for nontechnical skills, and the development of an ideal tool is warranted. Further studies are required to assess how outcomes, such as performance and patient safety, are influenced when using these tools.

  8. Applying lessons from commercial aviation safety and operations to resuscitation.

    Science.gov (United States)

    Ornato, Joseph P; Peberdy, Mary Ann

    2014-02-01

    Both commercial aviation and resuscitation are complex activities in which team members must respond to unexpected emergencies in a consistent, high quality manner. Lives are at stake in both activities and the two disciplines have similar leadership structures, standard setting processes, training methods, and operational tools. Commercial aviation crews operate with remarkable consistency and safety, while resuscitation team performance and outcomes are highly variable. This commentary provides the perspective of two physician-pilots showing how commercial aviation training, operations, and safety principles can be adapted to resuscitation team training and performance. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  9. Intensive care unit nurses' evaluation of simulation used for team training.

    Science.gov (United States)

    Ballangrud, Randi; Hall-Lord, Marie Louise; Hedelin, Birgitta; Persenius, Mona

    2014-07-01

    To implement a simulation-based team training programme and to investigate intensive care nurses' evaluations of simulation used for team training. Simulation-based training is recommended to make health care professionals aware of and understand the importance of teamwork related to patient safety. The study was based on a questionnaire evaluation design. A total of 63 registered nurses were recruited: 53 from seven intensive care units in four hospitals in one hospital trust and 10 from an intensive care postgraduate education programme. After conducting a simulation-based team training programme with two scenarios related to emergency situations in the intensive care, the participants evaluated each simulation activity with regard to: (i) outcome of satisfaction and self-confidence in learning, (ii) implementation of educational practice and (iii) simulation design/development. Intensive care nurses were highly satisfied with their simulation-based learning, and they were mostly in agreement with the statements about self-confidence in learning. They were generally positive in their evaluation of the implementation of the educational practice and the simulation design/development. Significant differences were found with regard to scenario roles, prior simulation experience and area of intensive care practice. The study indicates a positive reception of a simulation-based programme with regard to team training in emergency situations in an intensive care unit. The findings may motivate and facilitate the use of simulation for team training to promote patient safety in intensive care and provide educators with support to develop and improve simulation-based training programmes. © 2013 British Association of Critical Care Nurses.

  10. Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together

    International Nuclear Information System (INIS)

    Chao, Samuel T.; Meier, Tim; Hugebeck, Brian; Reddy, Chandana A.; Godley, Andrew; Kolar, Matt; Suh, John H.

    2014-01-01

    Purpose: To review the impact of a workflow enhancement (WE) team in reducing treatment errors that reach patients within radiation oncology. Methods and Materials: It was determined that flaws in our workflow and processes resulted in errors reaching the patient. The process improvement team (PIT) was developed in 2010 to reduce errors and was later modified in 2012 into the current WE team. Workflow issues and solutions were discussed in PIT and WE team meetings. Due to tensions within PIT that resulted in employee dissatisfaction, there was a 6-month hiatus between the end of PIT and initiation of the renamed/redesigned WE team. In addition to the PIT/WE team forms, the department had separate incident forms to document treatment errors reaching the patient. These incident forms are rapidly reviewed and monitored by our departmental and institutional quality and safety groups, reflecting how seriously these forms are treated. The number of these incident forms was compared before and after instituting the WE team. Results: When PIT was disbanded, a number of errors seemed to occur in succession, requiring reinstitution and redesign of this team, rebranded the WE team. Interestingly, the number of incident forms per patient visits did not change when comparing 6 months during the PIT, 6 months during the hiatus, and the first 6 months after instituting the WE team (P=.85). However, 6 to 12 months after instituting the WE team, the number of incident forms per patient visits decreased (P=.028). After the WE team, employee satisfaction and commitment to quality increased as demonstrated by Gallup surveys, suggesting a correlation to the WE team. Conclusions: A team focused on addressing workflow and improving processes can reduce the number of errors reaching the patient. Time is necessary before a reduction in errors reaching patients will be seen

  11. Workflow Enhancement (WE) Improves Safety in Radiation Oncology: Putting the WE and Team Together

    Energy Technology Data Exchange (ETDEWEB)

    Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Meier, Tim; Hugebeck, Brian; Reddy, Chandana A.; Godley, Andrew; Kolar, Matt [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Suh, John H. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-oncology Center, Cleveland Clinic, Cleveland, Ohio (United States)

    2014-07-15

    Purpose: To review the impact of a workflow enhancement (WE) team in reducing treatment errors that reach patients within radiation oncology. Methods and Materials: It was determined that flaws in our workflow and processes resulted in errors reaching the patient. The process improvement team (PIT) was developed in 2010 to reduce errors and was later modified in 2012 into the current WE team. Workflow issues and solutions were discussed in PIT and WE team meetings. Due to tensions within PIT that resulted in employee dissatisfaction, there was a 6-month hiatus between the end of PIT and initiation of the renamed/redesigned WE team. In addition to the PIT/WE team forms, the department had separate incident forms to document treatment errors reaching the patient. These incident forms are rapidly reviewed and monitored by our departmental and institutional quality and safety groups, reflecting how seriously these forms are treated. The number of these incident forms was compared before and after instituting the WE team. Results: When PIT was disbanded, a number of errors seemed to occur in succession, requiring reinstitution and redesign of this team, rebranded the WE team. Interestingly, the number of incident forms per patient visits did not change when comparing 6 months during the PIT, 6 months during the hiatus, and the first 6 months after instituting the WE team (P=.85). However, 6 to 12 months after instituting the WE team, the number of incident forms per patient visits decreased (P=.028). After the WE team, employee satisfaction and commitment to quality increased as demonstrated by Gallup surveys, suggesting a correlation to the WE team. Conclusions: A team focused on addressing workflow and improving processes can reduce the number of errors reaching the patient. Time is necessary before a reduction in errors reaching patients will be seen.

  12. Social Networking for Emergency Management and Public Safety

    Energy Technology Data Exchange (ETDEWEB)

    Lesperance, Ann M.; Olson, Jarrod; Godinez, Melanie A.

    2010-08-31

    On March 10, 2010 the workshop titled Social Networking for Emergency Management and Public Safety was held in Seattle, WA. The objective of this workshop was to showcase ways social media networking technologies can be used to support emergency management and public safety operations. The workshop highlighted the current state of social networking and where this dynamic engagement is heading, demonstrated some of the more commonly used technologies, highlighted case studies on how these tools have been used in a variety of jurisdictions and engaged the private sector on how these tools might serve as a conduit for two way communication between with the public sector to address regional recovery issues and decision making.

  13. Recent Experiences of the NASA Engineering and Safety Center (NESC) Guidance Navigation and Control (GN and C) Technical Discipline Team (TDT)

    Science.gov (United States)

    Dennehy, Cornelius J.

    2011-01-01

    The NASA Engineering and Safety Center (NESC) is an independently funded NASA Program whose dedicated team of technical experts provides objective engineering and safety assessments of critical, high risk projects. NESC's strength is rooted in the diverse perspectives and broad knowledge base that add value to its products, affording customers a responsive, alternate path for assessing and preventing technical problems while protecting vital human and national resources. The Guidance Navigation and Control (GN&C) Technical Discipline Team (TDT) is one of fifteen such discipline-focused teams within the NESC organization. The TDT membership is composed of GN&C specialists from across NASA and its partner organizations in other government agencies, industry, national laboratories, and universities. This paper will briefly define the vision, mission, and purpose of the NESC organization. The role of the GN&C TDT will then be described in detail along with an overview of how this team operates and engages in its objective engineering and safety assessments of critical NASA.

  14. Differences in emergency colorectal surgery in Medicaid and uninsured patients by hospital safety net status.

    Science.gov (United States)

    Bradley, Cathy J; Dahman, Bassam; Sabik, Lindsay M

    2015-02-01

    We examined whether safety net hospitals reduce the likelihood of emergency colorectal cancer (CRC) surgery in uninsured and Medicaid-insured patients. If these patients have better access to care through safety net providers, they should be less likely to undergo emergency resection relative to similar patients at non- safety net hospitals. Using population-based data, we estimated the relationship between safety net hospitals, patient insurance status, and emergency CRC surgery. We extracted inpatient admission data from the Virginia Health Information discharge database and matched them to the Virginia Cancer Registry for patients aged 21 to 64 years who underwent a CRC resection between January 1, 1999, and December 31, 2005 (n = 5488). We differentiated between medically defined emergencies and those that originated in the emergency department (ED). For each definition of emergency surgery, we estimated the linear probability models of the effects of being treated at a safety net hospital on the probability of having an emergency resection. Safety net hospitals reduce emergency surgeries among uninsured and Medicaid CRC patients. When defining an emergency resection as those that involved an ED visit, these patients were 15 to 20 percentage points less likely to have an emergency resection when treated in a safety net hospital. Our results suggest that these hospitals provide a benefit, most likely through the access they afford to timely and appropriate care, to uninsured and Medicaid-insured patients relative to hospitals without a safety net mission.

  15. Emergency department team communication with the patient: the patient's perspective.

    Science.gov (United States)

    McCarthy, Danielle M; Ellison, Emily P; Venkatesh, Arjun K; Engel, Kirsten G; Cameron, Kenzie A; Makoul, Gregory; Adams, James G

    2013-08-01

    Effective communication is important for the delivery of quality care. The Emergency Department (ED) environment poses significant challenges to effective communication. The objective of this study was to determine patients' perceptions of their ED team's communication skills. This was a cross-sectional study in an urban, academic ED. Patients completed the Communication Assessment Tool for Teams (CAT-T) survey upon ED exit. The CAT-T was adapted from the psychometrically validated Communication Assessment Tool (CAT) to measure patient perceptions of communication with a medical team. The 14 core CAT-T items are associated with a 5-point scale (5 = excellent); results are reported as the percent of participants who responded "excellent." Responses were analyzed for differences based on age, sex, race, and operational metrics (wait time, ED daily census). There were 346 patients identified; the final sample for analysis was 226 patients (53.5% female, 48.2% Caucasian), representing a response rate of 65.3%. The scores on CAT-T items (reported as % "excellent") ranged from 50.0% to 76.1%. The highest-scoring items were "let me talk without interruptions" (76.1%), "talked in terms I could understand" (75.2%), and "treated me with respect" (74.3%). The lowest-scoring item was "encouraged me to ask questions" (50.0%). No differences were noted based on patient sex, race, age, wait time, or daily census of the ED. The patients in this study perceived that the ED teams were respectful and allowed them to talk without interruptions; however, lower ratings were given for items related to actively engaging the patient in decision-making and asking questions. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Understanding the value of mixed methods research: the Children's Safety Initiative-Emergency Medical Services.

    Science.gov (United States)

    Hansen, Matthew; O'Brien, Kerth; Meckler, Garth; Chang, Anna Marie; Guise, Jeanne-Marie

    2016-07-01

    Mixed methods research has significant potential to broaden the scope of emergency care and specifically emergency medical services investigation. Mixed methods studies involve the coordinated use of qualitative and quantitative research approaches to gain a fuller understanding of practice. By combining what is learnt from multiple methods, these approaches can help to characterise complex healthcare systems, identify the mechanisms of complex problems such as medical errors and understand aspects of human interaction such as communication, behaviour and team performance. Mixed methods approaches may be particularly useful for out-of-hospital care researchers because care is provided in complex systems where equipment, interpersonal interactions, societal norms, environment and other factors influence patient outcomes. The overall objectives of this paper are to (1) introduce the fundamental concepts and approaches of mixed methods research and (2) describe the interrelation and complementary features of the quantitative and qualitative components of mixed methods studies using specific examples from the Children's Safety Initiative-Emergency Medical Services (CSI-EMS), a large National Institutes of Health-funded research project conducted in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Interprofessional Collaboration between General Physicians and Emergency Department Teams in Belgium: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Marlène Karam

    2017-10-01

    Full Text Available This study aimed to assess interprofessional collaboration between general physicians and emergency departments in the French speaking regions of Belgium. Eight group interviews were conducted both in rural and urban areas, including in Brussels. Findings showed that the relational components of collaboration, which are highly valued by individuals involved, comprise mutual acquaintanceship and trust, shared power and objectives. The organizational components of collaboration included out-of-hours services, role clarification, leadership and overall environment. Communication and patient’s role were also found to be key elements in enhancing or hindering collaboration across these two levels of care. Relationships between general physicians and emergency departments’ teams were tightly linked to organizational factors and the general macro-environment. Health system regulation did not appear to play a significant role in promoting collaboration between actors. A better role clarification is needed in order to foster multidisciplinary team coordination for a more efficient patient management. Finally, economic power and private practice impeded interprofessional collaboration between the care teams. In conclusion, many challenges need to be addressed for achievement of a better collaboration and more efficient integration. Not only should integration policies aim at reinforcing the role of general physicians as gatekeepers, also they should target patients’ awareness and empowerment.

  18. "We've Got Creative Differences": The Effects of Task Conflict and Participative Safety on Team Creative Performance

    Science.gov (United States)

    Fairchild, Joshua; Hunter, Samuel T.

    2014-01-01

    Although both participative safety and team task conflict are widely thought to be related to team creative performance, the nature of this relationship is still not well understood, and prior studies have frequently yielded conflicting results. This study examines the ambiguity in the extant literature and proposes that "both"…

  19. Collective leadership and safety cultures (Co-Lead): protocol for a mixed-methods pilot evaluation of the impact of a co-designed collective leadership intervention on team performance and safety culture in a hospital group in Ireland.

    Science.gov (United States)

    McAuliffe, Eilish; De Brún, Aoife; Ward, Marie; O'Shea, Marie; Cunningham, Una; O'Donovan, Róisín; McGinley, Sinead; Fitzsimons, John; Corrigan, Siobhán; McDonald, Nick

    2017-11-03

    There is accumulating evidence implicating the role of leadership in system failures that have resulted in a range of errors in healthcare, from misdiagnoses to failures to recognise and respond to patient deterioration. This has led to concerns about traditional hierarchical leadership structures and created an interest in the development of collective ways of working that distribute leadership roles and responsibilities across team members. Such collective leadership approaches have been associated with improved team performance and staff engagement. This research seeks to improve our understanding of collective leadership by addressing two specific issues: (1) Does collective leadership emerge organically (and in what forms) in a newly networked structure? and (2) Is it possible to design and implement collective leadership interventions that enable teams to collectively improve team performance and patient safety? The first phase will include a social network analysis, using an online survey and semistructured interviews at three time points over 12 months, to document the frequency of contact and collaboration between senior hospital management staff in a recently configured hospital group. This study will explore how the network of 11 hospitals is operating and will assess whether collective leadership emerges organically. Second, collective leadership interventions will be co-designed during a series of workshops with healthcare staff, researchers and patient representatives, and then implemented and evaluated with four healthcare teams within the hospital network. A mixed-methods evaluation will explore the impact of the intervention on team effectiveness and team performance indicators to assess whether the intervention is suitable for wider roll-out and evaluation across the hospital group. Favourable ethical opinion has been received from the University College Dublin Research Ethics Committee (HREC-LS-16-116397/LS-16-20). Results will be disseminated

  20. Development of the assessment method for the idealized images of teams. Investigation on the teamwork in emergency response situation (1)

    International Nuclear Information System (INIS)

    Misawa, Ryo

    2013-01-01

    Since the occurrence of the Tohoku Pacific Earthquake and the nuclear disaster in 2011, the strengthening of emergency response training has been emphasized in Japanese electric industries. When disasters and accidents occur in a nuclear power plant, workers should collaborate with each other to mitigate possible hazards and to recovery from emergencies, as self-effort is not sufficient in these times. Effective teamwork is essential for the success of emergency response. However, the aspects of teamwork that are required in emergencies remain unclear. This study developed a questionnaire instrument to assess the idealized image of effective power plant operator teams in three different levels of emergencies. A pilot test of the instrument was conducted with 21 training instructors who are subject-matter experts in nuclear power plant operation. In the questionnaire, three hypothetical situations of differing emergency levels were presented: 'normal' (routine operation), 'abnormal' (trouble shooting and malfunction correction), 'emergency' (severe accident and disaster response). The idealized image of teams in each situation was also assessed in four aspects: 'decision-making', 'coordination', 'adaptation and adjustment', and 'command and control'. Questionnaire responses were summarized in a profile form to picture the idealized images, ant the profile scores in each situation were compared. Results suggested that, the idealized image of effective teams is different depending on the level of emergency. The Implications of results for training and future research directions are discussed. (author)

  1. Safety vs. reputation: risk controversies in emerging policy networks regarding school safety in the Netherlands

    NARCIS (Netherlands)

    Binkhorst, J.; Kingma, S.F.

    2012-01-01

    This article deals with risk controversies in emerging policy networks regarding school safety in the Netherlands. It offers a grounded account of the interpretations of school risks and safety measures by the various stakeholders of the policy network, in particular, schools, local government and

  2. The Nuclear Emergency Assistance Team, a mobile intervention facility for nuclear accidents

    International Nuclear Information System (INIS)

    Koelzer, W.

    1975-01-01

    A nuclear emergency assistance team consisting of a vehicle pool and a stock of technical equipment was set up for operation in case of major reactor accidents. The equipment is kept in 6 containers which can be shipped on trucks, by rail or by helicopter or plane. Technical equipment and tasks of each container are briefly explained. Special transport vehicles for remote handling of contaminated material are described. (ORU) [de

  3. 21 CFR 25.16 - Public health and safety emergencies.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Public health and safety emergencies. 25.16... ENVIRONMENTAL IMPACT CONSIDERATIONS Agency Actions Requiring Environmental Consideration § 25.16 Public health... importance to the public health or safety, may make full adherence to the procedural provisions of NEPA and...

  4. Next Generation Public Safety and Emergency Technologies

    DEFF Research Database (Denmark)

    Bonde, Camilla; Tadayoni, Reza; Skouby, Knud Erik

    2014-01-01

    The paper researches the existing European standards for Public Safety and Emergency (PSE) services (also called Public Protection Disaster Relief “PPDR”), and identifies based on user studies in Denmark conflicts between the current deployments of the standards and the user requirements. The aim...

  5. 15 CFR 270.105 - Duties of a Team.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Duties of a Team. 270.105 Section 270... OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.105 Duties of a Team. (a) A Team's Lead...

  6. Bechtel Hanford, Inc./ERC team health and safety plan Environmental Restoration Disposal Facility operations

    International Nuclear Information System (INIS)

    Turney, S.R.

    1996-02-01

    A comprehensive safety and health program is essential for reducing work-related injuries and illnesses while maintaining a safe and health work environment. This document establishes Bechtel Hanford, Inc. (BHI)/Environmental Restoration Contractor (ERC) team requirements, policies, and procedures and provides preliminary guidance to the Environmental Restoration Disposal Facility (ERDF) subcontractor for use in preparing essential safety and health documents. This health and safety plan (HASP) defines potential safety and health issues associated with operating and maintaining the ERDF. A site-specific HASP shall be developed by the ERDF subcontractor and shall be implemented before operations and maintenance work can proceed. An activity hazard analysis (AHA) shall also be developed to provide procedures to identify, assess, and control hazards or potential incidents associated with specific operations and maintenance activities

  7. The safety implications of emerging software paradigms

    International Nuclear Information System (INIS)

    Suski, G.J.; Persons, W.L.; Johnson, G.L.

    1994-10-01

    This paper addresses some of the emerging software paradigms that may be used in developing safety-critical software applications. Paradigms considered in this paper include knowledge-based systems, neural networks, genetic algorithms, and fuzzy systems. It presents one view of the software verification and validation activities that should be associated with each paradigm. The paper begins with a discussion of the historical evolution of software verification and validation. Next, a comparison is made between the verification and validation processes used for conventional and emerging software systems. Several verification and validation issues for the emerging paradigms are discussed and some specific research topics are identified. This work is relevant for monitoring and control at nuclear power plants

  8. 'In situ simulation' versus 'off site simulation' in obstetric emergencies and their effect on knowledge, safety attitudes, team performance, stress, and motivation: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Sorensen, J.L.; Vleuten, C.P.M. van der; Lindschou, J.; Gluud, C.; Ostergaard, D.; Leblanc, V.; Johansen, M.; Ekelund, K.; Albrechtsen, C.K.; Pedersen, B.W.; Kjaergaard, H.; Weikop, P.; Ottesen, B.

    2013-01-01

    BACKGROUND: Unexpected obstetric emergencies threaten the safety of pregnant women. As emergencies are rare, they are difficult to learn. Therefore, simulation-based medical education (SBME) seems relevant. In non-systematic reviews on SBME, medical simulation has been suggested to be associated

  9. [Out of hospital emergencies towards a safety culture].

    Science.gov (United States)

    Cano-del Pozo, M I; Obón-Azuara, B; Valderrama-Rodríguez, M; Revilla-López, C; Brosed-Yuste, C; Fajardo-Trasobares, E; Garcés-Baquero, P; Mateo-Clavería, J; Molina-Estrada, I; Perona-Flores, N; Salcedo-de Dios, S; Tomé-Rey, A

    2014-01-01

    The aim of this study is to measure the degree of safety culture (CS) among healthcare professional workers of an out-of-hospital Emergency Medical Service. Most patient safety studies have been conducted in relation to the hospital rather than pre-hospital Emergency Medical Services. The objective is to analyze the dimensions with lower scores in order to plan futures strategies. A descriptive study using the AHRQ (Agency for Healthcare Research and Quality) questionnaire. The questionnaire was delivered to all healthcare professionals workers of 061 Advanced Life Support Units of Aragón, during the month of August 2013. The response rate was 55%. Main strengths detected: an adequate number of staff (96%), good working conditions (89%), tasks supported from immediate superior (77%), teamwork climate (74%), and non-punitive environment to report adverse events (68%). Areas for improvement: insufficient training in patient safety (53%) and lack of feedback of incidents reported (50%). The opportunities for improvement identified focus on the training of professionals in order to ensure safer care, while extending the safety culture. Also, the implementation of a system of notification and registration of adverse events in the service is deemed necessary. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  10. Investigation of nuclear safety regulation and emergency preparedness for other countries

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, Hitoshi; Kakuta, Akio; Yasuda, Makoto [Japan Nuclear Energy Safety Organization, Policy Planning and Coordination Department, Tokyo (Japan); Funahashi, Toshihiro [Japan Nuclear Energy Safety Organization, Nuclear Emergency Response and Prepardness Department, Tokyo (Japan)

    2012-10-15

    This investigation was carried out on organization and a role of nuclear regulatory body in the U.S., France, Germany, the U.K., Korea and Canada. In addition, nuclear emergency preparedness in these countries was investigated. A summary of this investigation is shown below. The Nuclear Regulatory Commission in the U.S. and the Nuclear Safety Authority in France have respectively headquarters and regional offices. The Nuclear Regulatory Commission has 4 regional offices and the Nuclear Safety Authority has 11 regional office. These regional offices are responsible primarily for the inspection of nuclear facilities. In Germany, the Federal Ministry of the Environment has delegated its regulatory authority to state governments, and the relevant department of each state government is in charge of inspection, oversight and approval of nuclear installations. In addition, in Korea, the U.S., and the U.K., the resident inspectors placed in each nuclear facility have the directed nuclear facilities. Meanwhile, Korea had changed its nuclear regulatory regime during this study period. The Nuclear Safety and Security Commission was newly established and took over from the Nuclear Safety Division of the Ministry of Education, Science and Technology. Regarding nuclear emergency preparedness system, it is secured that the public will be protected at the national level. And also the responding scheme and roles of regulatory agencies, operators, and the relevant ministries and agencies are identified. In addition, the licensee's responsibilities are defined. In France, existing organizations such as government organizations, governor who is appointed by the government and licensees respond to nuclear emergency. In Korea and the U.K., an emergency organization which consists of existing organizations are established and coped with nuclear emergency. In the U.S., Germany and Canada that have a federal system, the roles of state governments and the federal government are identified

  11. Safety in times of crises - the importance of industrial emergency plans

    International Nuclear Information System (INIS)

    Rademacher, H.; Schulten, R.

    1989-01-01

    Technical and organizational precautions cannot always avoid everyday risks such as accidents, fire, explosions, and other critical situations which without appropriate countermeasures can easily develop into emergencies. While in recent years considerable efforts have been going into improving the technical safety of industrial plants particularly susceptible to accidents (e.g. the nuclear and chemical industry), organizational safety seems to have been neglected. An analysis of different accidents reveals human fallibility rather than technical failures to be causing damage in many cases. Industrial emergency plans are considered to be contributing to the improvement of organizational safety. (orig.) [de

  12. Retrospective on the construction and practice of a state-level emergency medical rescue team.

    Science.gov (United States)

    Lei, Zhang; Haitao, Guo; Xin, Wang; Yundou, Wang

    2014-10-01

    For the past few years, disasters like earthquakes, landslides, mudslides, tsunamis, and traffic accidents have occurred with an ever-growing frequency, coverage, and intensity greatly beyond the expectation of the public. In order to respond effectively to disasters and to reduce casualties and property damage, countries around the world have invested more efforts in the theoretical study of emergency medicine and the construction of emergency medical rescue forces. Consequently, emergency medical rescue teams of all scales and types have come into being and have played significant roles in disaster response work. As the only state-level emergency medical rescue force from the Chinese People's Armed Police Forces, the force described here has developed, through continuous learning and practice, a characteristic mode in terms of grouping methods, equipment system construction, and training.

  13. The perception of the patient safety climate by professionals of the emergency department.

    Science.gov (United States)

    Rigobello, Mayara Carvalho Godinho; Carvalho, Rhanna Emanuela Fontenele Lima de; Guerreiro, Juliana Magalhães; Motta, Ana Paula Gobbo; Atila, Elizabeth; Gimenes, Fernanda Raphael Escobar

    2017-07-01

    The aim of this study was to assess the patient safety climate from the perspective of healthcare professionals working in the emergency department of a hospital in Brazil. Emergency departments are complex and dynamic environments. They are prone to adverse events that compromise the quality of care provided and reveal the importance of patient safety culture and climate. This was a quantitative, descriptive, cross-sectional study. The Safety Attitudes Questionnaire (SAQ) - Short Form 2006 was used for data collection, validated and adapted into Portuguese. The study sample consisted of 125 participants. Most of the participants were female (57.6%) and had worked in emergency department for more than 10years (56.8%). Sixty-two participants (49.6%) were nursing professionals. The participants demonstrated satisfaction with their jobs and dissatisfaction with the actions of management with regard to safety issues. Participants' perceptions about the patient safety climate were found to be negative. Knowledge of professionals' perceptions of patient safety climate in the context of emergency care helps with assessments of the safety culture, contributes to improvement of health care, reduces adverse events, and can focus efforts to improve the quality of care provided to patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Impact of a TeamSTEPPS Trauma Nurse Academy at a Level 1 Trauma Center.

    Science.gov (United States)

    Peters, V Kristen; Harvey, Ellen M; Wright, Andi; Bath, Jennifer; Freeman, Dan; Collier, Bryan

    2018-01-01

    Nurses are crucial members of the team caring for the acutely injured trauma patient. Until recently, nurses and physicians gained an understanding of leadership and supportive roles separately. With the advent of a multidisciplinary team approach to trauma care, formal team training and simulation has transpired. Since 2007, our Level I trauma system has integrated TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety; Agency for Healthcare Research and Quality, Rockville, MD) into our clinical care, joint training of nurses and physicians, using simulations with participation of all health care providers. With the increased expectations of a well-orchestrated team and larger number of emergency nurses, our program created the Trauma Nurse Academy. This academy provides a core of experienced nurses with an advanced level of training while decreasing the variability of personnel in the trauma bay. Components of the academy include multidisciplinary didactic education, the Essentials of TeamSTEPPS, and interactive trauma bay learning, to include both equipment and drug use. Once completed, academy graduates participate in the orientation and training of General Surgery and Emergency Medicine residents' trauma bay experience and injury prevention activities. Internal and published data have demonstrated growing evidence linking trauma teamwork training to knowledge and self-confidence in clinical judgment to team performance, patient outcomes, and quality of care. Although trauma resuscitations are stressful, high risk, dynamic, and a prime environment for error, new methods of teamwork training and collaboration among trauma team members have become essential. Copyright © 2017 Emergency Nurses Association. Published by Elsevier Inc. All rights reserved.

  15. Nuclear power safety

    International Nuclear Information System (INIS)

    1988-01-01

    The International Atomic Energy Agency, the organization concerned with worldwide nuclear safety has produced two international conventions to provide (1) prompt notification of nuclear accidents and (2) procedures to facilitate mutual assistance during an emergency. IAEA has also expanded operational safety review team missions, enhanced information exchange on operational safety events at nuclear power plants, and planned a review of its nuclear safety standards to ensure that they include the lessons learned from the Chernobyl nuclear plant accident. However, there appears to be a nearly unanimous belief among IAEA members that may attempt to impose international safety standards verified by an international inspection program would infringe on national sovereignty. Although several Western European countries have proposed establishing binding safety standards and inspections, no specific plant have been made; IAEA's member states are unlikely to adopt such standards and an inspection program

  16. Simulation-based education for building clinical teams

    Directory of Open Access Journals (Sweden)

    Marshall Stuart

    2010-01-01

    Full Text Available Failure to work as an effective team is commonly cited as a cause of adverse events and errors in emergency medicine. Until recently, individual knowledge and skills in managing emergencies were taught, without reference to the additional skills required to work as part of a team. Team training courses are now becoming commonplace, however their strategies and modes of delivery are varied. Just as different delivery methods of traditional education can result in different levels of retention and transfer to the real world, the same is true in team training of the material in different ways in traditional forms of education may lead to different levels of retention and transfer to the real world, the same is true in team training. As team training becomes more widespread, the effectiveness of different modes of delivery including the role of simulation-based education needs to be clearly understood. This review examines the basis of team working in emergency medicine, and the components of an effective emergency medical team. Lessons from other domains with more experience in team training are discussed, as well as the variations from these settings that can be observed in medical contexts. Methods and strategies for team training are listed, and experiences in other health care settings as well as emergency medicine are assessed. Finally, best practice guidelines for the development of team training programs in emergency medicine are presented.

  17. 75 FR 67807 - Pipeline Safety: Emergency Preparedness Communications

    Science.gov (United States)

    2010-11-03

    ... DEPARTMENT OF TRANSPORTATION Pipeline and Hazardous Materials Safety Administration [Docket No... is issuing an Advisory Bulletin to remind operators of gas and hazardous liquid pipeline facilities... Gas Pipeline Systems. Subject: Emergency Preparedness Communications. Advisory: To further enhance the...

  18. Trauma teams and time to early management during in situ trauma team training.

    Science.gov (United States)

    Härgestam, Maria; Lindkvist, Marie; Jacobsson, Maritha; Brulin, Christine; Hultin, Magnus

    2016-01-29

    To investigate the association between the time taken to make a decision to go to surgery and gender, ethnicity, years in profession, experience of trauma team training, experience of structured trauma courses and trauma in the trauma team, as well as use of closed-loop communication and leadership styles during trauma team training. In situ trauma team training. The patient simulator was preprogrammed to represent a severely injured patient (injury severity score: 25) suffering from hypovolemia due to external trauma. An emergency room in an urban Scandinavian level one trauma centre. A total of 96 participants were divided into 16 trauma teams. Each team consisted of six team members: one surgeon/emergency physician (designated team leader), one anaesthesiologist, one registered nurse anaesthetist, one registered nurse from the emergency department, one enrolled nurse from the emergency department and one enrolled nurse from the operating theatre. HRs with CIs (95% CI) for the time taken to make a decision to go to surgery was computed from a Cox proportional hazards model. Three variables remained significant in the final model. Closed-loop communication initiated by the team leader increased the chance of a decision to go to surgery (HR: 3.88; CI 1.02 to 14.69). Only 8 of the 16 teams made the decision to go to surgery within the timeframe of the trauma team training. Conversely, call-outs and closed-loop communication initiated by the team members significantly decreased the chance of a decision to go to surgery, (HR: 0.82; CI 0.71 to 0.96, and HR: 0.23; CI 0.08 to 0.71, respectively). Closed-loop communication initiated by the leader appears to be beneficial for teamwork. In contrast, a high number of call-outs and closed-loop communication initiated by team members might lead to a communication overload. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Safety and emergency preparedness considerations for geotechnical field operations

    Energy Technology Data Exchange (ETDEWEB)

    Wemple, R.P.

    1989-04-01

    The GEO Energy Technology Department at Sandia National Laboratories is involved in several remote-site drilling and/or experimental operations each year. In 1987, the Geothermal Research Division of the Department developed a general set of Safe Operating Procedures (SOPs) that could be applied to a variety of projects. This general set is supplemented by site-specific SOPs as needed. Effective field operations require: integration of safety and emergency preparedness planning with overall project planning, training of field personnel and inventorying of local emergency support resources, and, developing a clear line of responsibility and authority to enforce the safety requirements. Copies of SOPs used in recent operations are included as examples of working documents for the reader.

  20. Prehospital intraosseus access with the bone injection gun by a helicopter-transported emergency medical team.

    NARCIS (Netherlands)

    Gerritse, B.M.; Scheffer, G.J.; Draaisma, J.M.T.

    2009-01-01

    BACKGROUND: To evaluate the use of the bone injection gun to obtain vascular access in the prehospital setting by an Helicopter-Transported Emergency Medical Team. METHODS: Prospective descriptive study to assess the frequency and success rate of the use of the bone injection gun in prehospital care

  1. Nuclear regulatory policy concept on safety, security, safeguards and emergency preparedness (3S+EP)

    International Nuclear Information System (INIS)

    Ilyas, Zurias

    2009-01-01

    Regulatory Policy is formulated in regulations that stipulate the assurance of workers and public safety and environmental protection. Legislation and regulations on nuclear energy should consider nuclear safety, security and safeguards, as well as nuclear emergency preparedness (3S+EP) and liability for nuclear damage. Specific requirements stipulated in international conventions and agreements should also be taken into account. Regulatory Policy is formulated in regulations that stipulate the assurance of workers and public safety and environmental protection. Legislation and regulations on nuclear energy should consider nuclear safety, security and safeguards, as well as nuclear emergency preparedness (3S+EP) and liability for nuclear damage. Specific requirements stipulated in international conventions and agreements should also be taken into account. By undertaking proper regulatory oversight on Safety, Security and Emergency Preparedness (3S+EP) as an integrated and comprehensive system, safe and secure use of nuclear energy can be assured. Licence requirements and conditions should fulfil regulatory requirements pertaining to 3S+EP for nuclear installation as an integrated system. An effective emergency capacity that can be immediately mobilized is important. The capacity in protecting the personnel before, during and after the disaster should also be planned. Thus, proper emergency preparedness should be supported by adequate resources. The interface between safety, security, safeguards and emergency preparedness has to be set forth in nuclear regulations, such as regulatory requirements; 3S+EP; components, systems and structures of nuclear installations and human resources. Licensing regulations should stipulate, among others, DIQ, installations security system, safety analysis report, emergency preparedness requirements and necessary human resources that meet the 3S+EP requirements.

  2. Reducing errors in health care: cost-effectiveness of multidisciplinary team training in obstetric emergencies (TOSTI study); a randomised controlled trial

    NARCIS (Netherlands)

    van de Ven, Joost; Houterman, Saskia; Steinweg, Rob A. J. Q.; Scherpbier, Albert J. J. A.; Wijers, Willy; Mol, Ben Willem J.; Oei, S. Guid; Group, The Tosti-Trial

    2010-01-01

    ABSTRACT: BACKGROUND: There are many avoidable deaths in hospitals because the care team is not well attuned. Training in emergency situations is generally followed on an individual basis. In practice, however, hospital patients are treated by a team composed of various disciplines. To prevent

  3. Speeding Up Team Learning.

    Science.gov (United States)

    Edmondson, Amy; Bohmer, Richard; Pisano, Gary

    2001-01-01

    A study of 16 cardiac surgery teams looked at how the teams adapted to new ways of working. The challenge of team management is to implement new processes as quickly as possible. Steps for creating a learning team include selecting a mix of skills and expertise, framing the challenge, and creating an environment of psychological safety. (JOW)

  4. ASCOT guidelines revised 1996 edition. Guidelines for organizational self-assessment of safety culture and for reviews by the assessment of safety culture in organizations team

    International Nuclear Information System (INIS)

    1996-01-01

    In order to properly assess safety culture, it is necessary to consider the contribution of all organizations which have an impact on it. Therefore, while assessing the safety culture in an operating organization it is necessary to address at least its interfaces with the local regulatory agency, utility corporate headquarters and supporting organizations. These guidelines are primarily intended for use by any organization wishing to conduct a self-assessment of safety culture. They should also serve as a basis for conducting an international peer review of the organization's self-assessment carried out by an ASCOT (Assessment of Safety Culture in Organizations Team) mission

  5. Preparedness and response for a nuclear or radiological emergency. Safety requirements

    International Nuclear Information System (INIS)

    2004-01-01

    This Safety Requirements publication establishes the requirements for an adequate level of preparedness and response for a nuclear or radiological emergency in any State. Their implementation is intended to minimize the consequences for people, property and the environment of any nuclear or radiological emergency. The fulfilment of these requirements will also contribute to the harmonization of arrangements in the event of a transnational emergency. These requirements are intended to be applied by authorities at the national level by means of adopting legislation, establishing regulations and assigning responsibilities. The requirements apply to all those practices and sources that have the potential for causing radiation exposure or environmental radioactive contamination warranting an emergency intervention and that are: (a) Used in a State that chooses to adopt the requirements or that requests any of the sponsoring organizations to provide for the application of the requirements. (B) Used by States with the assistance of the FAO, IAEA, ILO, PAHO, OCHA or WHO in compliance with applicable national rules and regulations. (C) Used by the IAEA or which involve the use of materials, services, equipment, facilities and non-published information made available by the IAEA or at its request or under its control or supervision. Or (d) Used under any bilateral or multilateral arrangement whereby the parties request the IAEA to provide for the application of the requirements. The requirements also apply to the off-site jurisdictions that may need to make an emergency intervention in a State that adopts the requirements. The types of practices and sources covered by these requirements include: fixed and mobile nuclear reactors. Facilities for the mining and processing of radioactive ores. Facilities for fuel reprocessing and other fuel cycle facilities. Facilities for the management of radioactive waste. The transport of radioactive material. Sources of radiation used in

  6. A hyperacute neurology team - transforming emergency neurological care.

    Science.gov (United States)

    Nitkunan, Arani; MacDonald, Bridget K; Boodhoo, Ajay; Tomkins, Andrew; Smyth, Caitlin; Southam, Medina; Schon, Fred

    2017-07-01

    We present the results of an 18-month study of a new model of how to care for emergency neurological admissions. We have established a hyperacute neurology team at a single district general hospital. Key features are a senior acute neurology nurse coordinator, an exclusively consultant-delivered service, acute epilepsy nurses, an acute neurophysiology service supported by neuroradiology and acute physicians and based within the acute medical admissions unit. Key improvements are a major increase in the number of patients seen, the speed with which they are seen and the percentage seen on acute medical unit before going to the general wards. We have shown a reduced length of stay and readmission rates for patients with epilepsy. Epilepsy accounted for 30% of all referrals. The cost implications of running this service are modest. We feel that this model is worthy of widespread consideration. © Royal College of Physicians 2017. All rights reserved.

  7. The Emerging Role of Social Work in Primary Health Care: A Survey of Social Workers in Ontario Family Health Teams.

    Science.gov (United States)

    Ashcroft, Rachelle; McMillan, Colleen; Ambrose-Miller, Wayne; McKee, Ryan; Brown, Judith Belle

    2018-05-01

    Primary health care systems are increasingly integrating interprofessional team-based approaches to care delivery. As members of these interprofessional primary health care teams, it is important for social workers to explore our experiences of integration into these newly emerging teams to help strengthen patient care. Despite the expansion of social work within primary health care settings, few studies have examined the integration of social work's role into this expanding area of the health care system. A survey was conducted with Canadian social work practitioners who were employed within Family Health Teams (FHTs), an interprofessional model of primary health care in Ontario emerging from a period of health care reform. One hundred and twenty-eight (N = 128) respondents completed the online survey. Key barriers to social work integration in FHTs included difficulties associated with a medical model environment, confusion about social work role, and organizational barriers. Facilitators for integration of social work in FHTs included adequate education and competencies, collaborative engagement, and organizational structures.

  8. Training van crisismanagement-teams [Training of emergency management teams

    NARCIS (Netherlands)

    Berlo, M.P.W. van; Stroomer, S.; Bosch, K. van den

    2003-01-01

    Een rampenplan of bedrijfsnoodplan bestaat veelal slechts uit een lijst met telefoonnummers, of het is een plan dat niet is geactualiseerd. Bovendien is het trainen van crisismanagement-teams lastig omdat crises vaak een onvoorspelbaar karakter hebben. in deze bijdrage worden twee methoden

  9. Planning, conduct and principal features of NPP emergency exercises in Switzerland

    International Nuclear Information System (INIS)

    Baggenstos, M.

    1993-01-01

    Emergency exercises for each NPP are required on a regular basis by the Swiss Nuclear Safety Inspectorate. The purpose of such exercises is to train the NPP staff and the on-site emergency organization in the application of the emergency procedures and the cooperation with off-site emergency teams and public authorities. The paper discusses the purpose of the emergency exercises and experiences made especially with bilateral exercises. The responsibilities for the preparation and execution of the different emergency exercises in Switzerland are explained

  10. Safety assessment of emergency power systems for nuclear power plants

    International Nuclear Information System (INIS)

    1992-01-01

    This publication is intended to assist the safety assessor within a regulatory body, or one working as a consultant, in assessing the safety of a given design of the emergency power systems (EPS) for a nuclear power plant. The present publication refers closely to the NUSS Safety Guide 50-SG-D7 (Rev. 1), Emergency Power Systems at Nuclear Power Plants. It covers therefore exactly the same technical subject as that Safety Guide. In view of its objective, however, it attempts to help in the evaluation of possible technical solutions which are intended to fulfill the safety requirements. Section 2 clarifies the scope further by giving an outline of the assessment steps in the licensing process. After a general outline of the assessment process in relation to the licensing of a nuclear power plant, the publication is divided into two parts. First, all safety issues are presented in the form of questions that have to be answered in order for the assessor to be confident of a safe design. The second part presents the same topics in tabulated form, listing the required documentation which the assessor has to consult and those international and national technical standards pertinent to the topics. An extensive reference list provides information on standards. 1 tab

  11. Building Virtual Teams: Experiential Learning Using Emerging Technologies

    Science.gov (United States)

    Hu, Haihong

    2015-01-01

    Currently, virtual teams are being used exponentially in higher education and business because of the development of technologies and globalization. These teams have become an essential approach for collaborative learning as well as task completion. Team learning, especially in an online format, can be challenging due to lack of effective…

  12. Occupational Safety and Health System for Workers Engaged in Emergency Response Operations in the USA.

    Science.gov (United States)

    Toyoda, Hiroyuki; Kubo, Tatsuhiko; Mori, Koji

    2016-12-03

    To study the occupational safety and health systems used for emergency response workers in the USA, we performed interviews with related federal agencies and conducted research on related studies. We visited the Federal Emergency Management Agency (FEMA) and National Institute for Occupational Safety and Health (NIOSH) in the USA and performed interviews with their managers on the agencies' roles in the national emergency response system. We also obtained information prepared for our visit from the USA's Occupational Safety and Health Administration (OSHA). In addition, we conducted research on related studies and information on the website of the agencies. We found that the USA had an established emergency response system based on their National Incident Management System (NIMS). This enabled several organizations to respond to emergencies cooperatively using a National Response Framework (NRF) that clarifies the roles and cooperative functions of each federal agency. The core system in NIMS was the Incident Command System (ICS), within which a Safety Officer was positioned as one of the command staff supporting the commander. All ICS staff were required to complete a training program specific to their position; in addition, the Safety Officer was required to have experience. The All-Hazards model was commonly used in the emergency response system. We found that FEMA coordinated support functions, and OSHA and NIOSH, which had specific functions to protect workers, worked cooperatively under NRF. These agencies employed certified industrial hygienists that play a professional role in safety and health. NIOSH recently executed support activities during disasters and other emergencies. The USA's emergency response system is characterized by functions that protect the lives and health of emergency response workers. Trained and experienced human resources support system effectiveness. The findings provided valuable information that could be used to improve the

  13. Members of the emergency medical team may have difficulty diagnosing rapid atrial fibrillation in Wolff-Parkinson-White syndrome.

    Science.gov (United States)

    Koźluk, Edward; Timler, Dariusz; Zyśko, Dorota; Piątkowska, Agnieszka; Grzebieniak, Tomasz; Gajek, Jacek; Gałązkowski, Robert; Fedorowski, Artur

    2015-01-01

    Atrial fibrillation (AF) in patients with Wolff-Parkinson-White (WPW) syndrome is potentially life-threatening as it may deteriorate into ventricular fibrillation. The aim of this study was to assess whether the emergency medical team members are able to diagnose AF with a rapid ventricular response due to the presence of atrioventricular bypass tract in WPW syndrome. The study group consisted of 316 participants attending a national congress of emergency medicine. A total of 196 questionnaires regarding recognition and management of cardiac arrhythmias were distributed. The assessed part presented a clinical scenario with a young hemodynamically stable man who had a 12-lead electrocardiogram performed in the past with signs of pre-excitation, and who presented to the emergency team with an irregular broad QRS-complex tachycardia. A total of 71 questionnaires were filled in. Only one responder recognized AF due to WPW syndrome, while 5 other responders recognized WPW syndrome and paroxysmal supraventricular tachycardia or broad QRS-complex tachycardia. About 20% of participants did not select any diagnosis, pointing out a method of treatment only. The most common diagnosis found in the survey was ventricular tachycardia/broad QRS-complex tachycardia marked by approximately a half of the participants. Nearly 18% of participants recognized WPW syndrome, whereas AF was recognized by less than 10% of participants. Members of emergency medical teams have limited skills for recognizing WPW syndrome with rapid AF, and ventricular tachycardia is the most frequent incorrect diagnosis.

  14. The Emergency Action Plan of the Spanish Nuclear Safety Council (CSN)

    International Nuclear Information System (INIS)

    Calvin Cuarteto, M.; Camarma, J. R.; Martin Calvarro, J. M

    2007-01-01

    The Spanish Nuclear safety Council (CSN) has assigned by law among others the function to coordinate the measures of support and answer to nuclear emergency situations for all the aspects related with nuclear safety and radiological protection. Integrating and coordinating the different organisations public and private companies whose aid is necessary for the fulfilment of the functions attributed to the Regulatory Body. In order to suitable perform this function, CSN has equipped itself with an Emergency Action Plan that structures the response organization, establishes responsibility levels, incorporates basic performance procedures and includes capabilities to face the nuclear and radiological emergencies considering the external supports, resulting from the collaboration agreements with public institutions and private companies. To accomplish the above mentioned Emergency Action Plan, CSN has established and implanted a formation and training and re-training program for the organization response for emergencies and has update an operative centre (Emergency Room called Salem), equipped with infrastructures, tools and communication and operative systems that incorporate the more advanced technologies available to date. (Author)

  15. What Should I Do? A Safety and Emergency Care Handbook.

    Science.gov (United States)

    Crist, Mary Jo; And Others

    One of a series written especially for parents and other caregivers, this handbook offers an overview of emergency care and safety considerations. The discussion of emergency care focuses on supplies for the first aid kit and provides guidelines for dealing with bleeding, bites, burns, suffocation, eye injury, broken bones, head injuries, fevers,…

  16. Collaboration and patient safety at an emergency department - a qualitative case study.

    Science.gov (United States)

    Pedersen, Anna Helene Meldgaard; Rasmussen, Kurt; Grytnes, Regine; Nielsen, Kent Jacob

    2018-03-19

    Purpose The purpose of this paper is to examine how conflicts about collaboration between staff at different departments arose during the establishment of a new emergency department and how these conflicts affected the daily work and ultimately patient safety at the emergency department. Design/methodology/approach This qualitative single case study draws on qualitative semi-structured interviews and participant observation. The theoretical concepts "availability" and "receptiveness" as antecedents for collaboration will be applied in the analysis. Findings Close collaboration between departments was an essential precondition for the functioning of the new emergency department. The study shows how a lack of antecedents for collaboration affected the working relation and communication between employees and departments, which spurred negative feelings and reproduced conflicts. This situation was seen as a potential threat for the safety of the emergency patients. Research limitations/implications This study presents a single case study, at a specific point in time, and should be used as an illustrative example of how contextual and situational factors affect the working environment and through that patient safety. Originality/value Few studies provide an in-depth investigation of what actually takes place when collaboration between professional groups goes wrong and escalates, and how problems in collaboration may affect patient safety.

  17. Emergency canine surgery in a deployed forward surgical team: a case report.

    Science.gov (United States)

    Beitler, Alan L; Jeanette, Joseph P; McGraw, Andrew L; Butera, Jennifer R; Vanfosson, Christopher A; Seery, Jason M

    2011-04-01

    Forward surgical teams (FSTs) perform a variety of non-doctrinal functions. During their deployment to Afghanistan, the 541st FST (Airborne) performed emergency surgery on a German shepherd military working dog (MWD). Retrospective examination of a case of veterinary surgery in a deployed FST. A 5 1/2-year-old German shepherd MWD presented with extreme lethargy, tachycardia, excessive drooling, and a firm, distended abdomen. These conditions resulted from gastric dilatation with volvulus. Since evacuation to a veterinarian was untenable, emergency laparotomy was performed in the FST. The gastric dilatation with volvulus was treated by detorsion and gastropexy, and the canine patient fully recovered. Canine surgery can be safely performed in an FST. Based on the number of MWDs deployed throughout the theater, FSTs may be called upon to care for them in the absence of available veterinary care.

  18. Multidisciplinary safety team (MDST) factors of success.

    Science.gov (United States)

    2014-11-01

    This project included a literature review and summary that focused on subjects related to team building, team/committee member : motivational strategies, and tools for effective and efficient committee meetings. It also completed an online survey of ...

  19. Safety pharmacology — Current and emerging concepts

    International Nuclear Information System (INIS)

    Hamdam, Junnat; Sethu, Swaminathan; Smith, Trevor; Alfirevic, Ana; Alhaidari, Mohammad; Atkinson, Jeffrey; Ayala, Mimieveshiofuo; Box, Helen; Cross, Michael; Delaunois, Annie; Dermody, Ailsa; Govindappa, Karthik; Guillon, Jean-Michel; Jenkins, Rosalind; Kenna, Gerry; Lemmer, Björn; Meecham, Ken; Olayanju, Adedamola; Pestel, Sabine; Rothfuss, Andreas

    2013-01-01

    Safety pharmacology (SP) is an essential part of the drug development process that aims to identify and predict adverse effects prior to clinical trials. SP studies are described in the International Conference on Harmonisation (ICH) S7A and S7B guidelines. The core battery and supplemental SP studies evaluate effects of a new chemical entity (NCE) at both anticipated therapeutic and supra-therapeutic exposures on major organ systems, including cardiovascular, central nervous, respiratory, renal and gastrointestinal. This review outlines the current practices and emerging concepts in SP studies including frontloading, parallel assessment of core battery studies, use of non-standard species, biomarkers, and combining toxicology and SP assessments. Integration of the newer approaches to routine SP studies may significantly enhance the scope of SP by refining and providing mechanistic insight to potential adverse effects associated with test compounds. - Highlights: • SP — mandatory non-clinical risk assessments performed during drug development. • SP organ system studies ensure the safety of clinical participants in FiH trials. • Frontloading in SP facilitates lead candidate drug selection. • Emerging trends: integrating SP-Toxicological endpoints; combined core battery tests

  20. Safety pharmacology — Current and emerging concepts

    Energy Technology Data Exchange (ETDEWEB)

    Hamdam, Junnat; Sethu, Swaminathan; Smith, Trevor; Alfirevic, Ana; Alhaidari, Mohammad [MRC Centre for Drug Safety Science, University of Liverpool (United Kingdom); Atkinson, Jeffrey [Lorraine University Pharmacolor Consultants Nancy PCN (France); Ayala, Mimieveshiofuo; Box, Helen; Cross, Michael [MRC Centre for Drug Safety Science, University of Liverpool (United Kingdom); Delaunois, Annie [UCB Pharma (Belgium); Dermody, Ailsa; Govindappa, Karthik [MRC Centre for Drug Safety Science, University of Liverpool (United Kingdom); Guillon, Jean-Michel [Sanofi-aventis (France); Jenkins, Rosalind [MRC Centre for Drug Safety Science, University of Liverpool (United Kingdom); Kenna, Gerry [Astra-Zeneca (United Kingdom); Lemmer, Björn [Ruprecht-Karls-Universität Heidelberg (Germany); Meecham, Ken [Huntingdon Life Sciences (United Kingdom); Olayanju, Adedamola [MRC Centre for Drug Safety Science, University of Liverpool (United Kingdom); Pestel, Sabine [Boehringer-Ingelheim (Germany); Rothfuss, Andreas [Roche (Switzerland); and others

    2013-12-01

    Safety pharmacology (SP) is an essential part of the drug development process that aims to identify and predict adverse effects prior to clinical trials. SP studies are described in the International Conference on Harmonisation (ICH) S7A and S7B guidelines. The core battery and supplemental SP studies evaluate effects of a new chemical entity (NCE) at both anticipated therapeutic and supra-therapeutic exposures on major organ systems, including cardiovascular, central nervous, respiratory, renal and gastrointestinal. This review outlines the current practices and emerging concepts in SP studies including frontloading, parallel assessment of core battery studies, use of non-standard species, biomarkers, and combining toxicology and SP assessments. Integration of the newer approaches to routine SP studies may significantly enhance the scope of SP by refining and providing mechanistic insight to potential adverse effects associated with test compounds. - Highlights: • SP — mandatory non-clinical risk assessments performed during drug development. • SP organ system studies ensure the safety of clinical participants in FiH trials. • Frontloading in SP facilitates lead candidate drug selection. • Emerging trends: integrating SP-Toxicological endpoints; combined core battery tests.

  1. Evaluation of simparteam - a needs-orientated team training format for obstetrics and neonatology.

    Science.gov (United States)

    Zech, Alexandra; Gross, Benedict; Jasper-Birzele, Céline; Jeschke, Katharina; Kieber, Thomas; Lauterberg, Jörg; Lazarovici, Marc; Prückner, Stephan; Rall, Marcus; Reddersen, Silke; Sandmeyer, Benedikt; Scholz, Christoph; Stricker, Eric; Urban, Bert; Zobel, Astrid; Singer, Ingeborg

    2017-04-01

    A standardized team-training program for healthcare professionals in obstetric units was developed based on an analysis of common causes for adverse events found in claims registries. The interdisciplinary and inter-professional training concept included both technical and non-technical skill training. Evaluation of the program was carried out in hospitals with respect to the immediate personal learning of participants and also regarding changes in safety culture. Trainings in n=7 hospitals including n=270 participants was evaluated using questionnaires. These were administered at four points in time to staff from participating obstetric units: (1) 10 days ahead of the training (n=308), (2) on training day before (n=239), (3) right after training (n=248), and (4) 6 months after (n=188) the intervention. Questionnaires included several questions for technical and non-technical skills and the Hospital Survey on Patient Safety (HSOPS). Strong effects were found in the participants' perception of their own competence regarding technical skills and handling of emergencies. Small effects could be observed in the scales of the HSOPS questionnaire. Most effects differed depending on professional groups and hospitals. Integrated technical and team management training can raise employees' confidence with complex emergency management skills and processes. Some indications for improvements on the patient safety culture level were detected. Furthermore, differences between professional groups and hospitals were found, indicating the need for more research on contributing factors for patient safety and for the success of crew resource management (CRM) trainings.

  2. A Conceptual Framework for Studying the Safety of Transitions in Emergency Care

    National Research Council Canada - National Science Library

    Behara, Ravi; Wears, Robert L; Perry, Shawna J; Eisenberg, Eric; Murphy, Lexa; Vanderhoef, Mary; Shapiro, Marc; Beach, Christopher; Croskerry, Pat; Cosby, Karen

    2005-01-01

    .... We observed transitions of care in five hospital emergency departments as part of a larger study on safety in emergency care and found that in addition to many other differences in work patterns...

  3. Containment-emergency-sump performance. Technical findings related to Unresolved Safety Issue A-43

    International Nuclear Information System (INIS)

    1983-04-01

    This report summarizes key technical findings related to the Unresolved Safety Issue A-43, Containment Emergency Sump Performance, and provides recommendations for resolution of attendant safety issues. The key safety questions relate to: (a) effects of insulation debris on sump performance; (b) sump hydraulic performance as determined by design features, submergence, and plant induced effects, and (c) recirculation pump performance wherein air and/or particulate ingestion can occur. The technical findings presented in this report provide information relevant to the design and performance evaluation of the containment emergency sump

  4. Use of a Dedicated, Non-Physician-led Mental Health Team to Reduce Pediatric Emergency Department Lengths of Stay.

    Science.gov (United States)

    Uspal, Neil G; Rutman, Lori E; Kodish, Ian; Moore, Ann; Migita, Russell T

    2016-04-01

    Utilization of emergency departments (EDs) for pediatric mental health (MH) complaints is increasing. These patients require more resources and have higher admission rates than those with nonpsychiatric complaints. A multistage, multidisciplinary process to reduce length of stay (LOS) and improve the quality of care for patients with psychiatric complaints was performed at a tertiary care children's hospital's ED using Lean methodology. This process resulted in the implementation of a dedicated MH team, led by either a social worker or a psychiatric nurse, to evaluate patients, facilitate admissions, and arrange discharge planning. We conducted a retrospective, before-and-after study analyzing data 1 year before through 1 year after new process implementation (March 28, 2011). Our primary outcome was mean ED LOS. After process implementation there was a statistically significant decrease in mean ED LOS (332 minutes vs. 244 minutes, p vs. 204 minutes, p = 0.001), security physical interventions (2.0% vs. 0.4%, p = 0.004), and restraint use (1.7% vs. 0.1%, p safety. Use of quality improvement methodology led to a redesign that was associated with a significant reduction in mean LOS of patients with psychiatric complaints and improved ED staff perception of care. © 2016 by the Society for Academic Emergency Medicine.

  5. Training teams for emergency management

    NARCIS (Netherlands)

    Schaafstal, A.M.; Johnston, J.H.; Oser, R.L.

    2001-01-01

    Emergency management (EM), the decision making involved in directing the relief operation after a disaster or otherwise catastrophic accident is an issue of great public and private concern because of the high stakes involved. Due to the nature of emergencies, and especially mass emergencies, EM

  6. Multidisciplinary in-hospital teams improve patient outcomes: A review.

    Science.gov (United States)

    Epstein, Nancy E

    2014-01-01

    The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Acting like "well-oiled machines," multidisciplinary in-hospital teams include "staff" from different levels of the treatment pyramid (e.g. staff including nurses' aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the "silo effect" by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Multiple articles across diverse disciplines incorporate a variety of concepts of "teamwork" for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient "staff" satisfaction. Within hospitals, delivering the best medical/surgical care is a "team sport." The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers' performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their "well-oiled machines" enhancing the quality/safety of patient care, while enabling "staff" to optimize their performance and enhance their job satisfaction.

  7. Identification of training and emergency-planning needs through job-safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Veltrie, J.

    1987-01-01

    Training and emergency-planning needs within the photovoltaic industry may be more accurately determined through the performance of detailed job-safety analysis. This paper outlines the four major components of such an analysis, namely operational review, hazards evaluation, personnel review and resources evaluation. It then shows how these may be developed into coherent training and planning recommendations, for both emergency and non-emergency situations.

  8. Swiss-Slovak cooperation program: a training strategy for safety analyses

    International Nuclear Information System (INIS)

    Husarcek, J.

    2000-01-01

    During the 1996-1999 period, a new training strategy for safety analyses was implemented at the Slovak Nuclear Regulatory Authority (UJD) within the Swiss-Slovak cooperation programme in nuclear safety (SWISSLOVAK). The SWISSLOVAK project involved the recruitment, training, and integration of the newly established team into UJD's organizational structure. The training strategy consisted primarily of the following two elements: a) Probabilistic Safety Analysis (PSA) applications (regulatory review and technical evaluation of Level-1/Level-2 PSAs; PSA-based operational events analysis, PSA applications to assessment of Technical Specifications; and PSA-based hardware and/or procedure modifications) and b) Deterministic accident analyses (analysis of accidents and regulatory review of licensee Safety Analysis Reports; analysis of severe accidents/radiological releases and the potential impact of the containment and engineered safety systems, including the development of technical bases for emergency response planning; and application of deterministic methods for evaluation of accident management strategies/procedure modifications). The paper discusses the specific aspects of the training strategy performed at UJD in both the probabilistic and deterministic areas. The integration of team into UJD's organizational structure is described and examples of contributions of the team to UJD's statutory responsibilities are provided. (author)

  9. Building high reliability teams: progress and some reflections on teamwork training.

    Science.gov (United States)

    Salas, Eduardo; Rosen, Michael A

    2013-05-01

    The science of team training in healthcare has progressed dramatically in recent years. Methodologies have been refined and adapted for the unique and varied needs within healthcare, where once team training approaches were borrowed from other industries with little modification. Evidence continues to emerge and bolster the case that team training is an effective strategy for improving patient safety. Research is also elucidating the conditions under which teamwork training is most likely to have an impact, and what determines whether improvements achieved will be maintained over time. The articles in this special issue are a strong representation of the state of the science, the diversity of applications, and the growing sophistication of teamwork training research and practice in healthcare. In this article, we attempt to situate the findings in this issue within the broader context of healthcare team training, identify high level themes in the current state of the field, and discuss existing needs.

  10. The Safety Attitudes Questionnaire: psychometric properties, benchmarking data, and emerging research

    Directory of Open Access Journals (Sweden)

    Boyden James

    2006-04-01

    Full Text Available Abstract Background There is widespread interest in measuring healthcare provider attitudes about issues relevant to patient safety (often called safety climate or safety culture. Here we report the psychometric properties, establish benchmarking data, and discuss emerging areas of research with the University of Texas Safety Attitudes Questionnaire. Methods Six cross-sectional surveys of health care providers (n = 10,843 in 203 clinical areas (including critical care units, operating rooms, inpatient settings, and ambulatory clinics in three countries (USA, UK, New Zealand. Multilevel factor analyses yielded results at the clinical area level and the respondent nested within clinical area level. We report scale reliability, floor/ceiling effects, item factor loadings, inter-factor correlations, and percentage of respondents who agree with each item and scale. Results A six factor model of provider attitudes fit to the data at both the clinical area and respondent nested within clinical area levels. The factors were: Teamwork Climate, Safety Climate, Perceptions of Management, Job Satisfaction, Working Conditions, and Stress Recognition. Scale reliability was 0.9. Provider attitudes varied greatly both within and among organizations. Results are presented to allow benchmarking among organizations and emerging research is discussed. Conclusion The Safety Attitudes Questionnaire demonstrated good psychometric properties. Healthcare organizations can use the survey to measure caregiver attitudes about six patient safety-related domains, to compare themselves with other organizations, to prompt interventions to improve safety attitudes and to measure the effectiveness of these interventions.

  11. Emergency concepts for the safety level four; Notfallkonzepte der Sicherheitsebene Vier

    Energy Technology Data Exchange (ETDEWEB)

    Richner, Martin [Axpo Power AG, Doettingen (Switzerland). Kernkraftwerk Beznau

    2016-04-15

    According to the IAEA Guidelines and the Swiss Safety Guidelines the defence-in depth safety concept for a nuclear power plant consists of four safety levels. Emergency measures for the limitation of beyond design basis accidents are of safety level four. They are referred to as incident management. After the Chernobyl accident in 1986, in Switzerland the former regulatory body HSK (today ENSI) requested several retrofit measures in the field of accident management. The importance of accident management was visible again in Fukushima and demands for preventive measures grew.

  12. Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Requirements (Arabic Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication, jointly sponsored by the FAO, IAEA, ICAO, ILO, IMO, INTERPOL, OECD/NEA, PAHO, CTBTO, UNEP, OCHA, WHO and WMO, is the new edition establishing the requirements for preparedness and response for a nuclear or radiological emergency which takes into account the latest experience and developments in the area. It supersedes the previous edition of the Safety Requirements for emergency preparedness and response, Safety Standards Series No. GS-R-2, which was published in 2002. This publication establishes the requirements for ensuring an adequate level of preparedness and response for a nuclear or radiological emergency, irrespective of its cause. These Safety Requirements are intended to be used by governments, emergency response organizations, other authorities at the local, regional and national levels, operating organizations and the regulatory body as well as by relevant international organizations at the international level.

  13. Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Requirements (Russian Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication, jointly sponsored by the FAO, IAEA, ICAO, ILO, IMO, INTERPOL, OECD/NEA, PAHO, CTBTO, UNEP, OCHA, WHO and WMO, is the new edition establishing the requirements for preparedness and response for a nuclear or radiological emergency which takes into account the latest experience and developments in the area. It supersedes the previous edition of the Safety Requirements for emergency preparedness and response, Safety Standards Series No. GS-R-2, which was published in 2002. This publication establishes the requirements for ensuring an adequate level of preparedness and response for a nuclear or radiological emergency, irrespective of its cause. These Safety Requirements are intended to be used by governments, emergency response organizations, other authorities at the local, regional and national levels, operating organizations and the regulatory body as well as by relevant international organizations at the international level.

  14. Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Requirements (Chinese Edition)

    International Nuclear Information System (INIS)

    2016-01-01

    This publication, jointly sponsored by the FAO, IAEA, ICAO, ILO, IMO, INTERPOL, OECD/NEA, PAHO, CTBTO, UNEP, OCHA, WHO and WMO, is the new edition establishing the requirements for preparedness and response for a nuclear or radiological emergency which takes into account the latest experience and developments in the area. It supersedes the previous edition of the Safety Requirements for emergency preparedness and response, Safety Standards Series No. GS-R-2, which was published in 2002. This publication establishes the requirements for ensuring an adequate level of preparedness and response for a nuclear or radiological emergency, irrespective of its cause. These Safety Requirements are intended to be used by governments, emergency response organizations, other authorities at the local, regional and national levels, operating organizations and the regulatory body as well as by relevant international organizations at the international level.

  15. 15 CFR 270.104 - Size and composition of a Team.

    Science.gov (United States)

    2010-01-01

    ... 15 Commerce and Foreign Trade 1 2010-01-01 2010-01-01 false Size and composition of a Team. 270... NATIONAL INSTITUTE OF STANDARDS AND TECHNOLOGY, DEPARTMENT OF COMMERCE NATIONAL CONSTRUCTION SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.104 Size and composition of...

  16. 76 FR 23708 - Safety Zone; Pierce County Department of Emergency Management Regional Water Exercise, East...

    Science.gov (United States)

    2011-04-28

    ...-AA00 Safety Zone; Pierce County Department of Emergency Management Regional Water Exercise, East... the Regional Water Rescue Exercise. Basis and Purpose The Pierce County, Washington, Department of... to read as follows: Sec. 165.T13-0251 Safety Zone; Pierce County Department of Emergency Management...

  17. Action research, simulation, team communication, and bringing the tacit into voice society for simulation in healthcare.

    Science.gov (United States)

    Forsythe, Lydia

    2009-01-01

    In healthcare, professionals usually function in a time-constrained paradigm because of the nature of care delivery functions and the acute patient populations usually in need of emergent and urgent care. This leaves little, if no time for team reflection, or team processing as a collaborative action. Simulation can be used to create a safe space as a structure for recognition and innovation to continue to develop a culture of safety for healthcare delivery and patient care. To create and develop a safe space, three qualitative modified action research institutional review board-approved studies were developed using simulation to explore team communication as an unfolding in the acute care environment of the operating room. An action heuristic was used for data collection by capturing the participants' narratives in the form of collaborative recall and reflection to standardize task, process, and language. During the qualitative simulations, the team participants identified and changed multiple tasks, process, and language items. The simulations contributed to positive changes for task and efficiencies, team interactions, and overall functionality of the team. The studies demonstrated that simulation can be used in healthcare to define safe spaces to practice, reflect, and develop collaborative relationships, which contribute to the realization of a culture of safety.

  18. Integration of radiation monitoring for nuclear emergency response teams

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, J T; Thompson, N Y [Royal Military Coll. of Canada, Kingston, ON (Canada)

    1994-12-31

    The Canadian Forces have established Nuclear Emergency Response Teams to cope with potential radiation accidents. Previously, only gamma and high-energy beta radiation could be detected. Recently, new radiation sampling, detecting, and analytical equipment has been bought, including air samplers, beta counters, high-purity germanium gamma detectors, and multi-channel analyzers together with Gamma Vision Software to analyze gamma spectra. The purpose of the present study is to propose a way to use the new equipment, to analyze the results from the gamma and beta detectors, and to integrate the results into a format for decision making. Integration is achieved through the creation of a computer program, Radiation Integration Program (RIP). This program analyzes gross beta counts, and uses them to estimate danger to the thyroid. As well the results from Gamma Vision are converted from Bq to dose rate for several parts of the body. Overall gamma results affecting the thyroid are compared to the beta results to verify the initial estimations.

  19. Leading teams during simulated pediatric emergencies: a pilot study

    NARCIS (Netherlands)

    Coolen, E.H.; Draaisma, J.M.T.; Hamer, S. den; Loeffen, J.L.C.M.

    2015-01-01

    PURPOSE: Leadership has been identified as a key variable for the functioning of teams and as one of the main reasons for success or failure of team-based work systems. Pediatricians often function as team leaders in the resuscitation of a critically ill child. However, pediatric residents often

  20. Building Up an On-Line Plant Information System for the Emergency Response Center of the Hungarian Nuclear Safety Directorate

    International Nuclear Information System (INIS)

    Vegh, Janos; Major, Csaba; Horvath, Csaba; Hozer, Zoltan; Adorjan, Ferenc; Lux, Ivan; Horvath, Kristof

    2002-01-01

    The main design features, services, and human-machine interface characteristics are described of the CERTA VITA on-line plant information system developed and installed by KFKI AEKI at the Nuclear Safety Directorate (NSD) of the Hungarian Atomic Energy Authority (HAEA) in cooperation with experts from the NSD. The Center for Emergency Response, Training, and Analysis (CERTA) located at the headquarters of NSD, Budapest, Hungary, was established in 1997. The center supports the NSD installation, radiological monitoring, and advisory team in case of nuclear emergencies, with appropriate hardware and software for communication, diagnosis, prognosis, and prediction. The vital information transfer and analysis (VITA) system represents an important part of the CERTA, as it provides for the continuous remote inspection of the four VVER-440/V213 units of the Hungarian Paks nuclear power plant (NPP). The on-line information system maintains a continuous data link with the NPP through a managed leased line that connects CERTA to a gateway computer located at the Paks NPP. The present scope of the system is a result of a 4-yr development project: In addition to the basic safety parameter display functions, the VITA system now includes an on-line break parameter estimation module, an extensive training package based on simulated transients, and on-line data transfer capabilities to feed accident diagnosis/analysis codes

  1. Oak Ridge National Laboratory Corrective Action Plan in response to Tiger Team assessment

    International Nuclear Information System (INIS)

    1991-01-01

    This report presents a complete response to the Tiger Team assessment that was conducted to Oak Ridge National Laboratory (ORNL) and at the US Department of Energy (DOE) Oak Ridge Operations Office (ORO) from October 2, 1990, through November 30, 1990. The action plans have undergone both a discipline review and a cross-cutting review with respect to root cause. In addition, the action plans have been integrated with initiatives being pursued across Martin Marietta Energy Systems, Inc., in response to Tiger Team findings at other DOE facilities operated by Energy Systems. The root cause section is complete and describes how ORNL intends to address the root cause of the findings identified during the assessment. This report is concerned with reactors safety and health findings, responses, and planned actions. Specific areas include: organization and administration; quality verification; operations; maintenance; training and certification; auxiliary systems; emergency preparedness; technical support; nuclear criticality safety; security/safety interface; experimental activities; site/facility safety review; radiological protection; personnel protection; fire protection; management findings, responses, and planned actions; self-assessment findings, responses, and planned actions; and summary of planned actions, schedules, and costs

  2. 15 CFR 270.102 - Conditions for establishment and deployment of a Team.

    Science.gov (United States)

    2010-01-01

    ... deployment of a Team. 270.102 Section 270.102 Commerce and Foreign Trade Regulations Relating to Commerce and... SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.102 Conditions for establishment and deployment of a Team. (a) The Director may establish a Team for deployment...

  3. Collective autonomy and absenteeism within work teams: a team motivation approach.

    Science.gov (United States)

    Rousseau, Vincent; Aubé, Caroline

    2013-01-01

    This study investigates the role of collective autonomy in regard to team absenteeism by considering team potency as a motivational mediator and task routineness as a moderator. The sample consists of 90 work teams (327 members and 90 immediate superiors) drawn from a public safety organization. Results of structural equation modeling indicate that the relationships between collective autonomy and two indicators of team absenteeism (i.e., absence frequency and time lost) are mediated by team potency. Specifically, collective autonomy is positively related to team potency which in turn is negatively related to team absenteeism. Furthermore, results of hierarchical regression analyses show that task routineness moderates the relationships between collective autonomy and the two indicators of team absenteeism such that these relationships are stronger when the level of task routineness is low. On the whole, this study points out that collective autonomy may exercise a motivational effect on attendance at work within teams, but this effect is contingent on task routineness.

  4. Measures against radiation disaster/terrorism and radiation emergency medical assistance team

    International Nuclear Information System (INIS)

    Tominaga, Takako; Akashi, Makoto

    2016-01-01

    The probability of occurrence of radiological terrorism and disaster in Japan is not low. For this reason, preparations for coping with the occurrence of radiological terrorism should be an urgent issue. This paper describes the radiation medical system and the threat of radiological terrorism and disaster in Japan, and introduces the Radiation Emergency Medical Assistance Team (REMAT), one of the radiation accident/disaster response organizations at the National Institute of Radiological Sciences. Radiation exposure medical systems in Japan are constructed only in the location of nuclear facilities and adjacent prefectures. These medical systems have been developed only for the purpose of medical correspondence at the time of nuclear disaster, but preparations are not made by assuming measures against radiological terrorism. REMAT of the National Institute of Radiological Sciences is obligated to dispatch persons to the requesting prefecture to support radiation medical care in case of nuclear disaster or radiation accident. The designation of nuclear disaster orientated hospitals in each region, and the training of nuclear disaster medical staffing team were also started, but preparations are not enough. In addition to enhancing and strengthening experts, specialized agencies, and special forces dealing with radiological terrorism, it is essential to improve regional disaster management capacity and terrorism handling capacity. (A.O.)

  5. Experiences of an Engineer working in Reactor Safety and Emergency Response

    Science.gov (United States)

    Osborn, Douglas

    2015-04-01

    The U.S. Department of Energy's Federal Radiological Monitoring and Assessment Center Consequence Management Home Team (FRMAC/CMHT) Assessment Scientist's roles, responsibilities incorporate the FRMAC with other federal, state, and local agencies during a nuclear/radiological emergency. Before the Consequence Management Response Team arrives on-site, the FRMAC/CMHT provides technical and logistical support to the FRMAC and to state, local, and tribal authorities following a nuclear/radiological event. The FRMAC/CMHT support includes analyzing event data, evaluating hazards that relate to protection of the public, and providing event information and data products to protective action decision makers. The Assessment Scientist is the primary scientist responsible for performing calculations and analyses and communicating results to the field during any activation of the FRMAC/CMHT assets. As such, the FRMAC/CMHT Assessment Scientist has a number of different roles and responsibilities to fill depending upon the type of response that is required. Additionally, the Sandia National Laboratories (SNL) Consequence Assessment Team (CAT) Consequence Assessor roles, responsibilities involve hazardous materials operational emergency at SNL New Mexico facilities (SNL/NM) which include loss of control over radioactive, chemical, or explosive hazardous materials. When a hazardous materials operational emergency occurs, key decisions must be made in order to regain control over the hazards, protect personnel from the effects of the hazards, and mitigate impacts on operations, facilities, property, and the environment. Many of these decisions depend in whole or in part on the evaluation of potential consequences from a loss of control over the hazards. As such, the CAT has a number of different roles and responsibilities to fill depending upon the type of response that is required. Primary consequence-based decisions supported by the CAT during a hazardous materials operational

  6. TIA triage in emergency department using acute MRI (TIA-TEAM): a feasibility and safety study.

    Science.gov (United States)

    Vora, Nirali; Tung, Christie E; Mlynash, Michael; Garcia, Madelleine; Kemp, Stephanie; Kleinman, Jonathan; Zaharchuk, Greg; Albers, Gregory; Olivot, Jean-Marc

    2015-04-01

    Positive diffusion weighted imaging (DWI) on MRI is associated with increased recurrent stroke risk in TIA patients. Acute MRI aids in TIA risk stratification and diagnosis. To evaluate the feasibility and safety of TIA triage directly from the emergency department (ED) with acute MRI and neurological consultation. Consecutive ED TIA patients assessed by a neurologist underwent acute MRI/MRA of head/neck per protocol and were hospitalized if positive DWI, symptomatic vessel stenosis, or per clinical judgment. Stroke neurologist adjudicated the final TIA diagnosis as definite, possible, or not a cerebrovascular event. Stroke recurrence rates were calculated at 7, 90, 365 days and compared with predicted stroke rates derived from historical DWI and ABCD(2) score data. One hundred twenty-nine enrolled patients had a mean age of 69 years (± 17) and median ABCD(2) score of 3 (interquartile range [IQR] 3-4). During triage, 112 (87%) patients underwent acute MRI after a median of 16 h (IQR 10-23) from symptom onset. No patients experienced a recurrent event before imaging. Twenty-four (21%) had positive DWI and 8 (7%) had symptomatic vessel stenosis. Of the total cohort, 83 (64%) were discharged and 46 (36%) were hospitalized. By one-year follow-up, one patient in each group had experienced a stroke. Of 92 patients with MRI and index cerebrovascular event, recurrent stroke rates were 1.1% at 7 and 90 days. These were similar to predicted recurrence rates. TIA triage in the ED using a protocol with neurological consultation and acute MRI is feasible and safe. The majority of patients were discharged without hospitalization and rates of recurrent stroke were not higher than predicted. © 2014 World Stroke Organization.

  7. Team Regulation in a Simulated Medical Emergency: An In-Depth Analysis of Cognitive, Metacognitive, and Affective Processes

    Science.gov (United States)

    Duffy, Melissa C.; Azevedo, Roger; Sun, Ning-Zi; Griscom, Sophia E.; Stead, Victoria; Crelinsten, Linda; Wiseman, Jeffrey; Maniatis, Thomas; Lachapelle, Kevin

    2015-01-01

    This study examined the nature of cognitive, metacognitive, and affective processes among a medical team experiencing difficulty managing a challenging simulated medical emergency case by conducting in-depth analysis of process data. Medical residents participated in a simulation exercise designed to help trainees to develop medical expertise,…

  8. Effective Strategies to Spread Redesigning Care Processes Among Healthcare Teams.

    Science.gov (United States)

    Lavoie-Tremblay, Mélanie; O'Connor, Patricia; Lavigne, Geneviève L; Briand, Anaïck; Biron, Alain; Baillargeon, Sophie; MacGibbon, Brenda; Ringer, Justin; Cyr, Guylaine

    2015-07-01

    The purpose of this study was to describe how spread strategies facilitate the successful implementation of the Transforming Care at the Bedside (TCAB) program and their impact on healthcare workers and patients in a major Canadian healthcare organization. This study used a qualitative and descriptive design with focus groups and individual interviews held in May 2014. Participants included managers and healthcare providers from eight TCAB units in a university health center in Quebec, Canada. The sample was composed of 43 individuals. The data were analyzed using NVivo according to the method proposed by Miles and Huberman. The first two themes that emerged from the analysis are related to context (organizational transition requiring many changes) and spread strategies for the TCAB program (senior management support, release time and facilitation, rotation of team members, learning from previous TCAB teams, and engaging patients). The last theme that emerged from the analysis is the impact on healthcare professionals (providing front-line staff and managers with the training they need to make changes, team leadership, and increasing receptivity to hearing patients' and families' needs and requests). This study describes the perspectives of managers and team members to provide a better understanding of how spread strategies can facilitate the successful implementation of the TCAB program in a Canadian healthcare organization. Spread strategies facilitate the implementation of changes to improve the quality and safety of care provided to patients. © 2015 Sigma Theta Tau International.

  9. [Professional satisfaction for doctors of the Mobile Emergency Team and the Emergency Coordinator Office 061. Region of Murcia].

    Science.gov (United States)

    Carrillo-García, C; Martínez-Roche, M E; Vivo-Molina, M C; Quiñonero-Méndez, F; Gómez-Sánchez, R; Celdrán-Gil, F

    2014-01-01

    The objective was to analyze the phenomenon of work satisfaction of doctors of the Mobile Emergency Team and the Emergency Coordinator Office 061 of the Region of Murcia. A observational, analytical and cross-sectional study of development carried out with the medical staff of the Casualty and Emergency Operations Department 061 of the Region of Murcia. Data collection was carried out in December 2013 and January 2014. NTP 394 was used. Work satisfaction: general satisfaction scale. nonparametric tests for 2 samples or k samples depending on type of comparison. A participation rate of 88.2% was obtained, in relation to the general job satisfaction, the average of the participants was 69.55 (SD = 14.4). Of the 15 items that make up the questionnaire, « work colleagues » is the factor with which doctors are more satisfied with, indicating that up to an 87%, show a positive assessment on this point. Being the second aspect most respondents valued their « job stability » with a percentage of positive ratings of 76.7%. The main findings clearly demonstrate the importance of inter-professional relations and human potential as the cornerstone in the exercise of the activity of healthcare professionals. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  10. A Quantitative Team Situation Awareness Measurement Method Considering Technical and Nontechnical Skills of Teams

    Directory of Open Access Journals (Sweden)

    Ho Bin Yim

    2016-02-01

    Full Text Available Human capabilities, such as technical/nontechnical skills, have begun to be recognized as crucial factors for nuclear safety. One of the most common ways to improve human capabilities in general is training. The nuclear industry has constantly developed and used training as a tool to increase plant efficiency and safety. An integrated training framework was suggested for one of those efforts, especially during simulation training sessions of nuclear power plant operation teams. The developed training evaluation methods are based on measuring the levels of situation awareness of teams in terms of the level of shared confidence and consensus as well as the accuracy of team situation awareness. Verification of the developed methods was conducted by analyzing the training data of real nuclear power plant operation teams. The teams that achieved higher level of shared confidence showed better performance in solving problem situations when coupled with high consensus index values. The accuracy of nuclear power plant operation teams' situation awareness was approximately the same or showed a similar trend as that of senior reactor operators' situation awareness calculated by a situation awareness accuracy index (SAAI. Teams that had higher SAAI values performed better and faster than those that had lower SAAI values.

  11. Development of a health and safety manual for emergency response operations

    International Nuclear Information System (INIS)

    Riland, C.A.; Junio, S.S.

    2000-01-01

    The Federal Radiological Monitoring and Assessment Center (FRMAC) Health and Safety Manual, which has been under development by a multi-agency group, is nearing completion and publication. The manual applies to offsite monitoring during a radiological accident or incident. Though written for multi-agency offsite monitoring activities (FRMAC), the manual is generic in nature and should be readily adaptable for other emergency response operations. Health and safety issues for emergency response situations often differ from those of normal operations. Examples of these differences and methodologies to address these issues are discussed. Challenges in manual development, including lack of regulatory and guidance documentation, are also discussed. One overriding principle in the Health and Safety Manual development is the overall reduction of risk, not just dose. The manual is broken into several chapters, which include Overview of Responsibities, Health Physics, Industrial Hygiene and Safey, Medical, and Environmental Compliance and Records. Included is a series of appendices, which presents additional information on forms and plans for default scenarios

  12. Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME.

    Science.gov (United States)

    Vanderbilt, Allison A; Pappada, Scott M; Stein, Howard; Harper, David; Papadimos, Thomas J

    2017-01-01

    Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one's knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum.

  13. Teamwork education improves trauma team performance in undergraduate health professional students.

    Science.gov (United States)

    Baker, Valerie O'Toole; Cuzzola, Ronald; Knox, Carolyn; Liotta, Cynthia; Cornfield, Charles S; Tarkowski, Robert D; Masters, Carolynn; McCarthy, Michael; Sturdivant, Suzanne; Carlson, Jestin N

    2015-01-01

    Effective trauma resuscitation requires efficient and coordinated care from a team of providers; however, providers are rarely instructed on how to be effective members of trauma teams. Team-based learning using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) has been shown to improve team dynamics among practicing professionals, including physicians and nurses. The impact of TeamSTEPPS on students being trained in trauma management in an undergraduate health professional program is currently unknown. We sought to determine the impact of TeamSTEPPS on team dynamics among undergraduate students being trained in trauma resuscitation. We enrolled teams of undergraduate health professional students from four programs: nursing, physician assistant, radiologic science, and respiratory care. After completing an online training on trauma resuscitation principles, the participants completed a trauma resuscitation scenario. The participants then received teamwork training using TeamSTEPPS and completed a second trauma resuscitation scenario identical to the first. All resuscitations were recorded and scored offline by two blinded research assistants using both the Team Emergency Assessment Measure (TEAM) and Trauma Team Performance Observation Tool (TPOT) scoring systems. Pre-test and post-test TEAM and TPOT scores were compared. We enrolled a total of 48 students in 12 teams. Team leadership, situational monitoring, and overall communication improved with TeamSTEPPS training (P=0.04, P=0.02, and P=0.03, respectively), as assessed by the TPOT scoring system. TeamSTEPPS also improved the team's ability to prioritize tasks and work together to complete tasks in a rapid manner (P<0.01 and P=0.02, respectively) as measured by TEAM. Incorporating TeamSTEPPS into trauma team education leads to improved TEAM and TPOT scores among undergraduate health professionals.

  14. The management of health and safety at Atomic Weapons Establishment premises. Pt. 2: Detailed findings

    International Nuclear Information System (INIS)

    1994-10-01

    A review of the management of health and safety and the standards of risk control at premises run by Atomic Weapons Establishment plc (AWE) in the United Kingdom was completed in January 1994. This second volume of the review report records the findings relating to the eight health and safety topics chosen as the focus of the review because they provide evidence from AWE's key areas of activity. The topics are: Layard identification and risk assessment; operations; maintenance; research and experimentation; new facilities and modifications; decommissioning and waste; emergency preparedness; and health and safety specialist function. The Health and Safety Executive review team spent time at each of the four main AWE sites and observed an emergency exercise at Aldermaston. A report on the emergency exercise is included as an appendix. (UK)

  15. Expert forecast on emerging psychosocial risks related to occupational safety and health

    NARCIS (Netherlands)

    Milczarek, M.; Brun, E.; Houtman, I.; Goudswaard, A.; Evers, M.; Bovenkamp, M. van de; Roskams, N.; Op de Beeck, R.; Pahkin, K.; Berthet, M.; Morvan, E.; Kuhn, K.; Kaluza, K.; Hupke, M.; Hauke, A.; Reinert, D.; Widerszal-Bazyl, M.; Perez, J.; Oncins de Frutos, M.

    2007-01-01

    This report is in cooperation with TNO Work and Employment and the European Agency for Safety and Health at Work. The expert forecast on emerging psychosocial risks was carried out by means of the Delphi method. The main emerging psychosocial risks revealed were related to new forms of employment

  16. Crisis Resources for Emergency Workers (CREW II): results of a pilot study and simulation-based crisis resource management course for emergency medicine residents.

    Science.gov (United States)

    Hicks, Christopher M; Kiss, Alex; Bandiera, Glen W; Denny, Christopher J

    2012-11-01

    Emergency department resuscitation requires the coordinated efforts of an interdisciplinary team. Aviation-based crisis resource management (CRM) training can improve safety and performance during complex events. We describe the development, piloting, and multilevel evaluation of "Crisis Resources for Emergency Workers" (CREW), a simulation-based CRM curriculum for emergency medicine (EM) residents. Curriculum development was informed by an a priori needs assessment survey. We constructed a 1-day course using simulated resuscitation scenarios paired with focused debriefing sessions. Attitudinal shifts regarding team behaviours were assessed using the Human Factors Attitude Survey (HFAS). A subset of 10 residents participated in standardized pre- and postcourse simulated resuscitation scenarios to quantify the effect of CREW training on our primary outcome of CRM performance. Pre/post scenarios were videotaped and scored by two blinded reviewers using a validated behavioural rating scale, the Ottawa CRM Global Rating Scale (GRS). Postcourse survey responses were highly favourable, with the majority of participants reporting that CREW training can reduce errors and improve patient safety. There was a nonsignificant trend toward improved team-based attitudes as assessed by the HFAS (p  =  0.210). Postcourse performance demonstrated a similar trend toward improved scores in all categories on the Ottawa GRS (p  =  0.16). EM residents find simulation-based CRM instruction to be useful, effective, and highly relevant to their practice. Trends toward improved performance and attitudes may have arisen because our study was underpowered to detect a difference. Future efforts should focus on interdisciplinary training and recruiting a larger sample size.

  17. Reactor Safety Assessment System--A situation assessment aid for USNRC emergency response

    International Nuclear Information System (INIS)

    Bray, M.A.; Sebo, D.E.; Dixon, B.W.

    1985-01-01

    The Reactor Safety Assessment System (RSAS) is an expert system under development for the United States Nuclear Regulatory Commission (USNRC). RSAS is intended for use at the NRC's Operations Center in the event of a serious incident at a licensed nuclear power plant. The system uses plant parameter data and status information from the power plant. It has a rule base that uses the parametric values, the known operator actions, and the time sequence information in the data to generate situation assessment conclusions for use by the NRC Reactor Safety Team. RSAS rules currently cover one specific reactor type and use setpoints specific to one power plant

  18. Reactor Safety Assessment System: a situation assessment aid for USNRC emergency response

    International Nuclear Information System (INIS)

    Bray, M.A.; Sebo, D.E.; Dixon, B.W.

    1985-04-01

    The Reactor Safety Assessment System is an expert system under development for the United States Nuclear Regulatory Commission (NRC). RSAS is intended for use at the NRC's Operations Center in the event of a serious incident at a licensed nuclear power plant. The system uses plant parameter data and status information from the power plant. It has a rule base which uses the parametric values, the known operator actions and the time sequence information in the data to generate situation assessment conclusions for use by the NRC Reactor Safety Team. RSAS rules currently cover one specific reactor type and use setpoints specific to one power plant. 5 figs

  19. Teamwork education improves trauma team performance in undergraduate health professional students

    Directory of Open Access Journals (Sweden)

    Valerie O’Toole Baker

    2015-06-01

    Full Text Available Purpose: Effective trauma resuscitation requires efficient and coordinated care from a team of providers; however, providers are rarely instructed on how to be effective members of trauma teams. Team-based learning using Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS has been shown to improve team dynamics among practicing professionals, including physicians and nurses. The impact of TeamSTEPPS on students being trained in trauma management in an undergraduate health professional program is currently unknown. We sought to determine the impact of TeamSTEPPS on team dynamics among undergraduate students being trained in trauma resuscitation. Methods: We enrolled teams of undergraduate health professional students from four programs: nursing, physician assistant, radiologic science, and respiratory care. After completing an online training on trauma resuscitation principles, the participants completed a trauma resuscitation scenario. The participants then received teamwork training using TeamSTEPPS and completed a second trauma resuscitation scenario identical to the first. All resuscitations were recorded and scored offline by two blinded research assistants using both the Team Emergency Assessment Measure (TEAM and Trauma Team Performance Observation Tool (TPOT scoring systems. Pre-test and post-test TEAM and TPOT scores were compared. Results: We enrolled a total of 48 students in 12 teams. Team leadership, situational monitoring, and overall communication improved with TeamSTEPPS training (P=0.04, P=0.02, and P=0.03, respectively, as assessed by the TPOT scoring system. TeamSTEPPS also improved the team’s ability to prioritize tasks and work together to complete tasks in a rapid manner (P<0.01 and P=0.02, respectively as measured by TEAM. Conclusions: Incorporating TeamSTEPPS into trauma team education leads to improved TEAM and TPOT scores among undergraduate health professionals.

  20. Physical design correlates of efficiency and safety in emergency departments: a qualitative examination.

    Science.gov (United States)

    Pati, Debajyoti; Harvey, Thomas E; Pati, Sipra

    2014-01-01

    The objective of this study was to explore and identify physical design correlates of safety and efficiency in emergency department (ED) operations. This study adopted an exploratory, multimeasure approach to (1) examine the interactions between ED operations and physical design at 4 sites and (2) identify domains of physical design decision-making that potentially influence efficiency and safety. Multidisciplinary gaming and semistructured interviews were conducted with stakeholders at each site. Study data suggest that 16 domains of physical design decisions influence safety, efficiency, or both. These include (1) entrance and patient waiting, (2) traffic management, (3) subwaiting or internal waiting areas, (4) triage, (5) examination/treatment area configuration, (6) examination/treatment area centralization versus decentralization, (7) examination/treatment room standardization, (8) adequate space, (9) nurse work space, (10) physician work space, (11) adjacencies and access, (12) equipment room, (13) psych room, (14) staff de-stressing room, (15) hallway width, and (16) results waiting area. Safety and efficiency from a physical environment perspective in ED design are mutually reinforcing concepts--enhancing efficiency bears positive implications for safety. Furthermore, safety and security emerged as correlated concepts, with security issues bearing implications for safety, thereby suggesting important associations between safety, security, and efficiency.

  1. A crew resource management program tailored to trauma resuscitation improves team behavior and communication.

    Science.gov (United States)

    Hughes, K Michael; Benenson, Ronald S; Krichten, Amy E; Clancy, Keith D; Ryan, James Patrick; Hammond, Christopher

    2014-09-01

    Crew Resource Management (CRM) is a team-building communication process first implemented in the aviation industry to improve safety. It has been used in health care, particularly in surgical and intensive care settings, to improve team dynamics and reduce errors. We adapted a CRM process for implementation in the trauma resuscitation area. An interdisciplinary steering committee developed our CRM process to include a didactic classroom program based on a preimplementation survey of our trauma team members. Implementation with new cultural and process expectations followed. The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tool were used to design, evaluate, and validate our CRM program. The initial trauma communication survey was completed by 160 team members (49% response). Twenty-five trauma resuscitations were observed and scored using Communication and Teamwork Skills. Areas of concern were identified and 324 staff completed our 3-hour CRM course during a 3-month period. After CRM training, 132 communication surveys and 38 Communication and Teamwork Skills observations were completed. In the post-CRM survey, respondents indicated improvement in accuracy of field to medical command information (p = 0.029); accuracy of emergency department medical command information to the resuscitation area (p = 0.002); and team leader identity, communication of plan, and role assignment (p = 0.001). After CRM training, staff were more likely to speak up when patient safety was a concern (p = 0.002). Crew Resource Management in the trauma resuscitation area enhances team dynamics, communication, and, ostensibly, patient safety. Philosophy and culture of CRM should be compulsory components of trauma programs and in resuscitation of injured patients. Copyright © 2014 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  2. 76 FR 23810 - Public Safety and Homeland Security Bureau; Federal Advisory Committee Act; Emergency Response...

    Science.gov (United States)

    2011-04-28

    ... FEDERAL COMMUNICATIONS COMMISSION Public Safety and Homeland Security Bureau; Federal Advisory Committee Act; Emergency Response Interoperability Center Public Safety Advisory Committee Meeting AGENCY... Fullano, Associate Chief, Public Safety and Homeland Security Bureau, Federal Communications Commission...

  3. 15 CFR 270.106 - Conflicts of interest related to service on a Team.

    Science.gov (United States)

    2010-01-01

    ... service on a Team. 270.106 Section 270.106 Commerce and Foreign Trade Regulations Relating to Commerce and... SAFETY TEAMS NATIONAL CONSTRUCTION SAFETY TEAMS Establishment and Deployment of Teams § 270.106 Conflicts of interest related to service on a Team. (a) Team members who are not Federal employees will be...

  4. IAEA Leads Operational Safety Mission to Muehleberg Nuclear Power Plant

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: An international team of nuclear safety experts led by the International Atomic Energy Agency today concluded a review of the safety practices at the Muehleberg Nuclear Power Plant (NPP) near Bern in Switzerland. The team noted a series of good practices and made recommendations and suggestions to reinforce them. The IAEA assembled the Operational Safety Review Team at the request of the Swiss government. The team, led by the IAEA's Division of Nuclear Installation Safety, performed an in-depth operational safety review from 8 to 25 October 2012. The team comprised experts from Belgium, the Czech Republic, Finland, Germany, Hungary, Slovakia, Sweden, the United Kingdom and the United States as well as experts from the IAEA. The team conducted an in-depth review of the aspects essential to the safe operation of the Muehleberg NPP. The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Training; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry, Emergency Planning and Preparedness, Severe Accident Management and Long-Term Operation. The OSART team made 10 recommendations and 11 suggestions related to areas where operations of Muehleberg NPP could be further improved, for example: - Plant management could improve the operating experience program and methods throughout the plant to ensure corrective actions are taken in a timely manner; - In the area of Long-Term Operation, the ageing management review for some systems and components is not complete and the environmental qualification of originally installed safety cables has not yet been revalidated for long-term operation; and - The plant provisions for the protection of persons on the site during an emergency with radioactive release can be improved to minimize health risks to plant personnel. The team also identified 10 good

  5. Emergency response and nuclear risk governance. Nuclear safety at nuclear power plant accidents

    International Nuclear Information System (INIS)

    Kuhlen, Johannes

    2014-01-01

    The present study entitled ''Emergency Response and Nuclear Risk Governance: nuclear safety at nuclear power plant accidents'' deals with issues of the protection of the population and the environment against hazardous radiation (the hazards of nuclear energy) and the harmful effects of radioactivity during nuclear power plant accidents. The aim of this study is to contribute to both the identification and remediation of shortcomings and deficits in the management of severe nuclear accidents like those that occurred at Chernobyl in 1986 and at Fukushima in 2011 as well as to the improvement and harmonization of plans and measures taken on an international level in nuclear emergency management. This thesis is divided into a theoretical part and an empirical part. The theoretical part focuses on embedding the subject in a specifically global governance concept, which includes, as far as Nuclear Risk Governance is concerned, the global governance of nuclear risks. Due to their characteristic features the following governance concepts can be assigned to these risks: Nuclear Safety Governance is related to safety, Nuclear Security Governance to security and NonProliferation Governance to safeguards. The subject of investigation of the present study is as a special case of the Nuclear Safety Governance, the Nuclear Emergency governance, which refers to off-site emergency response. The global impact of nuclear accidents and the concepts of security, safety culture and residual risk are contemplated in this context. The findings (accident sequences, their consequences and implications) from the analyses of two reactor accidents prior to Fukushima (Three Mile Iceland in 1979, Chernobyl in 1986) are examined from a historical analytical perspective and the state of the Nuclear Emergency governance and international cooperation aimed at improving nuclear safety after Chernobyl is portrayed by discussing, among other topics, examples of &apos

  6. Psychometric test of the Team Climate Inventory-short version investigated in Dutch quality improvement teams

    Directory of Open Access Journals (Sweden)

    Nieboer Anna P

    2009-07-01

    Full Text Available Abstract Background Although some studies have used the Team Climate Inventory within teams working in health care settings, none of these included quality improvement teams. The aim of our study is to investigate the psychometric properties of the 14-item version of the Team Climate Inventory in healthcare quality improvement teams participating in a Dutch quality collaborative. Methods This study included quality improvement teams participating in the Care for Better improvement program for home care, care for the handicapped and the elderly in the Netherlands between 2006 and 2008. As part of a larger evaluation study 270 written questionnaires from team members were collected at baseline and 139 questionnaires at end measurement. Confirmatory factor analyses, reliability, Pearson correlations and paired samples t-tests were conducted to investigate construct validity, reliability, predictive validity and temporal stability. Results Confirmatory factor analyses revealed the expected four-factor structure and good fit indices. For the four subscales – vision, participative safety, task orientation and support for innovation – acceptable Cronbach's alpha coefficients and high inter-item correlations were found. The four subscales all proved significant predictors of perceived team effectiveness, with participatory safety being the best predictor. As expected the four subscales were found to be stable over time; i.e. without significant changes between baseline and end measurement. Conclusion The psychometric properties of the Dutch version of the TCI-14 are satisfactory. Together these results show that the TCI-14 is a useful instrument to assess to what extent aspects of team climate influence perceived team effectiveness of quality improvement teams.

  7. Psychometric test of the Team Climate Inventory-short version investigated in Dutch quality improvement teams.

    Science.gov (United States)

    Strating, Mathilde M H; Nieboer, Anna P

    2009-07-24

    Although some studies have used the Team Climate Inventory within teams working in health care settings, none of these included quality improvement teams. The aim of our study is to investigate the psychometric properties of the 14-item version of the Team Climate Inventory in healthcare quality improvement teams participating in a Dutch quality collaborative. This study included quality improvement teams participating in the Care for Better improvement program for home care, care for the handicapped and the elderly in the Netherlands between 2006 and 2008. As part of a larger evaluation study 270 written questionnaires from team members were collected at baseline and 139 questionnaires at end measurement. Confirmatory factor analyses, reliability, Pearson correlations and paired samples t-tests were conducted to investigate construct validity, reliability, predictive validity and temporal stability. Confirmatory factor analyses revealed the expected four-factor structure and good fit indices. For the four subscales--vision, participative safety, task orientation and support for innovation--acceptable Cronbach's alpha coefficients and high inter-item correlations were found. The four subscales all proved significant predictors of perceived team effectiveness, with participatory safety being the best predictor. As expected the four subscales were found to be stable over time; i.e. without significant changes between baseline and end measurement. The psychometric properties of the Dutch version of the TCI-14 are satisfactory. Together these results show that the TCI-14 is a useful instrument to assess to what extent aspects of team climate influence perceived team effectiveness of quality improvement teams.

  8. Evaluation of Coordination of Emergency Response Team through the Social Network Analysis. Case Study: Oil and Gas Refinery.

    Science.gov (United States)

    Mohammadfam, Iraj; Bastani, Susan; Esaghi, Mahbobeh; Golmohamadi, Rostam; Saee, Ali

    2015-03-01

    The purpose of this study was to examine the cohesions status of the coordination within response teams in the emergency response team (ERT) in a refinery. For this study, cohesion indicators of social network analysis (SNA; density, degree centrality, reciprocity, and transitivity) were utilized to examine the coordination of the response teams as a whole network. The ERT of this research, which was a case study, included seven teams consisting of 152 members. The required data were collected through structured interviews and were analyzed using the UCINET 6.0 Social Network Analysis Program. The results reported a relatively low number of triple connections, poor coordination with key members, and a high level of mutual relations in the network with low density, all implying that there were low cohesions of coordination in the ERT. The results showed that SNA provided a quantitative and logical approach for the examination of the coordination status among response teams and it also provided a main opportunity for managers and planners to have a clear understanding of the presented status. The research concluded that fundamental efforts were needed to improve the presented situations.

  9. Factors predicting adherence with psychiatric follow-up appointments for patients assessed by the liaison psychiatric team in the emergency department.

    LENUS (Irish Health Repository)

    Agyapong, Vincent I O

    2010-01-01

    Several factors may predict adherence with psychiatric follow-up appointment for patients seen in the emergency department (ED) by liaison psychiatric teams. Awareness of these factors would allow for interventions targeted at vulnerable groups.

  10. IAEA Leads Operational Safety Mission To Gravelines Nuclear Power Plant, France

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: An IAEA-led international team of experts today began an in-depth operational safety review of the Gravelines Nuclear Power Plant in France. The review, conducted at the invitation of the French government, focuses on programmes and activities essential to the safe operation of the nuclear power plant. The three-week review will cover the areas of Management, Organization and Administration; Training and Qualification; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry; Emergency Planning and Preparedness; and Severe Accident Management. The conclusions of the review will be based on the IAEA Safety Standards and on well-established international good practices. The mission is not a regulatory inspection, a design review or a substitute for an exhaustive assessment of the plant's overall safety status. The team, led by the IAEA's Division of Nuclear Installation Safety, comprises experts from Bulgaria, China, Germany, Hungary, Japan, Romania, Slovakia, South Africa, Spain and Ukraine. The Gravelines mission is the 173rd conducted as part of the IAEA's Operational Safety Review Team programme, which began in 1982. France participates actively in the programme and the Gravelines mission is the 24th hosted by the country. General information about OSART missions can be found on the IAEA Website: OSART Missions. (IAEA)

  11. Increasing patient safety with neonates via handoff communication during delivery: a call for interprofessional health care team training across GME and CME

    Directory of Open Access Journals (Sweden)

    Vanderbilt AA

    2017-06-01

    Full Text Available Allison A Vanderbilt,1 Scott M Pappada,2 Howard Stein,3 David Harper,4 Thomas J Papadimos5 1Department of Family Medicine, 2Department of Anesthesiology, College of Medicine and Life Sciences, University of Toledo, 3Department of Pediatrics, ProMedica Toledo Children’s Hospital, 4Department of Obstetrics and Gynecology, ProMedica Toledo Hospital, 5Department of Anesthesiology, College of Medicine and the Life Sciences, University of Toledo, Toledo, OH, USA Abstract: Hospitals have struggled for years regarding the handoff process of communicating patient information from one health care professional to another. Ineffective handoff communication is recognized as a serious patient safety risk within the health care community. It is essential to take communication into consideration when examining the safety of neonates who require immediate medical attention after birth; effective communication is vital for positive patient outcomes, especially with neonates in a delivery room setting. Teamwork and effective communication across the health care continuum are essential for providing efficient, quality care that leads to favorable patient outcomes. Interprofessional simulation and team training can benefit health care professionals by improving interprofessional competence, defined as one’s knowledge of other professionals including an understanding of their training and skillsets, and role clarity. Interprofessional teams that include members with specialization in obstetrics, gynecology, and neonatology have the potential to considerably benefit from training effective handoff and communication practices that would ensure the safety of the neonate upon birth. We must strive to provide the most comprehensive systematic, standardized, interprofessional handoff communication training sessions for such teams, through Graduate Medical Education and Continuing Medical Education that will meet the needs across the educational continuum. Keywords

  12. [Innovative training for enhancing patient safety. Safety culture and integrated concepts].

    Science.gov (United States)

    Rall, M; Schaedle, B; Zieger, J; Naef, W; Weinlich, M

    2002-11-01

    Patient safety is determined by the performance safety of the medical team. Errors in medicine are amongst the leading causes of death of hospitalized patients. These numbers call for action. Backgrounds, methods and new forms of training are introduced in this article. Concepts from safety research are transformed to the field of emergency medical treatment. Strategies from realistic patient simulator training sessions and innovative training concepts are discussed. The reasons for the high numbers of errors in medicine are not due to a lack of medical knowledge, but due to human factors and organisational circumstances. A first step towards an improved patient safety is to accept this. We always need to be prepared that errors will occur. A next step would be to separate "error" from guilt (culture of blame) allowing for a real analysis of accidents and establishment of meaningful incident reporting systems. Concepts with a good success record from aviation like "crew resource management" (CRM) training have been adapted my medicine and are ready to use. These concepts require theoretical education as well as practical training. Innovative team training sessions using realistic patient simulator systems with video taping (for self reflexion) and interactive debriefing following the sessions are very promising. As the need to reduce error rates in medicine is very high and the reasons, methods and training concepts are known, we are urged to implement these new training concepts widely and consequently. To err is human - not to counteract it is not.

  13. Is culture associated with patient safety in the emergency department? A study of staff perspectives.

    NARCIS (Netherlands)

    Verbeek-van Noord, I.; Wagner, C.; Dyck, C. van; Twisk, J.W.R.; Bruijne, M.C. de

    2014-01-01

    Objective: To describe the patient safety culture of Dutch emergency departments (EDs), to examine associations between safety culture dimensions and patient safety grades as reported by ED staff and to compare these associations between nurses and physicians. DESIGN: Cross-sectional survey

  14. Managing Geographically Dispersed Teams: From Temporary to Permanent Global Virtual Teams

    DEFF Research Database (Denmark)

    Svane Hansen, Tine; Hope, Alexander John; Moehler, Robert C.

    2012-01-01

    for organisations to move towards establishing permanent Global Virtual Teams in order to leverage knowledge sharing and cooperation across distance. To close this gap, this paper will set the scene for a research project investigating the changed preconditions for organisations. As daily face-to-face communication......The rise and spread of information communication technologies (ICT) has enabled increasing use of geographically dispersed work teams (Global Virtual Teams). Originally, Global Virtual Teams were mainly organised into temporary projects. Little research has focused on the emergent challenge...... generation of self-lead digital natives, who are already practising virtual relationships and a new approach to work, and currently joining the global workforce; and improved communication technologies. Keywords: Global Virtual teams, ICT, leadership, motivation, self-management, millenials....

  15. Sustainable Effectiveness of Applying Trauma Team Activation in Managing Trauma Patients in the Emergency Department.

    Science.gov (United States)

    Wuthisuthimethawee, Prasit; Molloy, Michael S; Ciottone, Gregory R

    2015-09-01

    To determine long term effectiveness of trauma team activation criteria by measuring emergency department length of stay (EDLOS) and 28-day mortality. A 3-year retrospective cohort study conducted in adult trauma patients who met one of the trauma team activation criteria (shock, penetrating torso injury, post traumatic arrest, respiratory rate of less than 12 or more than 30, and pulse rate of more than 120). Specific demographic data, physiologic parameters, EDLOS, injury severity score (ISS), and 28-day mortality were prospectively recorded into the Trauma Registry database. Multiple logistic regression analysis was used to determine factors affecting mortality. The Institutional Review Board approval was obtained prior to undertaking the project. Two hundred eighty two patients with a mean age of35.1 years old were eligible. The median ISS was 25 (range, 13-30). The median EDLOS was 85 minutes (range, 50-135) and the 28-day mortality rate was 46.5%. The mean age was 31.7 years in the survival group and 38.7 years in the fatal group (p = 0.001). The median ISS was 17 in the survival group and 26 in the fatal group (p = 0.000) and the median EDLOS was 110 minutes in the survival group and 82 minutes in the fatal group (p = 0.034). When compared to data prior to the TTA application, the median time of EDLOS improvedsustainably from 184 to 85 minutes (p = 0.000) and the mortality rate decreased from 66.7% to 46.5% (p = 0.057). The parameters affecting patient mortality were older age, high ISS, and shorter EDLOS. Trauma team activation criteria significantly improved acute trauma care in the emergency department and decreased mortality.

  16. Training of medical teams on-site for individual and coordinated response in emergency management

    DEFF Research Database (Denmark)

    Andersen, Verner

    2003-01-01

    A system for training of coordination and cooperation of decision makers in emergency management has been under construction for some time. A first prototype of the system was developed in the MUSTER system. The system is being developed modularly with one module for each of the suborganisations...... involved in the complete preparedness: fire brigade, police, medical team, civil defence, etc. All these modules will in the end be integrated on a common integration platform, either to a fully-fledged system covering all aspects of training for the complete preparedness, or for creating a dedicated...

  17. Ethical issues associated with in-hospital emergency from the Medical Emergency Team's perspective: a national survey.

    Science.gov (United States)

    Cabrini, Luca; Giannini, Alberto; Pintaudi, Margherita; Semeraro, Federico; Radeschi, Giulio; Borga, Sara; Landoni, Giovanni; Troiano, Herbert; Luchetti, Marco; Pellis, Thomas; Ristagno, Giuseppe; Minoja, Giulio; Mazzon, Davide; Alampi, Daniela

    2016-01-01

    Medical Emergency Teams (METs) are frequently involved in ethical issues associated to in-hospital emergencies, like decisions about end-of-life care and intensive care unit (ICU) admission. MET involvement offers both advantages and disadvantages, especially when an immediate decision must be made. We performed a survey among Italian intensivists/anesthesiologists evaluating MET's perspective on the most relevant ethical aspects faced in daily practice. A questionnaire was developed on behalf of the Italian scientific society of anesthesia and intensive care (SIAARTI) and administered to its members. Decision making criteria applied by respondents when dealing with ethical aspects, the estimated incidence of conflicts due to ethical issues and the impact on the respondents' emotional and moral distress were explored. The questionnaire was completed by 327 intensivists/anesthesiologists. Patient life-expectancy, wishes, and the quality of life were the factors most considered for decisions. Conflicts with ward physicians were reported by most respondents; disagreement on appropriateness of ICU admission and family unpreparedness to the imminent patient death were the most frequent reasons. Half of respondents considered that in case of conflicts the final decision should be made by the MET. Conflicts were generally recognized as causing increased and moral distress within the MET members. Few respondents reported that dedicated protocols or training were locally available. Italian intensivists/anesthesiologists reported that ethical issues associated with in-hospital emergencies are occurring commonly and are having a significant negative impact on MET well-being. Conflicts with ward physicians happen frequently. They also conveyed that hospitals don't offer ethics training and have no protocols in place to address ethical issues.

  18. The Emergence of Team Creativity: a social network perspective

    NARCIS (Netherlands)

    Y Yuan (Yingjie)

    2017-01-01

    textabstractTo overcome complex and dynamic economic challenges, organizations increasingly employ teams and build their competitive advantages on the inimitable capital of creativity. Naturally, when and how individual inputs combine to form team outcomes has therefore become one of the core

  19. Using Co-Design to Develop a Collective Leadership Intervention for Healthcare Teams to Improve Safety Culture

    Directory of Open Access Journals (Sweden)

    Marie E. Ward

    2018-06-01

    Full Text Available While co-design methods are becoming more popular in healthcare; there is a gap within the peer-reviewed literature on how to do co-design in practice. This paper addresses this gap by delineating the approach taken in the co-design of a collective leadership intervention to improve healthcare team performance and patient safety culture. Over the course of six workshops healthcare staff, patient representatives and advocates, and health systems researchers collaboratively co-designed the intervention. The inputs to the process, exercises and activities that took place during the workshops and the outputs of the workshops are described. The co-design method, while challenging at times, had many benefits including grounding the intervention in the real-world experiences of healthcare teams. Implications of the method for health systems research are discussed.

  20. OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

    International Nuclear Information System (INIS)

    2005-01-01

    The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards; - Integrated approach to the provision for the application of safety standards; and - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices; on the capability and reliability of the commissioning and operating personnel; on comprehensive instructions; and on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and

  1. OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

    International Nuclear Information System (INIS)

    2007-01-01

    The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards. - Integrated approach to the provision for the application of safety standards. And - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices. On the capability and reliability of the commissioning and operating personnel. On comprehensive instructions. And on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and

  2. OSART guidelines - 2005 edition. Reference report for IAEA Operational Safety Review Teams (OSARTs)

    International Nuclear Information System (INIS)

    2008-01-01

    The International Atomic Energy Agency (IAEA) has put forward the vision of a global nuclear safety regime that provides for the protection of people and the environment from the effects of ionizing radiation from nuclear facilities, the minimization of the likelihood of accidents that could endanger life and property and effective mitigation of the effects of any such events should they occur. The strategic approach for achieving the vision of enhancing this regime involves four elements and aims at ensuring that the overall nuclear safety level in Member States continues to improve: - Improvement of national and international safety infrastructures: - Establishment and global acceptance of IAEA safety standards. - Integrated approach to the provision for the application of safety standards. And - Global network of knowledge and experience. The IAEA Operational Safety Review Team (OSART) programme provides advice and assistance to Member States to enhance the safety of nuclear power plants during commissioning and operation. The OSART programme, initiated in 1982, is available to all Member States with nuclear power plants under commissioning or in operation. The OSART methodology and its safety services may also be applied to other nuclear installations (e.g. fuel cycle facilities, research reactors). Conservative design, careful manufacture and sound construction are all prerequisites for safe operation of nuclear power plants. However, the safety of the plant depends ultimately on sound policies, procedures, processes and practices. On the capability and reliability of the commissioning and operating personnel. On comprehensive instructions. And on adequate resources. A positive attitude and conscientiousness on the part of the management and staff in discharging their responsibilities is important to safety. OSART missions consider these aspects in assessing a facility's operational practices in comparison with those used successfully in other countries and

  3. Toward a definition of teamwork in emergency medicine.

    Science.gov (United States)

    Fernandez, Rosemarie; Kozlowski, Steve W J; Shapiro, Marc J; Salas, Eduardo

    2008-11-01

    The patient safety literature from the past decade emphasizes the importance of teamwork skills and human factors in preventing medical errors. Simulation has been used within aviation, the military, and now health care domains to effectively teach and assess teamwork skills. However, attempts to expand and generalize research and training principles have been limited due to a lack of a well-defined, well-researched taxonomy. As part of the 2008 Academic Emergency Medicine Consensus Conference on "The Science of Simulation in Healthcare," a subset of the group expertise and group assessment breakout sections identified evidence-based recommendations for an emergency medicine (EM) team taxonomy and performance model. This material was disseminated within the morning session and was discussed both during breakout sessions and via online messaging. Below we present a well-defined, well-described taxonomy that will help guide design, implementation, and assessment of simulation-based team training programs.

  4. Trauma team activation criteria in managing trauma patients at an emergency room in Thailand.

    Science.gov (United States)

    Wuthisuthimethawee, P

    2017-02-01

    Trauma team activation (TTA) criteria were first implemented in the Emergency Department (ED) of Songklanagarind Hospital in 2009 to treat severe trauma patients. To determine the efficacy of the TTA criteria on the acute trauma care process in the ED and the 28-day mortality rate. A 1-year prospective cohort study was conducted at the ED. Trauma patients who were 18 years old and over who met the TTA criteria were enrolled. Demographic data, physiologic parameters, ED length of stay (EDLOS), and the injury severity score (ISS) were recorded. Multiple logistic regression was used to determine the factors affecting 28-day mortality. Institutional review board approval was obtained from the Prince of Songkla University. A total of 80 patients (74 male and 6 female) were eligible with a mean age of 34.3 years old. Shock, penetrating torso injury, and pulse rate >120 beats per minute were the three most common criteria for trauma team consultation. At the ED, 9 patients (11.3 %) were non-survivors, 30 patients (37.5 %) needed immediate operation, and 41 patients (51.2 %) were admitted. All of the arrest patients died (p team activation criteria improved acute trauma care in the ED which was demonstrated by the decreased EDLOS and mortality rate. A high ISS is the sole parameter predicting mortality.

  5. IAEA Concludes Safety Review at Gravelines Nuclear Power Plant, France

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: An IAEA-led international team of nuclear safety experts noted a series of good practices and made recommendations to reinforce some safety measures during a review of operational safety at France's Gravelines Nuclear Power Plant (NPP) that concluded today. The Operational Safety Review Team (OSART) was assembled at the French Government's request. The in-depth review, which began 12 November 2012, focused on aspects essential to the safe operation of the NPP. The team was composed of experts from Bulgaria, China, Germany, Hungary, Japan, Romania, Slovakia, South Africa, Spain, Ukraine and the IAEA. The review covered the areas of management, organization and administration; training and qualification; operations; maintenance; technical support; operating experience; radiation protection; chemistry; emergency planning and preparedness; and severe accident management. The conclusions of the review are based on the IAEA's Safety Standards. The OSART team has identified good plant practices, which will be shared with the rest of the nuclear industry for consideration of their possible use elsewhere. Examples include the following: - The Power Plant uses a staff-skills mapping process that significantly enhances knowledge of the facility's collective and individual skills and provides proactive management to address the loss of such skills; - As a measure to reduce the risk of workers' radiation exposure, the Power Plant uses a system to ensure that dose rate measurements are carried out at a precise distance from the source of radiation; and - Flood protection of the Power Plant is supported by special technical guidance documents and associated arrangements. The team identified a number of proposals for improvements to operational safety at Gravelines NPP. Examples include the following: - The Power Plant should reinforce its measures to prevent foreign objects from entering plant systems; - The Power Plant should ensure the 24-hour presence of an operator

  6. Final Action Plan to Tiger Team

    International Nuclear Information System (INIS)

    1992-01-01

    This document presents planned actions, and their associated costs, for addressing the findings in the Environmental, Safety and Health Tiger Team Assessment of the Sandia National Laboratories, Albuquerque, May 1991, hereafter called the Assessment. This Final Action Plan should be read in conjunction with the Assessment to ensure full understanding of the findings addressed herein. The Assessment presented 353 findings in four general categories: (1)Environmental (82 findings); (2) Safety and Health (243 findings); (3) Management and Organization (18 findings); and (4) Self-Assessment (10 findings). Additionally, 436 noncompliance items with Occupational Safety and Health Administration (OSHA) standards were addressed during and immediately after the Tiger Team visit

  7. Evaluation of communication characteristics of operating teams in NPPs using SNA technique

    Energy Technology Data Exchange (ETDEWEB)

    Kim, H. J.; Lee, S. W.; Kang, H. G.; Seong, P. H. [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Park, J. K. [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Kang, H. G. [Khalifa Univ. of Science, Abu Dhabi (United Arab Emirates)

    2012-03-15

    Inappropriate communications within operational teams can lead to serious consequences of a system since it can cause lack of exchange of important information to perform the task to secure the safety of the system in nuclear power plants (NPPs). For that reason, we studied the communication characteristics However, existing studies on the communication characteristics seem to have problem since they have characterized team communications from a single perspective. According that, we have developed an evaluation method to characterize team communications using social network techniques which can evaluate them from various perspectives which are group cohesiveness, frequency of communications, degree of hierarchy, and communication contents. In addition, we suggested some kids of specific communication characteristics of operating teams that can reduce the occurrence of inappropriate communications. Eight verbal protocol data which are audio-visual recorded under emergency training sessions by main control room (MCR) operating teams are used. As a result of the study, there was negative relationship between group cohesiveness and the ratio of inappropriate communications. Moreover, some kinds of specific communication contents are related to the ratio of inappropriate communications. Consequently, we can evaluate communications characteristics of operating teams in NPPs and suggest specific characteristics to provide useful insights to prevent inappropriate communications.

  8. Evaluation of communication characteristics of operating teams in NPPs using SNA technique

    International Nuclear Information System (INIS)

    Kim, H. J.; Lee, S. W.; Kang, H. G.; Seong, P. H.; Park, J. K.; Kang, H. G.

    2012-01-01

    Inappropriate communications within operational teams can lead to serious consequences of a system since it can cause lack of exchange of important information to perform the task to secure the safety of the system in nuclear power plants (NPPs). For that reason, we studied the communication characteristics However, existing studies on the communication characteristics seem to have problem since they have characterized team communications from a single perspective. According that, we have developed an evaluation method to characterize team communications using social network techniques which can evaluate them from various perspectives which are group cohesiveness, frequency of communications, degree of hierarchy, and communication contents. In addition, we suggested some kids of specific communication characteristics of operating teams that can reduce the occurrence of inappropriate communications. Eight verbal protocol data which are audio-visual recorded under emergency training sessions by main control room (MCR) operating teams are used. As a result of the study, there was negative relationship between group cohesiveness and the ratio of inappropriate communications. Moreover, some kinds of specific communication contents are related to the ratio of inappropriate communications. Consequently, we can evaluate communications characteristics of operating teams in NPPs and suggest specific characteristics to provide useful insights to prevent inappropriate communications

  9. Radiation safety for the emergency situation of the power plant accident. Radiation safety in society and its education

    International Nuclear Information System (INIS)

    Kosako, Toshiso

    2012-01-01

    Great East Japan Earthquake and Tsunamis, and following Fukushima Daiichi Nuclear Power Accident brought about great impact on society in Japan. Accident analysis of inside reactor was studied by reactor physics or reactor engineering knowledge, while dissipation of a large amount of radioactive materials outside reactor facilities, and radiation and radioactivity effects on people by way of atmosphere, water and soil were dealt with radiation safety or radiation protection. Due to extremely low frequency and experience of an emergency, there occurred a great confusion in the response of electric power company concerned, relevant regulating competent authorities, local government and media, and related scholars and researchers, which caused great anxieties amount affected residents and people. This article described radiation safety in the society and its education. Referring to actual examples, how radiation safety or radiation protection knowledge should be dealt with emergency risk management in the society was discussed as well as problem of education related with nuclear power, radiation and prevention of disaster and fostering of personnel for relevant people. (T. Tanaka)

  10. Managing emergencies and abnormal situations in air traffic control (part II): teamwork strategies.

    Science.gov (United States)

    Malakis, Stathis; Kontogiannis, Tom; Kirwan, Barry

    2010-07-01

    Team performance has been studied in many safety-critical organizations including aviation, nuclear power plant, offshore oil platforms and health organizations. This study looks into teamwork strategies that air traffic controllers employ to manage emergencies and abnormal situations. Two field studies were carried out in the form of observations of simulator training in emergency and unusual scenarios of novices and experienced controllers. Teamwork strategies covered aspects of team orientation and coordination, information exchange, change management and error handling. Several performance metrics were used to rate the efficiency of teamwork and test the construct validity of a prototype model of teamwork. This is a companion study to an earlier investigation of taskwork strategies in the same field (part I) and contributes to the development of a generic model for Taskwork and Teamwork strategies in Emergencies in Air traffic Management (T(2)EAM). Suggestions are made on how to use T(2)EAM to develop training programs, assess team performance and improve mishap investigations. Copyright 2010 Elsevier Ltd. All rights reserved.

  11. Foundational workplace safety and health competencies for the emerging workforce☆

    Science.gov (United States)

    Okun, Andrea H.; Guerin, Rebecca J.; Schulte, Paul A.

    2016-01-01

    Introduction Young workers (aged 15–24) suffer disproportionately from workplace injuries, with a nonfatal injury rate estimated to be two times higher than among workers age 25 or over. These workers make up approximately 9% of the U.S. workforce and studies have shown that nearly 80% of high school students work at some point during high school. Although young worker injuries are a pressing public health problem, the critical knowledge and skills needed to prepare youth for safe and healthy work are missing from most frameworks used to prepare the emerging U.S. workforce. Methods A framework of foundational workplace safety and health knowledge and skills (the NIOSH 8 Core Competencies)was developed based on the Health Belief Model (HBM). Results The proposed NIOSH Core Competencies utilize the HBM to provide a framework for foundational workplace safety and health knowledge and skills. An examination of how these competencies and the HBM apply to actions that workers take to protect themselves is provided. The social and physical environments that influence these actions are also discussed. Conclusions The NIOSH 8 Core Competencies, grounded in one of the most widely used health behavior theories, fill a critical gap in preparing the emerging U.S. workforce to be cognizant of workplace risks. Practical applications Integration of the NIOSH 8 Core Competencies into school curricula is one way to ensure that every young person has the foundational workplace safety and health knowledge and skills to participate in, and benefit from, safe and healthy work. National Safety Council and Elsevier Ltd. All rights reserved. PMID:27846998

  12. Plutonium working group report on environmental, safety and health vulnerabilities associated with the department's plutonium storage. Volume II, part 9, Oak Ridge Site working group assessment team report

    International Nuclear Information System (INIS)

    1994-09-01

    The objective of the Plutonium Environmental Safety and Health (ES ampersand H) Vulnerability Assessment at the Oak Ridge (OR) Site was to conduct a comprehensive assessment of the ES ampersand H vulnerabilities arising from the storage and handling of its current plutonium holdings. The term open-quotes ES ampersand H Vulnerabilityclose quotes is defined for the purpose of this project to mean conditions or weaknesses that could lead to unnecessary or increased radiation exposure of workers, release of radioactive materials to the environment, or radiation exposure to the public. This assessment was intended to take a open-quotes snap-shotclose quotes of Oak Ridge National Laboratory (ORNL) and the Y-12 Plant's plutonium holdings and associated ES ampersand H vulnerabilities in the time frame of June 1 994. This vulnerability assessment process began with the OR Site Assessment Team (SAT) generating a self-assessment report including proposed vulnerabilities. The SAT identified 55 facilities which contain plutonium and other transuranics they considered might be in-scope for purposes of this study. The Working Group Assessment Team (WGAT), however, determined that 37 of the facilities actually contained only out-of-scope material (e.g., transuranic material not colocated with plutonium or transuranic (TRU) waste). The WGAT performed an independent assessment of the SATs report, conducted facility walkdowns, and reviewed reference documents such as Safety Analysis Reports (SARs), Operational Safety Requirements (OSRs), emergency preparedness plans, and procedures. The results of the WGAT review and open-quotes walkdownsclose quotes (a term as used here incorporating tours, document reviews, and detailed discussions with cognizant personnel) are discussed in Section 3.0. The ES ampersand H vulnerabilities that were identified are documented in Appendix A

  13. The Influence Paths of Emotion on the Occupational Safety of Rescuers Involved in Environmental Emergencies- Systematic Review Article.

    Science.gov (United States)

    Lu, Jintao; Yang, Naiding; Ye, Jinfu; Wu, Haoran

    2014-11-01

    A detailed study and analysis of previous research has been carried out to illustrate the relationships between a range of environmental emergencies, and their effects on the emotional state of the rescuers involved in responding to them, by employing Pub Med, Science Direct, Web of Science, Google Scholar, CNKI and Scopus for required information with the several keywords "emergency rescue", "occupational safety", "natural disaster", "emotional management". The effect of the rescuers' emotion on their occupational safety and immediate and long-term emotional behavior is then considered. From these considerations, we suggested four research propositions related to the emotional effects at both individual and group levels, and to the responsibilities of emergency response agencies in respect of ensuring the psychological and physical occupational safety of rescuers during and after environmental emergencies. An analysis framework is proposed which could be used to study the influence paths of these different aspects of emotional impact on a range of occupational safety issues for rescue workers. The authors believe that the conclusions drawn in this paper can provide a useful theoretical reference for decision-making related to the management and protection of the occupational safety of rescuers responding to natural disasters and environmental emergencies.

  14. Improving safety margin of LWRs by rethinking the emergency core cooling system criteria and safety system capacity

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Youho, E-mail: euo@kaist.ac.kr; Kim, Bokyung, E-mail: bkkim2@kaist.ac.kr; NO, Hee Cheon, E-mail: hcno@kaist.ac.kr

    2016-10-15

    Highlights: • Zircaloy embrittlement criteria can increase to 1370 °C for CP-ECR lower than 13%. • The draft ECCS criteria of U.S. NRC allow less than 5% in power margin. • The Japanese fracture-based criteria allow around 5% in power margin. • Increasing SIT inventory is effective in assuring safety margin for power uprates. - Abstract: This study investigates the engineering compatibility between emergency core cooling system criteria and safety water injection systems, in the pursuit of safety margin increase of light water reactors. This study proposes an acceptable temperature increase to 1370 °C as long as equivalent cladding reacted calculated by the Cathcart–Pawel equation is below 13%, after an extensive literature review. The influence of different ECCS criteria on the safety margin during large break loss of coolant accident is investigated for OPR-1000 by the system code MARS-KS, implemented with the KINS-REM method. The fracture-based emergency core cooling system (ECCS) criteria proposed in this study are shown to enable power margins up to 10%. In the meantime, the draft U.S. NRC’s embrittlement criteria (burnup-sensitive) and Japanese fracture-based criteria are shown to allow less than 5%, and around 5% of power margins, respectively. Increasing safety injection tank (SIT) water inventory is the key, yet convenient, way of assuring safety margin for power increase. More than 20% increase in the SIT water inventory is required to allow 15% power margins, for the U.S. NRC’s burnup-dependent embrittlement criteria. Controlling SIT water inventory would be a useful option that could allow the industrial desire to pursue power margins even under the recent atmosphere of imposing stricter ECCS criteria for the considerable burnup effects.

  15. Implementation of team training in medical education in Denmark.

    Science.gov (United States)

    Østergaard, H T; Østergaard, D; Lippert, A

    2008-10-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies to document the effect of the different types of training on patient safety are discussed.

  16. Building a collaborative culture in cardiothoracic operating rooms: pre and postintervention study protocol for evaluation of the implementation of teamSTEPPS training and the impact on perceived psychological safety.

    Science.gov (United States)

    Dahl, Aaron Benjamin; Ben Abdallah, Arbi; Maniar, Hersh; Avidan, Michael Simon; Bollini, Mara L; Patterson, George Alexander; Steinberg, Aaron; Scaggs, Katie; Dribin, Brenda V; Ridley, Clare H

    2017-09-27

    The importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment. This study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA. All team members participating in cardiac and thoracic OR cases during this 17-month study period will be identified by the primary surgical staff attending on the OR schedule.TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) training course will be taught to all CT OR staff. Before TeamSTEPPS training, staff will respond to a 39-item questionnaire that includes constructs from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, Edmondson's 'Measure of psychological safety' questionnaire, and questionnaires on turnover intentions, job satisfaction and 'burnout'. The questionnaires will be readministered at 6 and 12 months.The primary outcomes to be assessed include the perceived psychological safety of CT OR team members, the overall effect of TeamSTEPPS on burnout and job satisfaction, and observed turnover rate among the OR nurses. As secondary outcomes, we will be assessing self-reported rates of medical error and near misses in the ORs with a questionnaire at the end of each case. Ethics approval is not indicated as this project does not meet the federal definitions of research requiring the oversight of the Institutional Review Board (IRB). Patient health information (PHI) will not be generated during the implementation of this project. Results of the trial will be made accessible to the public when published in a peer-reviewed journal following the completion of the study. © Article author(s) (or their employer(s) unless

  17. Team knowledge assessment of nursing on international targets patient safety in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Maria Nathália da Silva Souza

    2017-08-01

    Full Text Available Background e Objectives: The quality of hospital care provided to the patient and the safety of their stay at the site triggered discussions around the world after the analysis of epidemiological studies conducted in the USA that concluded the high rate of adverse events in the hospital setting Caused by professional error, with that the theme gained strength and motivated discussions about the care models applied to the patients. Therefore the research was aimed at evaluating the knowledge of the Nursing Team of the Intensive Care Unit sector of a public hospital in Recife-PE on the International Patient Safety Goals. Methods: A cross-sectional study with descriptive quantitative approach was carried out from June to August 2016. Data collection was performed through a semi-structured questionnaire that addressed the social and professional aspects of the respondents. The studied variables: gender, age, professional category and training time. The data were analyzed in epiinfo software version 3.2.2. Results: The sample consisted of 50 professionals, 18% of whom were Nurses and 82% were Nursing technicians. Most respondents scored more than 50% of questions about international patient safety goals and had more than one employment relationship. Conclusion: It was verified that the lack of training, work overload and more of an employment relationship can contribute to a precarious professional assistance. KEYWORDS: Patient Safety. Nursing. Safety Management. Intensive Care Units

  18. Creating High Reliability Teams in Healthcare through In situ Simulation Training

    Directory of Open Access Journals (Sweden)

    Kristi Miller RN

    2011-07-01

    Full Text Available The importance of teamwork on patient safety in healthcare has been well established. However, the theory and research of healthcare teams are seriously lacking in clinical application. While conventional team theory assumes that teams are stable and leadership is constant, a growing body of evidence indicates that most healthcare teams are unstable and lack constant leadership. For healthcare organizations to reduce error and ensure patient safety, the true nature of healthcare teams must be better understood. This study presents a taxonomy of healthcare teams and the determinants of high reliability in healthcare teams based on a series of studies undertaken over a five-year period (2005–2010.

  19. The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings.

    Science.gov (United States)

    Roberts, Nicole K; Williams, Reed G; Schwind, Cathy J; Sutyak, John A; McDowell, Christopher; Griffen, David; Wall, Jarrod; Sanfey, Hilary; Chestnut, Audra; Meier, Andreas H; Wohltmann, Christopher; Clark, Ted R; Wetter, Nathan

    2014-02-01

    Communication breakdowns and care coordination problems often cause preventable adverse patient care events, which can be especially acute in the trauma setting, in which ad hoc teams have little time for advanced planning. Existing teamwork curricula do not address the particular issues associated with ad hoc emergency teams providing trauma care. Ad hoc trauma teams completed a preinstruction simulated trauma encounter and were provided with instruction on appropriate team behaviors and team communication. Teams completed a postinstruction simulated trauma encounter immediately afterward and 3 weeks later, then completed a questionnaire. Blinded raters rated videotapes of the simulations. Participants expressed high levels of satisfaction and intent to change practice after the intervention. Participants changed teamwork and communication behavior on the posttest, and changes were sustained after a 3-week interval, though there was some loss of retention. Brief training exercises can change teamwork and communication behaviors on ad hoc trauma teams. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Conceptualizing Interprofessional Teams as Multi-Team Systems-Implications for Assessment and Training.

    Science.gov (United States)

    West, Courtney; Landry, Karen; Graham, Anna; Graham, Lori; Cianciolo, Anna T; Kalet, Adina; Rosen, Michael; Sherman, Deborah Witt

    2015-01-01

    SGEA 2015 CONFERENCE ABSTRACT (EDITED). Evaluating Interprofessional Teamwork During a Large-Scale Simulation. Courtney West, Karen Landry, Anna Graham, and Lori Graham. CONSTRUCT: This study investigated the multidimensional measurement of interprofessional (IPE) teamwork as part of large-scale simulation training. Healthcare team function has a direct impact on patient safety and quality of care. However, IPE team training has not been the norm. Recognizing the importance of developing team-based collaborative care, our College of Nursing implemented an IPE simulation activity called Disaster Day and invited other professions to participate. The exercise consists of two sessions: one in the morning and another in the afternoon. The disaster scenario is announced just prior to each session, which consists of team building, a 90-minute simulation, and debriefing. Approximately 300 Nursing, Medicine, Pharmacy, Emergency Medical Technicians, and Radiology students and over 500 standardized and volunteer patients participated in the Disaster Day event. To improve student learning outcomes, we created 3 competency-based instruments to evaluate collaborative practice in multidimensional fashion during this exercise. A 20-item IPE Team Observation Instrument designed to assess interprofessional team's attainment of Interprofessional Education Collaborative (IPEC) competencies was completed by 20 faculty and staff observing the Disaster Day simulation. One hundred sixty-six standardized patients completed a 10-item Standardized Patient IPE Team Evaluation Instrument developed from the IPEC competencies and adapted items from the 2014 Henry et al. PIVOT Questionnaire. This instrument assessed the standardized or volunteer patient's perception of the team's collaborative performance. A 29-item IPE Team's Perception of Collaborative Care Questionnaire, also created from the IPEC competencies and divided into 5 categories of Values/Ethics, Roles and Responsibilities

  1. Leadership emergence in engineering design teams.

    Science.gov (United States)

    Guastello, Stephen J

    2011-01-01

    Leaders emerge from leaderless groups as part of a more complex emerging social structure. Several studies have shown that the emerging structure is aptly described by a swallowtail catastrophe model where the control parameters differ depending on whether creative problem solving, production, coordination-intensive, or emergency management groups are involved. The present study explored creative problem solving further where the participants were engaged in real-world tasks extending over several months rather than short laboratory tasks. Participants were engineering students who were organized into groups of to people who designed, built, and tested a prototype product that would solve a real-world problem. At the th week of work they completed a questionnaire indicating who was most like the leader of their group, second most like the leader, along with other questions about individuals' contributions to the group process. Results showed that the swallowtail model (R = .) exhibited a strong advantage over the linear alternative model (R = .) for predicting leadership emergence. The three control variables were control of the task, creative contributions to the group's work, and facilitating the creative contributions of others.

  2. Patient safety culture at neonatal intensive care units: perspectives of the nursing and medical team 1

    Science.gov (United States)

    Tomazoni, Andréia; Rocha, Patrícia Kuerten; de Souza, Sabrina; Anders, Jane Cristina; de Malfussi, Hamilton Filipe Correia

    2014-01-01

    OBJECTIVE: to verify the assessment of the patient safety culture according to the function and length of experience of the nursing and medical teams at Neonatal Intensive Care Units. METHOD: quantitative survey undertaken at four Neonatal Intensive Care Units in Florianópolis, Brazil. The sample totaled 141 subjects. The data were collected between February and April 2013 through the application of the Hospital Survey on Patient Safety Culture. For analysis, the Kruskal-Wallis and Chi-Square tests and Cronbach's Alpha coefficient were used. Approval for the research project was obtained from the Ethics Committee, CAAE: 05274612.7.0000.0121. RESULTS: differences in the number of positive answers to the Hospital Survey on Patient Safety Culture, the safety grade and the number of reported events were found according to the professional characteristics. A significant association was found between a shorter Length of work at the hospital and Length of work at the unit and a larger number of positive answers; longer length of experience in the profession represented higher grades and less reported events. The physicians and nursing technicians assessed the patient safety culture more positively. Cronbach's alpha demonstrated the reliability of the instrument. CONCLUSION: the differences found reveal a possible relation between the assessment of the safety culture and the subjects' professional characteristics at the Neonatal Intensive Care Units. PMID:25493670

  3. Geospatial Information Response Team

    Science.gov (United States)

    Witt, Emitt C.

    2010-01-01

    Extreme emergency events of national significance that include manmade and natural disasters seem to have become more frequent during the past two decades. The Nation is becoming more resilient to these emergencies through better preparedness, reduced duplication, and establishing better communications so every response and recovery effort saves lives and mitigates the long-term social and economic impacts on the Nation. The National Response Framework (NRF) (http://www.fema.gov/NRF) was developed to provide the guiding principles that enable all response partners to prepare for and provide a unified national response to disasters and emergencies. The NRF provides five key principles for better preparation, coordination, and response: 1) engaged partnerships, 2) a tiered response, 3) scalable, flexible, and adaptable operations, 4) unity of effort, and 5) readiness to act. The NRF also describes how communities, tribes, States, Federal Government, privatesector, and non-governmental partners apply these principles for a coordinated, effective national response. The U.S. Geological Survey (USGS) has adopted the NRF doctrine by establishing several earth-sciences, discipline-level teams to ensure that USGS science, data, and individual expertise are readily available during emergencies. The Geospatial Information Response Team (GIRT) is one of these teams. The USGS established the GIRT to facilitate the effective collection, storage, and dissemination of geospatial data information and products during an emergency. The GIRT ensures that timely geospatial data are available for use by emergency responders, land and resource managers, and for scientific analysis. In an emergency and response capacity, the GIRT is responsible for establishing procedures for geospatial data acquisition, processing, and archiving; discovery, access, and delivery of data; anticipating geospatial needs; and providing coordinated products and services utilizing the USGS' exceptional pool of

  4. Introduction of an Emergency Response Plan for flood loading of Sultan Abu Bakar Dam in Malaysia

    Science.gov (United States)

    Said, N. F. Md; Sidek, L. M.; Basri, H.; Muda, R. S.; Razad, A. Z. Abdul

    2016-03-01

    Sultan Abu Bakar Dam Emergency Response Plan (ERP) is designed to assist employees for identifying, monitoring, responding and mitigation dam safety emergencies. This paper is outlined to identification of an organization chart, responsibility for emergency management team and triggering level in Sultan Abu Bakar Dam ERP. ERP is a plan that guides responsibilities for proper operation of Sultan Abu Bakar Dam in respond to emergency incidents affecting the dam. Based on this study four major responsibilities are needed for Abu Bakar Dam owing to protect any probable risk for downstream which they can be Incident Commander, Deputy Incident Commander, On-Scene Commander, Civil Engineer. In conclusion, having organization charts based on ERP studies can be helpful for decreasing the probable risks in any projects such as Abu Bakar Dam and it is a way to identify and suspected and actual dam safety emergencies.

  5. [Simulation-based training in anesthesia and emergency medicine: preparation for the unexpected: on the way to new standards of education in Germany].

    Science.gov (United States)

    Issleib, Malte; Zöllner, C

    2015-01-01

    Medical expertise consists of knowledge, professional skills and individual attitudes. Training and education of this expertise starts in medical school and develops throughout the qualification process of anesthesists and emergency physicians. Medical decisions are not only rational but also intuitive. The combination of these characteristics cannot and should not be trained on patients. The implementation of modern simulation techniques offers the opportunity to train for emergency situations similar to training systems in the energy industry and aviation. Repetitive training of rare emergency situations brings routine to seldomly used procedures. In simulation training mistakes can be detected and systematically corrected. The team interactions and soft skills can also be focussed on. Video analysis gives the participant the opportunity for self-reflection and can lead to correction of individual behavior patterns. This dimension of education cannot be done in real patient care. This training goes far beyond the level of skills training. Through simulation training involves the whole team, the communication and the interaction between the team members in medically challenging situations. Crisis resource management leads to measurable improvements in patient safety and safety culture as well as personnel satisfaction.

  6. Safety Design Strategy for the Advanced Test Reactor Emergency Firewater Injection System Replacement Project

    International Nuclear Information System (INIS)

    Duckwitz, Noel

    2011-01-01

    In accordance with the requirements of U.S. Department of Energy (DOE) Order 413.3B, 'Program and Project Management for the Acquisition of Capital Assets,' safety must be integrated into the design process for new or major modifications to DOE Hazard Category 1, 2, and 3 nuclear facilities. The intended purpose of this requirement involves the handling of hazardous materials, both radiological and chemical, in a way that provides adequate protection to the public, workers, and the environment. Requirements provided in DOE Order 413.3B and DOE Order 420.1B, 'Facility Safety,' and the expectations of DOE-STD-1189-2008, 'Integration of Safety into the Design Process,' provide for identification of hazards early in the project and use of an integrated team approach to design safety into the facility. This safety design strategy provides the basic safety-in-design principles and concepts that will be used for the Advanced Test Reactor Reliability Sustainment Project. While this project does not introduce new hazards to the ATR, it has the potential for significant impacts to safety-related systems, structures, and components that are credited in the ATR safety basis and are being replaced. Thus the project has been determined to meet the definition of a major modification and is being managed accordingly.

  7. Construction of the All-region Linkage System for Emergency Management of Agricultural Product Quality and Safety in West China

    Institute of Scientific and Technical Information of China (English)

    Hua; YU; Yanbin; QI; Yubao; YAN

    2013-01-01

    Quality and safety of agricultural products are significant for national socioeconomic development,sustainable development,and vital interests of people.To safeguard quality and safety of agricultural products in west China is to safeguard economic safety and ecological safety of the country,public health and social stability,of which an important task is to properly handle emergencies concerning quality and safety of agricultural products.Considering actual conditions of west China,suggestions are given to construct the all-region linkage system for emergency management of agricultural product quality and safety in the local area,enhance the all-region linkage,and improve the linkage efficiency.

  8. FirstAED emergency dispatch, global positioning of community first responders with distinct roles

    DEFF Research Database (Denmark)

    Henriksen, Finn Lund; Schorling, Per; Hansen, Bruno

    2016-01-01

    their roles in a team structure to reduce response times, ensure citizens' safety and offer equal possibility of early defibrillation. First aid is provided by community first responders who use their smartphone. FirstAED global positioning system (GPS)-tracks the nine nearby first responders and enables......FirstAED is a supplement to the existing emergency response systems. The aim is to shorten the community first responder response times at emergency calls to below five minutes in a bridge connected island area. FirstAED defines a way to dispatch the nearby three first responders and organise...... the emergency dispatcher to send an organised team of three first responders with distinct roles to the scene automatically. During the first 24 months the FirstAED system was used 718 times. Three first responders arrived in ∼89% of the cases, and they arrived before the ambulance in ∼94% of the cases. First...

  9. Strategic environmental safety inspection for the National disposal program. Description of the inspection volume. Documentation for the scoping team

    International Nuclear Information System (INIS)

    2015-01-01

    The Strategic environmental safety inspection for the National disposal program covers the following topics: Legal framework: determination of the requirement for an environmental inspection program, coordination of the scoping team into the overall context; environmental targets; approach for assessment and evaluation of environmental impact, description of the inspection targets for the strategic environmental inspection; consideration of alternatives.

  10. Investigation of Fire Safety Awareness and Management in Mall

    Directory of Open Access Journals (Sweden)

    Abdul Rahim N.

    2014-03-01

    Full Text Available In spite of having sufficient fire safety system installed in buildings, the incidence of fire hazard becomes the furthermost and supreme threat to health and safety, as well as property to any community. In order to make sure that the safety of the building and its users, the fundamental features depends on the fire precaution system and equipment which should be according to the standard requirements. Nevertheless, the awareness on fire safety could necessarily alleviate the damages or rate of fatality during the event of fire. This paper presents the results on the investigation of fire safety awareness and management, concentrating on shopping mall. The endeavour of this study is to explore the level of fire safety knowledge of the users in the mall, and to study the effectiveness level of fire safety management in a mall. From the study, public awareness is highly related to understanding human behaviour and their personal background. The respondents’ levels of awareness are rather low, which reflects on their poor action when facing emergency situation during fire. The most effective methods identified to improve the awareness and effectiveness of fire safety level is through involvement in related fire safety programmes, distribution of pamphlets or brochures on fire safety and appointing specific personnel for Emergency Response Team in the mall.

  11. High-fidelity hybrid simulation of allergic emergencies demonstrates improved preparedness for office emergencies in pediatric allergy clinics.

    Science.gov (United States)

    Kennedy, Joshua L; Jones, Stacie M; Porter, Nicholas; White, Marjorie L; Gephardt, Grace; Hill, Travis; Cantrell, Mary; Nick, Todd G; Melguizo, Maria; Smith, Chris; Boateng, Beatrice A; Perry, Tamara T; Scurlock, Amy M; Thompson, Tonya M

    2013-01-01

    Simulation models that used high-fidelity mannequins have shown promise in medical education, particularly for cases in which the event is uncommon. Allergy physicians encounter emergencies in their offices, and these can be the source of much trepidation. To determine if case-based simulations with high-fidelity mannequins are effective in teaching and retention of emergency management team skills. Allergy clinics were invited to Arkansas Children's Hospital Pediatric Understanding and Learning through Simulation Education center for a 1-day workshop to evaluate skills concerning the management of allergic emergencies. A Clinical Emergency Preparedness Team Performance Evaluation was developed to evaluate the competence of teams in several areas: leadership and/or role clarity, closed-loop communication, team support, situational awareness, and scenario-specific skills. Four cases, which focus on common allergic emergencies, were simulated by using high-fidelity mannequins and standardized patients. Teams were evaluated by multiple reviewers by using video recording and standardized scoring. Ten to 12 months after initial training, an unannounced in situ case was performed to determine retention of the skills training. Clinics showed significant improvements for role clarity, teamwork, situational awareness, and scenario-specific skills during the 1-day workshop (all P clinics (all P ≤ .004). Clinical Emergency Preparedness Team Performance Evaluation scores demonstrated improved team management skills with simulation training in office emergencies. Significant recall of team emergency management skills was demonstrated months after the initial training. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  12. Nuclear criticality safety aspects of emergency response at the Los Alamos National Laboratory

    International Nuclear Information System (INIS)

    Baker, J.S.

    2003-01-01

    Emergency response at Los Alamos National Laboratory (LANL) is handled through a graded approach depending on the specific emergency situation . LANL maintains a comprehensive capability to respond to events ranging from minor facility events (alerts) through major community events (general emergencies), including criticality accidents . Criticality safety and emergency response apply to all activities involving significant quantities of fissile material at LANL, primarily at Technical Area 18 (TA-18, the Los Alamos Critical Experiments Facility) and Technical Area 55 (TA-55, the Plutonium Facility). This discussion focuses on response to a criticality accident at TA-55; the approach at TA-18 is comparable .

  13. Navigating Through Chaos: Charge Nurses and Patient Safety.

    Science.gov (United States)

    Cathro, Heather

    2016-04-01

    The aim of this study was to explore actions and the processes charge nurses (CNs) implement to keep patients safe and generate an emerging theory to inform CN job descriptions, orientation, and training to promote patient safety in practice. Healthcare workers must provide a safe environment for patients. CNs are the frontline leaders on most hospital units and can function as gatekeepers for safe patient care. This grounded theory study utilized purposive sampling of CNs on medical-surgical units in a 400-bed metropolitan hospital. Data collection consisted of 11 interviews and 6 observations. The emerging theory was navigating through chaos: CNs balancing multiple roles, maintaining a watchful eye, and working with and leading the healthcare team to keep patients safe. CNs have knowledge of patients, staff, and complex healthcare environments, putting them in opportune positions to influence patient safety.

  14. IAEA Completes Safety Review at Czech Nuclear Power Plant

    International Nuclear Information System (INIS)

    2012-01-01

    Power Plant has a Technical Support Centre Manual to establish the decision-making process necessary to support the Control Room Crew in implementing Emergency Operating Procedures. The team identified a number of proposals for improvements in operational safety at Temelin Nuclear Power Station. Examples include the following: - Management and Plant staff should improve their practices to enable more efficient reporting of minor deficiencies; - Power Plant operators should improve their adherence to existing human error prevention procedures; and - The Power Plant has underway too many temporary modifications to the plant systems, many of which have no specific schedule for completion and could have adverse implications for safety. Temelin management expressed a determination to address all the areas identified for improvement and requested the IAEA to schedule a follow-up mission in approximately 18 months. The team delivered a draft of its recommendations, suggestions and good practices to the plant management in the form of ''Technical Notes'' for factual comments. These notes will be reviewed at IAEA headquarters, including any comments from Temelin Nuclear Power Station and the Czech Republic regulatory body SUJB. The final report will be submitted to the Government of the Czech Republic within three months. This was the 172th mission of the OSART programme, which began in 1982. General information about OSART missions can be found on the IAEA Website. Background The IAEA Nuclear Safety Action Plan defines a programme of work to strengthen the nuclear safety framework worldwide in the light of the Fukushima Daiichi Nuclear Power Plant accident. The plan was unanimously endorsed by IAEA Member States during the Agency's 55th General Conference in September 2011. The Action Plan recommended: ''Each Member State with nuclear power plants to voluntarily host at least one IAEA Operational Safety Review Team (OSART) mission during the coming three years, with the initial

  15. Rapid response teams: qualitative analysis of their effectiveness.

    Science.gov (United States)

    Leach, Linda Searle; Mayo, Ann M

    2013-05-01

    Multidisciplinary rapid response teams focus on patients' emergent needs and manage critical situations to prevent avoidable deaths. Although research has focused primarily on outcomes, studies of the actual team effectiveness within the teams from multiple perspectives have been limited. To describe effectiveness of rapid response teams in a large teaching hospital in California that had been using such teams for 5 years. The grounded-theory method was used to discover if substantive theory might emerge from interview and/or observational data. Purposeful sampling was used to conduct in-person semistructured interviews with 17 key informants. Convenience sampling was used for the 9 observed events that involved a rapid response team. Analysis involved use of a concept or indicator model to generate empirical results from the data. Data were coded, compared, and contrasted, and, when appropriate, relationships between concepts were formed. Results Dimensions of effective team performance included the concepts of organizational culture, team structure, expertise, communication, and teamwork. Professionals involved reported that rapid response teams functioned well in managing patients at risk or in crisis; however, unique challenges were identified. Teams were loosely coupled because of the inconsistency of team members from day to day. Team members had little opportunity to develop relationships or team skills. The need for team training may be greater than that among teams that work together regularly under less time pressure to perform. Communication between team members and managing a crisis were critical aspects of an effective response team.

  16. [Developing team reflexivity as a learning and working tool for medical teams].

    Science.gov (United States)

    Riskin, Arieh; Bamberger, Peter

    2014-01-01

    Team reflexivity is a collective activity in which team members review their previous work, and develop ideas on how to modify their work behavior in order to achieve better future results. It is an important learning tool and a key factor in explaining the varying effectiveness of teams. Team reflexivity encompasses both self-awareness and agency, and includes three main activities: reflection, planning, and adaptation. The model of briefing-debriefing cycles promotes team reflexivity. Its key elements include: Pre-action briefing--setting objectives, roles, and strategies the mission, as well as proposing adaptations based on what was previously learnt from similar procedures; Post-action debriefing--reflecting on the procedure performed and reviewing the extent to which objectives were met, and what can be learnt for future tasks. Given the widespread attention to team-based work systems and organizational learning, efforts should be made toward ntroducing team reflexivity in health administration systems. Implementation could be difficult because most teams in hospitals are short-lived action teams formed for a particular event, with limited time and opportunity to consciously reflect upon their actions. But it is precisely in these contexts that reflexive processes have the most to offer instead of the natural impulsive collective logics. Team reflexivity suggests a potential solution to the major problems of iatorgenesis--avoidable medical errors, as it forces all team members to participate in a reflexive process together. Briefing-debriefing technology was studied mainly in surgical teams and was shown to enhance team-based learning and to improve quality-related outcomes and safety.

  17. Endoscopic non-technical skills team training: the next step in quality assurance of endoscopy training.

    Science.gov (United States)

    Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

    2014-12-14

    To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes. A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day's training utilising real clinical examples. Pre and post-course evaluation comprised participants' patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected. Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training. A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams' knowledge and safety attitudes.

  18. Development of Operational Safety Monitoring System and Emergency Preparedness Advisory System for CANDU Reactors (I)

    International Nuclear Information System (INIS)

    Kim, Ma Woong; Shin, Hyeong Ki; Lee, Sang Kyu; Kim, Hyun Koon; Yoo, Kun Joong; Ryu, Yong Ho; Son, Han Seong; Song, Deok Yong

    2007-01-01

    As increase of operating nuclear power plants, an accident monitoring system is essential to ensure the operational safety of nuclear power plant. Thus, KINS has developed the Computerized Advisory System for a Radiological Emergency (CARE) system to monitor the operating status of nuclear power plant continuously. However, during the accidents or/and incidents some parameters could not be provided from the process computer of nuclear power plant to the CARE system due to limitation of To enhance the CARE system more effective for CANDU reactors, there is a need to provide complement the feature of the CARE in such a way to providing the operating parameters using to using safety analysis tool such as CANDU Integrated Safety Analysis System (CISAS) for CANDU reactors. In this study, to enhance the safety monitoring measurement two computerized systems such as a CANDU Operational Safety Monitoring System (COSMOS) and prototype of CANDU Emergency Preparedness Advisory System (CEPAS) are developed. This study introduces the two integrated safety monitoring system using the R and D products of the national mid- and long-term R and D such as CISAS and ISSAC code

  19. 75 FR 32855 - Safety Zone; Pierce County, WA, Department of Emergency Management, Regional Water Exercise

    Science.gov (United States)

    2010-06-10

    ...-AA00 Safety Zone; Pierce County, WA, Department of Emergency Management, Regional Water Exercise AGENCY: Coast Guard, DHS. ACTION: Temporary final rule. SUMMARY: The Pierce County, Washington, Department of... immediate action is necessary to ensure safety of participants in the Pierce County Regional Water Rescue...

  20. Targeted On-Demand Team Performance App Development

    Science.gov (United States)

    2018-02-01

    management protocols and set up file management using encryption and a secure server. Complete 10 Customize Data Collection App Modify CareAssess App to...greater team morale. An App that serves to build relationships around the management of emergency medicine cases over time, could stimulate the... Management 4. Casualty Care 5. Trauma Care 6. Critical Care 7. Trauma Management 8. High Performing Teams 9. Team Characteristics 10. Team Composition

  1. Regular in-situ simulation training of paediatric Medical Emergency Team leads to sustained improvements in hospital response to deteriorating patients, improved outcomes in intensive care and financial savings.

    Science.gov (United States)

    Theilen, Ulf; Fraser, Laura; Jones, Patricia; Leonard, Paul; Simpson, Dave

    2017-06-01

    The introduction of a paediatric Medical Emergency Team (pMET) was accompanied by weekly in-situ simulation team training. Key ward staff participated in team training, focusing on recognition of the deteriorating child, teamwork and early involvement of senior staff. Following an earlier study [1], this investigation aimed to evaluate the long-term impact of ongoing regular team training on hospital response to deteriorating ward patients, patient outcome and financial implications. Prospective cohort study of all deteriorating in-patients in a tertiary paediatric hospital requiring admission to paediatric intensive care (PICU) the year before, 1year after and 3 years after the introduction of pMET and team training. Deteriorating patients were recognised more promptly (before/1year after/3years after pMET; median time 4/1.5/0.5h, pIntroduction of pMET coincided with significantly reduced hospital mortality (p<0.001). These results indicate that lessons learnt by ward staff during team training led to sustained improvements in the hospital response to critically deteriorating in-patients, significantly improved patient outcomes and substantial savings. Integration of regular in-situ simulation training of medical emergency teams, including key ward staff, in routine clinical care has potential application in all acute specialties. Copyright © 2017. Published by Elsevier B.V.

  2. Qualitative evaluation of the Safety and Improvement in Primary Care (SIPC) pilot collaborative in Scotland: perceptions and experiences of participating care teams.

    Science.gov (United States)

    Bowie, Paul; Halley, Lyn; Blamey, Avril; Gillies, Jill; Houston, Neil

    2016-01-29

    To explore general practitioner (GP) team perceptions and experiences of participating in a large-scale safety and improvement pilot programme to develop and test a range of interventions that were largely new to this setting. Qualitative study using semistructured interviews. Data were analysed thematically. Purposive sample of multiprofessional study participants from 11 GP teams based in 3 Scottish National Health Service (NHS) Boards. 27 participants were interviewed. 3 themes were generated: (1) programme experiences and benefits, for example, a majority of participants referred to gaining new theoretical and experiential safety knowledge (such as how unreliable evidence-based care can be) and skills (such as how to search electronic records for undetected risks) related to the programme interventions; (2) improvements to patient care systems, for example, improvements in care systems reliability using care bundles were reported by many, but this was an evolving process strongly dependent on closer working arrangements between clinical and administrative staff; (3) the utility of the programme improvement interventions, for example, mixed views and experiences of participating in the safety climate survey and meeting to reflect on the feedback report provided were apparent. Initial theories on the utilisation and potential impact of some interventions were refined based on evidence. The pilot was positively received with many practices reporting improvements in safety systems, team working and communications with colleagues and patients. Barriers and facilitators were identified related to how interventions were used as the programme evolved, while other challenges around spreading implementation beyond this pilot were highlighted. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Safety technology: Emergency equipment and sea rescue techniques

    Energy Technology Data Exchange (ETDEWEB)

    1986-06-01

    In June 1986, a two day workshop was convened to review mobile offshore drilling unit (MODU) evacuation research and development (R D) requirements for programs currently sponsored by the Marine Engineering Committee for PERD (Panel on Energy Research and Development) task 6.2. The proceedings of the workshop are presented in terms of: evacuation technology needs; a review of current R D projects for their relevance to the technological needs; recommended changes to current projects where warranted; and recommended priority R D projects that are not presently being undertaken to meet the evacuation technology needs. Current R D projects reviewed include: preferred orientation and displacement (PROD) lifeboat launching, personal transfer baskets, arctic escape system (AES), fast rescue craft (FRC), helicopter survival suits, diving bell emergency heaters, working immersion suits, diving bell emergency ascent system, undersea robotics systems and DCIEM decompression tables. It was concluded that gaps in offshore safety/evacuation capability cannot be adequately addressed by one or two major projects. Rather, a wider range of problems exist that require attention through a greater financial commitment than is presently the case. Government-industry cooperation in this field is required. Overall, the projects were judged to have been well planned, managed, and relevant to offshore safety needs. The only exception was a feeling that diving related projects consummed a disproportionate share of the available funding. Further, there was some reservation that the robotics study was outside the 6.2 PERD R D mandate. A list of recommendations is presented. 1 tab.

  4. Food safety ontology and text mining strategies as a tool in (re)emerging risk identification

    NARCIS (Netherlands)

    Brug, F. van de

    2009-01-01

    Industry and government are held responsible for the safety of food and feed products. Therefore actual and relevant information concerning emerging safety risks is crucial. But how is it possible to filter relevant information from the fast growing volumes of information produced by science and the

  5. [Regional Study of Patient Safety Incidents (ERIDA) in the Emergency Services].

    Science.gov (United States)

    Alcaraz-Martínez, J; Aranaz-Andrés, J M; Martínez-Ros, C; Moreno-Reina, S; Escobar-Álvaro, L; Ortega-Liarte, J V

    2016-01-01

    Evaluate the patient safety incidents that occur in the emergency departments of our region. Observational study conducted in all the hospital emergency departments in the Regional Health Service of Murcia. After systematic random sampling, data were collected during care and a week later by telephone survey. Health professionals of each service were trained and collected the information, following the methodology of the National Study of Adverse Events Related to Hospitalization -ENEAS- and the Adverse Events Related to Spanish Hospital Emergency Department Care -EVADUR-. A total of 393 samples were collected, proportional to the cases treated in each hospital. In 10 cases (3.1%) the complaint was a previous safety incident. At least one incident was detected in 47 patients (11.95%; 8.7 to 15.1%). In 3 cases there were 2 incidents, bringing the number of incidents to 50. Regarding the impact, the 51% of incidents caused harm to the patients. The effects more frequent in patients were the need for repeat visits (9 cases), and mismanagement of pain (8 cases). In 24 cases (51.1%) health care was not affected, although 3 cases required an additional test, 11 cases required further consultation, and led to hospitalisation in 2 cases. The most frequent causal factors of these incidents were medication (14) and care (12). The incidents were considered preventable in 60% of cases. A rate of incidents in the emergency departments, representative of the region, has been obtained. The implications of the results for the population means that 12 out of every 100 patients treated in emergency departments have an adverse event, and 7 of these are avoidable. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  6. Team-training in healthcare: a narrative synthesis of the literature

    Science.gov (United States)

    Weaver, Sallie J; Dy, Sydney M; Rosen, Michael A

    2014-01-01

    Background Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings. Methods A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes. Results Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice. Conclusions Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective

  7. Report of the ASSET (Assessment of Safety Significant Events Team) mission to the Cernavoda nuclear power plant in Romania 8-12 August 1994 Division of Nuclear Safety. Root cause analysis of a significant event that occurred during commissioning of unit 1

    International Nuclear Information System (INIS)

    1994-01-01

    The IAEA Assessment of Safety Significant Events Team (ASSET) report presents the results of the team's investigation of a significant event that occurred during commissioning of Unit 1 of Cernavoda nuclear power plant. The results, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible authorities in Romania. The ASSET team's views presented in this report are based on visits to the plant, on review of documentation made available by the operating organization and on discussions with utility personnel. The report is intended to enhance operational safety at Cernavoda by proposing improvements to the policy for the prevention of incidents at the plant. The report includes, as a usual practice, the official response of the Regulatory Body and Operating Organization to the ASSET recommendations. Figs

  8. Tiger Team assessment of the Pinellas Plant

    Energy Technology Data Exchange (ETDEWEB)

    1990-05-01

    This Document contains findings identified during the Tiger Team Compliance Assessment of the Department of Energy's (DOE's) Pinellas Plant, Pinellas County, Florida. The assessment wa directed by the Department's Office of Environment, Safety, and Health (ES H) from January 15 to February 2, 1990. The Pinellas Tiger Team Compliance Assessment is comprehensive in scope. It covers the Environment Safety and Health, and Management areas and determines the plant's compliance with applicable Federal (including DOE), State, and local regulations and requirements.

  9. Development of an Integrated Team Training Design and Assessment Architecture to Support Adaptability in Healthcare Teams

    Science.gov (United States)

    2016-10-01

    chosen for their expertise and to ensure geographical representation. COMPLETED Human Research Protection Office IRB 3 The HRPO has granted exempt... taxonomy (Figure 3) can help guide the selection of appropriate training targets and can help educators target correct task complexity, appropriate...team assessment. We extended this knowledge by investigating the team science, safety science, and human factors literature. Because our work

  10. Improving the safety of remote site emergency airway management.

    Science.gov (United States)

    Wijesuriya, Julian; Brand, Jonathan

    2014-01-01

    Airway management, particularly in non-theatre settings, is an area of anaesthesia and critical care associated with significant risk of morbidity & mortality, as highlighted during the 4th National Audit Project of the Royal College of Anaesthetists (NAP4). A survey of junior anaesthetists at our hospital highlighted a lack of confidence and perceived lack of safety in emergency airway management, especially in non-theatre settings. We developed and implemented a multifaceted airway package designed to improve the safety of remote site airway management. A Rapid Sequence Induction (RSI) checklist was developed; this was combined with new advanced airway equipment and drugs bags. Additionally, new carbon dioxide detector filters were procured in order to comply with NAP4 monitoring recommendations. The RSI checklists were placed in key locations throughout the hospital and the drugs and advanced airway equipment bags were centralised in the Intensive Care Unit (ICU). It was agreed with the senior nursing staff that an appropriately trained ICU nurse would attend all emergency situations with new airway resources upon request. Departmental guidelines were updated to include details of the new resources and the on-call anaesthetist's responsibilities regarding checks and maintenance. Following our intervention trainees reported higher confidence levels regarding remote site emergency airway management. Nine trusts within the Northern Region were surveyed and we found large variations in the provision of remote site airway management resources. Complications in remote site airway management due lack of available appropriate drugs, equipment or trained staff are potentially life threatening and completely avoidable. Utilising the intervention package an anaesthetist would be able to safely plan and prepare for airway management in any setting. They would subsequently have the drugs, equipment, and trained assistance required to manage any difficulties or complications

  11. Design and evaluation of simulation scenarios for a program introducing patient safety, teamwork, safety leadership, and simulation to healthcare leaders and managers.

    Science.gov (United States)

    Cooper, Jeffrey B; Singer, Sara J; Hayes, Jennifer; Sales, Michael; Vogt, Jay W; Raemer, Daniel; Meyer, Gregg S

    2011-08-01

    We developed a training program to introduce managers and informal leaders of healthcare organizations to key concepts of teamwork, safety leadership, and simulation to motivate them to act as leaders to improve safety within their sphere of influence. This report describes the simulation scenario and debriefing that are core elements of that program. Twelve teams of clinician and nonclinician managers were selected from a larger set of volunteers to participate in a 1-day, multielement training program. Two simulation exercises were developed: one for teams of nonclinicians and the other for clinicians or mixed groups. The scenarios represented two different clinical situations, each designed to engage participants in discussions of their safety leadership and teamwork issues immediately after the experience. In the scenarios for nonclinicians, participants conducted an anesthetic induction and then managed an ethical situation. The scenario for clinicians simulated a consulting visit to an emergency room that evolved into a problem-solving challenge. Participants in this scenario had a limited time to prepare advice for hospital leadership on how to improve observed safety and cultural deficiencies. Debriefings after both types of scenarios were conducted using principles of "debriefing with good judgment." We assessed the relevance and impact of the program by analyzing participant reactions to the simulation through transcript data and facilitator observations as well as a postcourse questionnaire. The teams generally reported positive perceptions of the relevance and quality of the simulation with varying types and degrees of impact on their leadership and teamwork behaviors. These kinds of clinical simulation exercises can be used to teach healthcare leaders and managers safety leadership and teamwork skills and behaviors.

  12. Promoting teamwork and surgical optimization: combining TeamSTEPPS with a specialty team protocol.

    Science.gov (United States)

    Tibbs, Sheila Marie; Moss, Jacqueline

    2014-11-01

    This quality improvement project was a 300-day descriptive preintervention and postintervention comparison consisting of a convenience sample of 18 gynecology surgical team members. We administered the Team Strategies & Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) Teamwork Perception Questionnaire to measure the perception of teamwork. In addition, we collected data regarding rates of compliance (ie, huddle, time out) and measurable surgical procedure times. Results showed a statistically significant increase in the number of team members present for each procedure, 2.34 μ before compared with 2.61 μ after (P = .038), and in the final time-out (FTO) compliance as a result of a clarification of the definition of FTO, 1.05 μ before compared with 1.18 μ after (P = .004). Additionally, there was improvement in staff members' perception of teamwork. The implementation of team training, protocols, and algorithms can enhance surgical optimization, communication, and work relationships. Copyright © 2014 AORN, Inc. Published by Elsevier Inc. All rights reserved.

  13. Simulation-based multiprofessional obstetric anaesthesia training conducted in situ versus off-site leads to similar individual and team outcomes: a randomised educational trial

    Science.gov (United States)

    Sørensen, Jette Led; van der Vleuten, Cees; Rosthøj, Susanne; Østergaard, Doris; LeBlanc, Vicki; Johansen, Marianne; Ekelund, Kim; Starkopf, Liis; Lindschou, Jane; Gluud, Christian; Weikop, Pia; Ottesen, Bent

    2015-01-01

    Objective To investigate the effect of in situ simulation (ISS) versus off-site simulation (OSS) on knowledge, patient safety attitude, stress, motivation, perceptions of simulation, team performance and organisational impact. Design Investigator-initiated single-centre randomised superiority educational trial. Setting Obstetrics and anaesthesiology departments, Rigshospitalet, University of Copenhagen, Denmark. Participants 100 participants in teams of 10, comprising midwives, specialised midwives, auxiliary nurses, nurse anaesthetists, operating theatre nurses, and consultant doctors and trainees in obstetrics and anaesthesiology. Interventions Two multiprofessional simulations (clinical management of an emergency caesarean section and a postpartum haemorrhage scenario) were conducted in teams of 10 in the ISS versus the OSS setting. Primary outcome Knowledge assessed by a multiple choice question test. Exploratory outcomes Individual outcomes: scores on the Safety Attitudes Questionnaire, stress measurements (State-Trait Anxiety Inventory, cognitive appraisal and salivary cortisol), Intrinsic Motivation Inventory and perceptions of simulations. Team outcome: video assessment of team performance. Organisational impact: suggestions for organisational changes. Results The trial was conducted from April to June 2013. No differences between the two groups were found for the multiple choice question test, patient safety attitude, stress measurements, motivation or the evaluation of the simulations. The participants in the ISS group scored the authenticity of the simulation significantly higher than did the participants in the OSS group. Expert video assessment of team performance showed no differences between the ISS versus the OSS group. The ISS group provided more ideas and suggestions for changes at the organisational level. Conclusions In this randomised trial, no significant differences were found regarding knowledge, patient safety attitude, motivation or stress

  14. Moving Forward with Computational Red Teaming

    Science.gov (United States)

    2012-07-01

    Red Teaming is used across both public and private sectors and is not the sole domain of the military. Red Team Consulting (2011) notes that “the use...open for review. Consider also the context of application. Oh (2009) explains how globalisation , the rise of emerging powers, environmental

  15. Diving and Environmental Simulation Team

    Data.gov (United States)

    Federal Laboratory Consortium — The Diving and Environmental Simulation Team focuses on ways to optimize the performance and safety of Navy divers. Our goal is to increase mission effectiveness by...

  16. Safety pharmacology--current and emerging concepts.

    Science.gov (United States)

    Hamdam, Junnat; Sethu, Swaminathan; Smith, Trevor; Alfirevic, Ana; Alhaidari, Mohammad; Atkinson, Jeffrey; Ayala, Mimieveshiofuo; Box, Helen; Cross, Michael; Delaunois, Annie; Dermody, Ailsa; Govindappa, Karthik; Guillon, Jean-Michel; Jenkins, Rosalind; Kenna, Gerry; Lemmer, Björn; Meecham, Ken; Olayanju, Adedamola; Pestel, Sabine; Rothfuss, Andreas; Sidaway, James; Sison-Young, Rowena; Smith, Emma; Stebbings, Richard; Tingle, Yulia; Valentin, Jean-Pierre; Williams, Awel; Williams, Dominic; Park, Kevin; Goldring, Christopher

    2013-12-01

    Safety pharmacology (SP) is an essential part of the drug development process that aims to identify and predict adverse effects prior to clinical trials. SP studies are described in the International Conference on Harmonisation (ICH) S7A and S7B guidelines. The core battery and supplemental SP studies evaluate effects of a new chemical entity (NCE) at both anticipated therapeutic and supra-therapeutic exposures on major organ systems, including cardiovascular, central nervous, respiratory, renal and gastrointestinal. This review outlines the current practices and emerging concepts in SP studies including frontloading, parallel assessment of core battery studies, use of non-standard species, biomarkers, and combining toxicology and SP assessments. Integration of the newer approaches to routine SP studies may significantly enhance the scope of SP by refining and providing mechanistic insight to potential adverse effects associated with test compounds. Copyright © 2013 Elsevier Inc. All rights reserved.

  17. Training programs for emergency response personnel at Hanford

    International Nuclear Information System (INIS)

    Oscarson, E.E.

    1979-01-01

    The Three Mile Island reactor accident has focused attention on emergency planning and preparedness including selection and training of personnel. At Hanford, Pacific Northwest Laboratory (PNL) is in the unique position of providing emergency response personnel, planning, training and equipment not only for its own organization and facilities but also for the Hanford Site in general, as well as the Interagency Radiological Assistance Plan (IRAP) Region 8 Team. Team members are chosen for one or more of the emergency teams based upon professional education and/or experience as well as interest, aptitude and specialized knowledge. Consequently, the initial training orientation of each new team member is not directed toward general professional ability, but rather toward specialized knowledge required to carry out their assigned emergency tasks. Continual training and practice is necessary to maintain the interest and skills for effectively coping with major emergencies. The types of training which are conducted include: tests of emergency systems and/or procedures; drills involving plant employees and/or emergency team members (e.g., activation of emergency notification systems); short training sessions on special topics; and realistic emergency exercises involving the simulation of major accidents wherein the emergency team must solve specific problems on a real time basis

  18. Integrated Safety, Environmental and Emergency Management System (ISEEMS)

    International Nuclear Information System (INIS)

    Silver, R.; Langwell, G.; Thomas, C.; Coffing, S.

    1996-01-01

    The Risk Management and NEPA (National Environmental Policy Act) Department of Sandia National Laboratories/New Mexico (SNL/NM) recognized the need for hazard and environmental data analysis and management to support the line managers' need to know, understand, manage and document the hazards in their facilities and activities. The Integrated Safety, Environmental, and Emergency Management System (ISEEMS) was developed in response to this need. SNL needed a process that would quickly and easily determine if a facility or project activity contained only standard industrial hazards and therefore require minimal safety documentation, or if non-standard industrial hazards existed which would require more extensive analysis and documentation. Many facilities and project activities at SNL would benefit from the quick screening process used in ISEEMS. In addition, a process was needed that would expedite the NEPA process. ISEEMS takes advantage of the fact that there is some information needed for the NEPA process that is also needed for the safety documentation process. The ISEEMS process enables SNL line organizations to identify and manage hazards and environmental concerns at a level of effort commensurate with the hazards themselves by adopting a necessary and sufficient (graded) approach to compliance. All hazard-related information contained within ISEEMS is location based and can be displayed using on-line maps and building floor plans. This visual representation provides for quick assimilation and analysis

  19. Building the occupational health team: keys to successful interdisciplinary collaboration.

    Science.gov (United States)

    Wachs, Joy E

    2005-04-01

    Teamwork among occupational health and safety professionals, management, and employees is vital to solving today's complex problems cost-effectively. No single discipline can meet all the needs of workers and the workplace. However, teamwork can be time-consuming and difficult if attention is not given to the role of the team leader, the necessary skills of team members, and the importance of a supportive environment. Bringing team members together regularly to foster positive relationships and infuse them with the philosophy of strength in diversity is essential for teams to be sustained and work to be accomplished. By working in tandem, occupational health and safety professionals can become the model team in business and industry delivering on their promise of a safe and healthy workplace for America's work force.

  20. Endoscopic non-technical skills team training: The next step in quality assurance of endoscopy training

    Science.gov (United States)

    Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

    2014-01-01

    AIM: To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes. METHODS: A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day’s training utilising real clinical examples. Pre and post-course evaluation comprised participants’ patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected. RESULTS: Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training. CONCLUSION: A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams’ knowledge and safety attitudes. PMID:25516665

  1. Implementation of team training in medical education in Denmark

    OpenAIRE

    Ostergaard, H; Ostergaard, D; Lippert, A

    2004-01-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessme...

  2. Quality charters or quality members? A control theory perspective on team charters and team performance.

    Science.gov (United States)

    Courtright, Stephen H; McCormick, Brian W; Mistry, Sal; Wang, Jiexin

    2017-10-01

    Though prevalent in practice, team charters have only recently received scholarly attention. However, most of this work has been relatively devoid of theory, and consequently, key questions about why and under what conditions team charter quality affects team performance remain unanswered. To address these gaps, we draw on macro organizational control theory to propose that team charter quality serves as a team-level "behavior" control mechanism that builds task cohesion through a structured exercise. We then juxtapose team charter quality with an "input" team control mechanism that influences the emergence of task cohesion more organically: team conscientiousness. Given their redundant effects on task cohesion, we propose that the effects of team charter quality and team conscientiousness on team performance (through task cohesion) are substitutive such that team charter quality primarily impacts team performance for teams that are low (vs. high) on conscientiousness. We test and find support for our hypotheses in a sample of 239 undergraduate self-managing project teams. Our study contributes to the groups and teams literature in the following ways: first, relative to previous studies, we take a more theory-driven approach toward understanding team charters, and in doing so, uncover when and why team charter quality impacts team performance; second, we integrate two normally disparate perspectives on team effectiveness (team development and team selection) to offer a broader perspective on how teams are "built"; and third, we introduce team charter quality as a performance-enhancing mechanism for teams lower on conscientiousness. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  3. Communication and relationship skills for rapid response teams at hamilton health sciences.

    Science.gov (United States)

    Cziraki, Karen; Lucas, Janie; Rogers, Toni; Page, Laura; Zimmerman, Rosanne; Hauer, Lois Ann; Daniels, Charlotte; Gregoroff, Susan

    2008-01-01

    Rapid response teams (RRT) are an important safety strategy in the prevention of deaths in patients who are progressively failing outside of the intensive care unit. The goal is to intervene before a critical event occurs. Effective teamwork and communication skills are frequently cited as critical success factors in the implementation of these teams. However, there is very little literature that clearly provides an education strategy for the development of these skills. Training in simulation labs offers an opportunity to assess and build on current team skills; however, this approach does not address how to meet the gaps in team communication and relationship skill management. At Hamilton Health Sciences (HHS) a two-day program was developed in collaboration with the RRT Team Leads, Organizational Effectiveness and Patient Safety Leaders. Participants reflected on their conflict management styles and considered how their personality traits may contribute to team function. Communication and relationship theories were reviewed and applied in simulated sessions in the relative safety of off-site team sessions. The overwhelming positive response to this training has been demonstrated in the incredible success of these teams from the perspective of the satisfaction surveys of the care units that call the team, and in the multi-phased team evaluation of their application to practice. These sessions offer a useful approach to the development of the soft skills required for successful RRT implementation.

  4. Multidisciplinary crisis simulations: the way forward for training surgical teams.

    Science.gov (United States)

    Undre, Shabnam; Koutantji, Maria; Sevdalis, Nick; Gautama, Sanjay; Selvapatt, Nowlan; Williams, Samantha; Sains, Parvinderpal; McCulloch, Peter; Darzi, Ara; Vincent, Charles

    2007-09-01

    High-reliability organizations have stressed the importance of non-technical skills for safety and of regularly providing such training to their teams. Recently safety skills training has been applied in the practice of medicine. In this study, we developed and piloted a module using multidisciplinary crisis scenarios in a simulated operating theatre to train entire surgical teams. Twenty teams participated (n = 80); each consisted of a trainee surgeon, anesthetist, operating department practitioner (ODP), and scrub nurse. Crisis scenarios such as difficult intubation, hemorrhage, or cardiac arrest were simulated. Technical and non-technical skills (leadership, communication, team skills, decision making, and vigilance), were assessed by clinical experts and by two psychologists using relevant technical and human factors rating scales. Participants received technical and non-technical feedback, and the whole team received feedback on teamwork. Trainees assessed the training favorably. For technical skills there were no differences between surgical trainees' assessment scores and the assessment scores of the trainers. However, nurses overrated their technical skill. Regarding non-technical skills, leadership and decision making were scored lower than the other three non-technical skills (communication, team skills, and vigilance). Surgeons scored lower than nurses on communication and teamwork skills. Surgeons and anesthetists scored lower than nurses on leadership. Multidisciplinary simulation-based team training is feasible and well received by surgical teams. Non-technical skills can be assessed alongside technical skills, and differences in performance indicate where there is a need for further training. Future work should focus on developing team performance measures for training and on the development and evaluation of systematic training for technical and non-technical skills to enhance team performance and safety in surgery.

  5. High-performing trauma teams: frequency of behavioral markers of a shared mental model displayed by team leaders and quality of medical performance.

    Science.gov (United States)

    Johnsen, Bjørn Helge; Westli, Heidi Kristina; Espevik, Roar; Wisborg, Torben; Brattebø, Guttorm

    2017-11-10

    High quality team leadership is important for the outcome of medical emergencies. However, the behavioral marker of leadership are not well defined. The present study investigated frequency of behavioral markers of shared mental models (SMM) on quality of medical management. Training video recordings of 27 trauma teams simulating emergencies were analyzed according to team -leader's frequency of shared mental model behavioral markers. The results showed a positive correlation of quality of medical management with leaders sharing information without an explicit demand for the information ("push" of information) and with leaders communicating their situational awareness (SA) and demonstrating implicit supporting behavior. When separating the sample into higher versus lower performing teams, the higher performing teams had leaders who displayed a greater frequency of "push" of information and communication of SA and supportive behavior. No difference was found for the behavioral marker of team initiative, measured as bringing up suggestions to other teammembers. The results of this study emphasize the team leader's role in initiating and updating a team's shared mental model. Team leaders should also set expectations for acceptable interaction patterns (e.g., promoting information exchange) and create a team climate that encourages behaviors, such as mutual performance monitoring, backup behavior, and adaptability to enhance SMM.

  6. Interprofessional team management in pediatric critical care: some challenges and possible solutions.

    Science.gov (United States)

    Stocker, Martin; Pilgrim, Sina B; Burmester, Margarita; Allen, Meredith L; Gijselaers, Wim H

    2016-01-01

    Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU) has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous. We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts. The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal factors to learning in daily practice. Finally, changes in small steps at the level of the microlevel unit are the bases to improve interprofessional team management and patient safety. Once small things with potential impact can be changed in one's own unit, engagement of health care professionals occurs and projects become accepted. Bottom-up patient safety initiatives encouraging participation of every single care provider by learning effective interprofessional team management within daily practice may be an effective way of fostering patient safety.

  7. 29 CFR 1926.1076 - Qualifications of dive team.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 8 2010-07-01 2010-07-01 false Qualifications of dive team. 1926.1076 Section 1926.1076 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... § 1926.1076 Qualifications of dive team. Note: The requirements applicable to construction work under...

  8. The Surgical Teams' Perception of the Effects of a Routine Intraoperative Pause.

    Science.gov (United States)

    Erestam, Sofia; Angenete, Eva; Derwinger, Kristoffer

    2016-12-01

    A pause routine may reduce stress and errors during surgery. The aim of this study was to explore how the team, divided into the different professional groups, perceived the implementation of a pause routine and its possible impact on safety. A pause routine was introduced at a University hospital operating theatre in Sweden in 2013. Questionnaires were distributed about 1 year later to all members of the operating theatre team. The questions included different perspectives of possible effects of the pause routine. A majority were positive to scheduled pauses. The surgeons often felt refreshed and at times changed their view on both anatomy and their surgical strategy. They were also perceived by other team members as improved regarding communication. All groups felt that patient safety was promoted. There were differences by profession in perception of team communication. The pause routine was well perceived by the surgical team. A majority believed that scheduled and regular pauses contribute to improved patient safety and better team communication. There were also findings of differences in communication and experience of team coherence between personnel categories that could benefit from further acknowledgement and exploration.

  9. Internal safety review team at Comanche Peak SES

    Energy Technology Data Exchange (ETDEWEB)

    Davis, D [Comanche Peak Steam Electric Staion, Texas Utilities, TX (United States)

    1997-09-01

    The presentations describes the following issues: levels of defense in depth; internal safety review organizations; methods used to perform safety assessment; safety committee review; quality verification; root cause analysis; human performance program; industry operating experience.

  10. Planning and preparing for emergency response to transport accidents involving radioactive material. Safety guide

    International Nuclear Information System (INIS)

    2005-01-01

    The objective of this Safety Guide is to provide guidance to the public authorities and others (including consignors, carriers and emergency response authorities) who are responsible for developing and establishing emergency arrangements for dealing effectively and safely with transport accidents involving radioactive material. It may assist those concerned with establishing the capability to respond to such transport emergencies. It provides guidance for those Member States whose involvement with radioactive material is just beginning. It also provides guidance for those Member States that have already developed their radioactive material industries and the attendant emergency plans but that may need to review and improve these plans

  11. International Nuclear and Radiation Safety Experts Conclude IAEA Peer Review of Slovenia's Regulatory System

    International Nuclear Information System (INIS)

    2011-01-01

    within the Slovenian nuclear industry and coordination with international stakeholders was considered effective. Further lessons learned will also need to be adequately addressed. Among the good practices identified by the IRRS Review Team were: The development of SSNA's quality management system, through which it will be able to improve its regulatory effectiveness; and SNSA has developed, maintains and uses an integrated information management system. The IRRS Review Team also identified certain issues warranting attention or in need of improvement. It believes that consideration of these would enhance the overall performance of the future regulatory system: Slovenia should develop a national policy and strategy for nuclear safety which would be supported by a national co-ordinated plan to ensure the appropriate national infrastructure is in place; Consideration should be given to possible alternative methods of financing SNSA to provide it with the flexibility to meet its regulatory responsibilities while also ensuring it operates effectively. This should include provision for research and development; SNSA should develop and implement a process for carrying out a systematic review of the organisational structure, competencies and resource needed for it to effectively discharge its current and future responsibilities; and The Government should make the necessary provision for the Low and Intermediate Level Waste Repository to ensure radioactive waste can be disposed at the appropriate time. Background The IRRS mission to Slovenia was conducted from 25 September to 4 October, mainly in Ljubljana. The team also visited several nuclear and radiation facilities, including the nuclear power plant, the research reactor and the country's emergency response centres. The IRRS reviewed the following regulatory areas: responsibilities and functions of the government; the global nuclear safety regime; responsibilities and functions of the regulatory body; the management system of

  12. The emergence of international food safety standards and guidelines: understanding the current landscape through a historical approach.

    Science.gov (United States)

    Ramsingh, Brigit

    2014-07-01

    Following the Second World War, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) teamed up to construct an International Codex Alimentarius (or 'food code') which emerged in 1963. The Codex Committee on Food Hygiene (CCFH) was charged with the task of developing microbial hygiene standards, although it found itself embroiled in debate with the WHO over the nature these standards should take. The WHO was increasingly relying upon the input of biometricians and especially the International Commission on Microbial Specifications for Foods (ICMSF) which had developed statistical sampling plans for determining the microbial counts in the final end products. The CCFH, however, was initially more focused on a qualitative approach which looked at the entire food production system and developed codes of practice as well as more descriptive end-product specifications which the WHO argued were 'not scientifically correct'. Drawing upon historical archival material (correspondence and reports) from the WHO and FAO, this article examines this debate over microbial hygiene standards and suggests that there are many lessons from history which could shed light upon current debates and efforts in international food safety management systems and approaches.

  13. Healthcare management strategies: interdisciplinary team factors.

    Science.gov (United States)

    Andreatta, Pamela; Marzano, David

    2012-12-01

    Interdisciplinary team factors are significant contributors to clinical performance and associated patient outcomes. Quality of care and patient safety initiatives identify human factors associated with team performance as a prime improvement area for clinical patient care. The majority of references to interdisciplinary teams in obstetrics and gynecology in the literature recommends the use of multidisciplinary approaches when managing complex medical cases. The reviewed literature suggests that interdisciplinary team development is important for achieving optimally efficient and effective performance; however, few reports provide specific recommendations for how to optimally achieve these objectives in the process of providing interdisciplinary care to patients. The absence of these recommendations presents a significant challenge for those tasked with improving team performance in the workplace. The prescribed team development programs cited in the review are principally built around communication strategies and simulation-based training mechanisms. Few reports provide descriptions of optimal team-based competencies in the various contexts of obstetric and gynecology teams. However, team-based evaluation strategies and empirical data documenting the transfer of team training to applied clinical care are increasing in number and quality. Our findings suggest that research toward determining team factors that promote optimal performance in applied clinical practice requires definition of specific competencies for the variable teams serving obstetrics and gynecology.

  14. Confluence and convergence: team effectiveness in complex systems.

    Science.gov (United States)

    Porter-OʼGrady, Tim

    2015-01-01

    Complex adaptive systems require nursing leadership to rethink organizational work and the viability and effectiveness of teams. Much of emergent thinking about complexity and systems and organizations alter the understanding of the nature and function of teamwork and the configuration and leadership of team effort. Reflecting on basic concepts of complexity and their application to team formation, dynamics, and outcomes lays an important foundation for effectively guiding the strategic activity of systems through the focused tactical action of teams. Basic principles of complexity, their impact on teams, and the fundamental elements of team effectiveness are explored.

  15. Evaluating trauma team performance in a Level I trauma center: Validation of the trauma team communication assessment (TTCA-24).

    Science.gov (United States)

    DeMoor, Stephanie; Abdel-Rehim, Shady; Olmsted, Richard; Myers, John G; Parker-Raley, Jessica

    2017-07-01

    Nontechnical skills (NTS), such as team communication, are well-recognized determinants of trauma team performance and good patient care. Measuring these competencies during trauma resuscitations is essential, yet few valid and reliable tools are available. We aimed to demonstrate that the Trauma Team Communication Assessment (TTCA-24) is a valid and reliable instrument that measures communication effectiveness during activations. Two tools with adequate psychometric strength (Trauma Nontechnical Skills Scale [T-NOTECHS], Team Emergency Assessment Measure [TEAM]) were identified during a systematic review of medical literature and compared with TTCA-24. Three coders used each tool to evaluate 35 stable and 35 unstable patient activations (defined according to Advanced Trauma Life Support criteria). Interrater reliability was calculated between coders using the intraclass correlation coefficient. Spearman rank correlation coefficient was used to establish concurrent validity between TTCA-24 and the other two validated tools. Coders achieved an intraclass correlation coefficient of 0.87 for stable patient activations and 0.78 for unstable activations scoring excellent on the interrater agreement guidelines. The median score for each assessment showed good team communication for all 70 videos (TEAM, 39.8 of 54; T-NOTECHS, 17.4 of 25; and TTCA-24, 87.4 of 96). A significant correlation between TTTC-24 and T-NOTECHS was revealed (p = 0.029), but no significant correlation between TTCA-24 and TEAM (p = 0.77). Team communication was rated slightly better across all assessments for stable versus unstable patient activations, but not statistically significant. TTCA-24 correlated with T-NOTECHS, an instrument measuring nontechnical skills for trauma teams, but not TEAM, a tool that assesses communication in generic emergency settings. TTCA-24 is a reliable and valid assessment that can be a useful adjunct when evaluating interpersonal and team communication during trauma

  16. The role of emerging technologies to ensure the microbial safety of fresh produce, milk and eggs

    Science.gov (United States)

    This article reviews emerging techniques that are applied in the produce and dairy industry to ensure product safety. Microbial safety of produce, dairy and egg continues to be a major concern. According to Economic Research Service, USDA the cost of foodborne illnesses in the U.S. tops $15.6 billio...

  17. Barriers and facilitators of Canadian quality and safety teams: a mixed-methods study exploring the views of health care leaders

    Directory of Open Access Journals (Sweden)

    White DE

    2016-12-01

    Full Text Available Deborah E White,1 Jill M Norris,1 Karen Jackson,2 Farah Khandwala3 1Faculty of Nursing, University of Calgary, 2Workforce Research and Evaluation, Alberta Health Services, 3Cancer Care Services, Alberta Health Services, Calgary, AB, Canada Background: Health care organizations are utilizing quality and safety (QS teams as a mechanism to optimize care. However, there is a lack of evidence-informed best practices for creating and sustaining successful QS teams. This study aimed to understand what health care leaders viewed as barriers and facilitators to establishing/implementing and measuring the impact of Canadian acute care QS teams.Methods: Organizational senior leaders (SLs and QS team leaders (TLs participated. A mixed-methods sequential explanatory design included surveys (n=249 and interviews (n=89. Chi-squared and Fisher’s exact tests were used to compare categorical variables for region, organization size, and leader position. Interviews were digitally recorded and transcribed for constant comparison analysis.Results: Five qualitative themes overlapped with quantitative data: (1 resources, time, and capacity; (2 data availability and information technology; (3 leadership; (4 organizational plan and culture; and (5 team composition and processes. Leaders from larger organizations more often reported that clear objectives and physician champions facilitated QS teams (p<0.01. Fewer Eastern respondents viewed board/senior leadership as a facilitator (p<0.001, and fewer Ontario respondents viewed geography as a barrier to measurement (p<0.001. TLs and SLs differed on several factors, including time to meet with the team, data availability, leadership, and culture.Conclusion: QS teams need strong, committed leaders who align initiatives to strategic directions of the organization, foster a quality culture, and provide tools teams require for their work. There are excellent opportunities to create synergy across the country to address each

  18. Who Gets to Lead the Multinational Team?

    DEFF Research Database (Denmark)

    Paunova, Minna

    2017-01-01

    of their core self-evaluations. A study of over 230 individuals from 46 nationalities working in 36 self-managing teams generally supports the expected main and moderation effects. Individual core self-evaluations enhance an otherwise weak effect of English proficiency, but compensate for low levels of national......This article examines the emergence of informal leadership in multinational teams. Building on and extending status characteristics theory, the article proposes and tests a model that describes how global inequalities reproduce in multinational teams, and accounts for who gets to lead these teams...

  19. Interprofessional team management in pediatric critical care: some challenges and possible solutions

    Directory of Open Access Journals (Sweden)

    Stocker M

    2016-02-01

    Full Text Available Martin Stocker,1 Sina B Pilgrim,2 Margarita Burmester,3 Meredith L Allen,4 Wim H Gijselaers5 1Neonatal and Pediatric Intensive Care Unit, Children's Hospital Lucerne, Lucerne, 2Pediatric Intensive Care, University Children's Hospital Berne, Berne, Switzerland; 3Pediatric Intensive Care Unit, Royal Brompton Hospital, London, UK; 4Department of Pediatrics, The Royal Children's Hospital, Victoria, Australia; 5Educational Research and Development, School of Business and Economics, Maastricht University, Maastricht, the Netherlands Background: Aiming for and ensuring effective patient safety is a major priority in the management and culture of every health care organization. The pediatric intensive care unit (PICU has become a workplace with a high diversity of multidisciplinary physicians and professionals. Therefore, delivery of high-quality care with optimal patient safety in a PICU is dependent on effective interprofessional team management. Nevertheless, ineffective interprofessional teamwork remains ubiquitous.Methods: We based our review on the framework for interprofessional teamwork recently published in association with the UK Centre for Advancement of Interprofessional Education. Articles were selected to achieve better understanding and to include and translate new ideas and concepts.Findings: The barrier between autonomous nurses and doctors in the PICU within their silos of specialization, the failure of shared mental models, a culture of disrespect, and the lack of empowering parents as team members preclude interprofessional team management and patient safety. A mindset of individual responsibility and accountability embedded in a network of equivalent partners, including the patient and their family members, is required to achieve optimal interprofessional care. Second, working competently as an interprofessional team is a learning process. Working declared as a learning process, psychological safety, and speaking up are pivotal

  20. Team Climate Inventory with a merged organization.

    Science.gov (United States)

    Dackert, Ingrid; Brenner, Sten-Olof; Johansson, Curt R

    2002-10-01

    The present study examines the team climate for innovation in work teams within a newly merged organization. Four teams working at a regional head office of a Social Insurance organization answered the Team Climate Inventory. The results were compared to those of a study by Agrell and Gustafson of more stable teams. The comparison showed that participative safety and support for innovation were rated lower and that vision was rated higher in the newly merged teams. The 38-item original inventory was used and based on the results, a 1999 proposed shortened version of 14 items by Kivimäki and Elovainio was compared with the original one. Analysis indicated that the short version can be a valid alternative to the original version but that further testing of the short version is needed.

  1. Study on dynamic team performance evaluation methodology based on team situation awareness model

    International Nuclear Information System (INIS)

    Kim, Suk Chul

    2005-02-01

    The purpose of this thesis is to provide a theoretical framework and its evaluation methodology of team dynamic task performance of operating team at nuclear power plant under the dynamic and tactical environment such as radiological accident. This thesis suggested a team dynamic task performance evaluation model so called team crystallization model stemmed from Endsely's situation awareness model being comprised of four elements: state, information, organization, and orientation and its quantification methods using system dynamics approach and a communication process model based on a receding horizon control approach. The team crystallization model is a holistic approach for evaluating the team dynamic task performance in conjunction with team situation awareness considering physical system dynamics and team behavioral dynamics for a tactical and dynamic task at nuclear power plant. This model provides a systematic measure to evaluate time-dependent team effectiveness or performance affected by multi-agents such as plant states, communication quality in terms of transferring situation-specific information and strategies for achieving the team task goal at given time, and organizational factors. To demonstrate the applicability of the proposed model and its quantification method, the case study was carried out using the data obtained from a full-scope power plant simulator for 1,000MWe pressurized water reactors with four on-the-job operating groups and one expert group who knows accident sequences. Simulated results team dynamic task performance with reference key plant parameters behavior and team-specific organizational center of gravity and cue-and-response matrix illustrated good symmetry with observed value. The team crystallization model will be useful and effective tool for evaluating team effectiveness in terms of recruiting new operating team for new plant as cost-benefit manner. Also, this model can be utilized as a systematic analysis tool for

  2. Study on dynamic team performance evaluation methodology based on team situation awareness model

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Suk Chul

    2005-02-15

    The purpose of this thesis is to provide a theoretical framework and its evaluation methodology of team dynamic task performance of operating team at nuclear power plant under the dynamic and tactical environment such as radiological accident. This thesis suggested a team dynamic task performance evaluation model so called team crystallization model stemmed from Endsely's situation awareness model being comprised of four elements: state, information, organization, and orientation and its quantification methods using system dynamics approach and a communication process model based on a receding horizon control approach. The team crystallization model is a holistic approach for evaluating the team dynamic task performance in conjunction with team situation awareness considering physical system dynamics and team behavioral dynamics for a tactical and dynamic task at nuclear power plant. This model provides a systematic measure to evaluate time-dependent team effectiveness or performance affected by multi-agents such as plant states, communication quality in terms of transferring situation-specific information and strategies for achieving the team task goal at given time, and organizational factors. To demonstrate the applicability of the proposed model and its quantification method, the case study was carried out using the data obtained from a full-scope power plant simulator for 1,000MWe pressurized water reactors with four on-the-job operating groups and one expert group who knows accident sequences. Simulated results team dynamic task performance with reference key plant parameters behavior and team-specific organizational center of gravity and cue-and-response matrix illustrated good symmetry with observed value. The team crystallization model will be useful and effective tool for evaluating team effectiveness in terms of recruiting new operating team for new plant as cost-benefit manner. Also, this model can be utilized as a systematic analysis tool for

  3. [Human factors and crisis resource management: improving patient safety].

    Science.gov (United States)

    Rall, M; Oberfrank, S

    2013-10-01

    A continuing high number of patients suffer harm from medical treatment. In 60-70% of the cases the sources of harm can be attributed to the field of human factors (HFs) and teamwork; nevertheless, those topics are still neither part of medical education nor of basic and advanced training even though it has been known for many years and it has meanwhile also been demonstrated for surgical specialties that training in human factors and teamwork considerably reduces surgical mortality.Besides the medical field, the concept of crisis resource management (CRM) has already proven its worth in many other industries by improving teamwork and reducing errors in the domain of human factors. One of the best ways to learn about CRM and HFs is realistic simulation team training with well-trained instructors in CRM and HF. The educational concept of the HOTT (hand over team training) courses for trauma room training offered by the DGU integrates these elements based on the current state of science. It is time to establish such training for all medical teams in emergency medicine and operative care. Accompanying safety measures, such as the development of a positive culture of safety in every department and the use of effective critical incident reporting systems (CIRs) should be pursued.

  4. [Concepts of a multidisciplinar team on runaway patients].

    Science.gov (United States)

    Vieira, Sílvio Antônio; Dall'agnol, Clarice Maria

    2009-01-01

    A qualitative study that aimed at learning the way an emergency care multidisciplinary team at a public university hospital conceives and deals with the problem of patients who run away from hospital was carried out. Data were collected using the focus groups technique, whose sample was constituted by ten individuals, approached by non-directive group dynamics. Three thematic classes resulted from content analysis: a certain ambivalence; emergency, a place of (lack of) control; fears and insecurities. The study indicates the chaotic situation encountered by emergency services and, in this context, when patients run away, the health care team is imminently subject to a triple judgment: social, legal and institutional.

  5. IAEA Says Finland's Loviisa Nuclear Power Plant Committed to Safety, Sees Areas for Enhancement

    International Nuclear Information System (INIS)

    2018-01-01

    An International Atomic Energy Agency (IAEA) team of experts said the operator of Finland’s Loviisa Nuclear Power Plant (NPP) demonstrated a commitment to safety. The team also identified areas for further enhancement. The Operational Safety Review Team (OSART) concluded an 18-day mission on 22 March to Loviisa NPP, whose two 531-MWe pressurized-water reactors started commercial operation in 1977 and 1980, respectively. Fortum Power and Heat OY operate the plant, located about 100 km east of Helsinki, the capital. Nuclear power generates one-third of electricity in Finland, which has four operating power reactors and is constructing a fifth reactor. OSART missions aim to improve operational safety by objectively assessing safety performance using the IAEA’s safety standards and proposing improvement where appropriate. The 16-member team comprised experts from Brazil, Canada, China, France, Germany, Hungary, Romania, Russia Federation, Slovak Republic, South Africa, Spain, Ukraine, United Kingdom, United States of America as well as IAEA officials. The review covered the areas of leadership and management for safety; training and qualification; operations; maintenance; technical support; operating experience; radiation protection; chemistry; emergency preparedness and response; accident management; human, technology and organizational interactions; and long-term operation. The team identified a number of good practices that will be shared with the nuclear industry globally, including: • The plant has developed the capability to automatically calculate leak rate tests of containment. • The plant established a process to test and improve modifications and updates early. • The plant has adopted a key system to effectively control access to various rooms in the plant. The mission made several proposals to improve operational safety, including: • The plant management should improve communications of their expectations and consistently reinforce their

  6. Structuring Successful Global Virtual Teams

    Science.gov (United States)

    2015-01-01

    e.g., email) to a lot (e.g., video conferencing ). Finally, global teams can vary in their level of synchronicity, or the degree to which a team’s... electronic communication. Thus, we view these types of teams as analogous enough that they can be discussed together under the overarching term of “global...emergence. Balthazard, Waldman, and Warren (2009) found that communication media that mim- ics face-to-face interactions (e.g., video conferencing

  7. International Nuclear Safety Experts Conclude IAEA Peer Review of Korea's Regulatory System

    International Nuclear Information System (INIS)

    2011-01-01

    organizational change management are needed; Regulations and guides should be developed for decommissioning and management of spent fuel. Regulations should be changed to require a quality assurance plan for the licensing of research and test reactors; and Enhancements to the licensing process are needed to clarify and strengthen the safety information in license amendments and assessment reports. Background The IRRS mission to the Republic of Korea was conducted from 10 to 22 July, mainly in Daejeon. The team also visited several nuclear installations, including a nuclear power plant, a research reactor and the country's emergency response centres. The IRRS team reviewed the following regulatory areas: the government's responsibilities and functions in the nuclear safety regime; the responsibilities and functions of the regulatory body and its management system; the activities of the regulatory body including authorizations; review and assessment; inspection and enforcement processes; and the development of regulations and guides. Team experts came from 14 different countries: Canada, China, the Czech Republic, Finland, France, Hungary, Mexico, Slovakia, Slovenia, Sweden, Switzerland, the United Kingdom, United Arab Emirates and the United States. About IRRS Missions IRRS missions are designed to strengthen and enhance the effectiveness of the national nuclear regulatory infrastructure of States, whilst recognizing the ultimate responsibility of each State to ensure safety in this area. This is done through consideration of both regulatory, technical and policy issues, with comparisons against IAEA safety standards and, where appropriate, good practices elsewhere. (IAEA)

  8. Video registration of trauma team performance in the emergency department: the results of a 2-year analysis in a Level 1 trauma center.

    Science.gov (United States)

    Lubbert, Pieter H W; Kaasschieter, Edgar G; Hoorntje, Lidewij E; Leenen, Loek P H

    2009-12-01

    Trauma teams responsible for the first response to patients with multiple injuries upon arrival in a hospital consist of medical specialists or resident physicians. We hypothesized that 24-hour video registration in the trauma room would allow for precise evaluation of team functioning and deviations from Advanced Trauma Life Support (ATLS) protocols. We analyzed all video registrations of trauma patients who visited the emergency room of a Level I trauma center in the Netherlands between September 1, 2000, and September 1, 2002. Analysis was performed with a score list based on ATLS protocols. From a total of 1,256 trauma room presentations, we found a total of 387 video registrations suitable for analysis. The majority of patients had an injury severity score lower than 17 (264 patients), whereas 123 patients were classified as multiple injuries (injury severity score >or=17). Errors in team organization (omission of prehospital report, no evident leadership, unorganized resuscitation, not working according to protocol, and no continued supervision of the patient) lead to significantly more deviations in the treatment than when team organization was uncomplicated. Video registration of diagnostic and therapeutic procedures by a multidisciplinary trauma team facilitates an accurate analysis of possible deviations from protocol. In addition to identifying technical errors, the role of the team leader can clearly be analyzed and related to team actions. Registration strongly depends on availability of video tapes, timely started registration, and hardware functioning. The results from this study were used to develop a training program for trauma teams in our hospital that specifically focuses on the team leader's functioning.

  9. Evaluation and Customization of WHO Safety Checklist for Patient Safety in Otorhinolaryngology.

    Science.gov (United States)

    Dabholkar, Yogesh; Velankar, Haritosh; Suryanarayan, Sneha; Dabholkar, Twinkle Y; Saberwal, Akanksha A; Verma, Bhavika

    2018-03-01

    The WHO has designed a safe surgery checklist to enhance communication and awareness of patient safety during surgery and to minimise complications. WHO recommends that the check-list be evaluated and customised by end users as a tool to promote safe surgery. The aim of present study was to evaluate the impact of WHO safety checklist on patient safety awareness in otorhinolaryngology and to customise it for the speciality. A prospective structured questionnaire based study was done in ENT operating room for duration of 1 month each for cases, before and after implementation of safe surgery checklist. The feedback from respondents (surgeons, nurses and anaesthetists) was used to arrive at a customised checklist for otolaryngology as per WHO guidelines. The checklist significantly improved team member's awareness of patient's identity (from 17 to 86%) and each other's identity and roles (from 46 to 94%) and improved team communication (from 73 to 92%) in operation theatre. There was a significant improvement in preoperative check of equipment and critical events were discussed more frequently. The checklist could be effectively customised to suit otolaryngology needs as per WHO guidelines. The modified checklist needs to be validated by otolaryngology associations. We conclude from our study that the WHO Surgical safety check-list has a favourable impact on patient safety awareness, team-work and communication of operating team and can be customised for otolaryngology setting.

  10. Shared responsibility: school nurses' experience of collaborating in school-based interprofessional teams.

    Science.gov (United States)

    Reuterswärd, Marina; Hylander, Ingrid

    2017-06-01

    The Swedish Education Act (2011) mandated a new combination of services to boost students' physical health, their mental health and special education through interprofessional pupil health and well-being (PH) teams. For Swedish school nurses, providing these services presents new challenges. To describe how Swedish school nurses experience their work and collaboration within the interprofessional PH teams. Twenty-five school nurses (SNs) were interviewed in five focus groups. Content analysis was used to examine the data and to explore SNs' workplace characteristics by using the components of the sense of coherence (SOC) framework. SNs' experiences of work and collaboration within PH teams can be described using three domains: the expectations of others regarding SNs' roles, SNs' contributions to pupils' health and well-being, and collaboration among SNs within PH teams. The results indicate a discrepancy between SNs' own experiences of their contribution and their experiences of other professionals' expectations regarding those contributions. Some duties were perceived as expected, comprehensible, manageable and meaningful, while other duties - though expected - were perceived as less meaningful, taking time away from school-related matters. Other duties that were not explicitly expected - promoting general health and creating safety zones for pupils, teachers and parents, for example - were nonetheless perceived as meaningful. Collaboration within PH teams was considered meaningful, comprehensible and manageable only if the objectives of the team meetings were clear, if other professionals were available and if professional roles on the team were clearly communicated. The SNs reported a lack of clarity regarding their role in PH and its implementation in schools, indicating that professionals in PH teams need to discuss collaboration so as to find their niche given the new conditions. SOC theory emerged as a useful framework for discussing concrete work

  11. Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands.

    Science.gov (United States)

    Hagemann, Vera; Kluge, Annette

    2017-01-01

    Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes), the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high ( n = 58) or low ( n = 58) collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes such as

  12. The Competence Promoting by NNSA for Keeping High Level Nuclear Safety: The Corner Stone of the Nuclear Safety Regulation Edifice

    International Nuclear Information System (INIS)

    Hu, L.

    2016-01-01

    Facing the fast development of the nuclear power industry and the application of radioactive sources, The MEP(NNSA) is endeavoured to promoting its competency, including: complementing the law system, training and recruiting staff to keep a capable team, constructing the R&D base to keep the basic capability, promoting safety culture both for the industry and the regulator. After the Fukushima nuclear accident, the MEP(NNSA) planned to construct R&D base, in which the Platform Nuclear Safety Monitoring and Emergency Responding, the Platform of Safety Technology of PWR Testing, the Laboratory of Safety Management Technology of Nuclear Waste Verification, the Laboratory of Environmental Radiation Monitoring and the Center of International Cooperation are included. On the other hand, the MEP(NNSA) issued Chinese nuclear safety culture policy declaration in 2014, and carried out a large scale Specialized Action for Nuclear Safety Promotion to promote the nuclear safety culture both for the industry and herself. For the nuclear regulator, It is essential to conduct the competence promoting by both “hardware” and “software”, the former is the material foundation of regulation authority, which will be effectively functioning under the facilitating of the latter. (author)

  13. Behavioral emergency in the elderly: a descriptive study of patients referred to an Aggression Response Team in an acute hospital

    Directory of Open Access Journals (Sweden)

    Simpkins D

    2016-10-01

    Full Text Available Daniel Simpkins,1 Carmelle Peisah,2,3 Irene Boyatzis1 1Division of Rehabilitation and Aged Care, Hornsby Ku-ring-gai Hospital, 2School of Psychiatry, University of New South Wales, 3Discipline of Psychiatry, University of Sydney, Sydney, NSW, Australia Aim: The management of severely agitated elderly patients is not easy, and limited guidelines are available to assist practitioners. At a Sydney hospital, an Aggression Response Team (ART comprising clinical and security staff can be alerted when a staff member has safety concerns. Our aims were to describe the patient population referred for ART calls, reasons for and interventions during ART calls, and complications following them.Methods: Patients 65 years and older referred for ART calls in the emergency department or wards during 2014 were identified using the Incident Information Management System database and medical records were reviewed. Demographic and clinical data were collected. Results: Of 43 elderly patients with ART calls, 30 had repeat ART calls. Thirty-one patients (72% had underlying dementia, and 22 (51% were agitated at the time of admission. The main reasons for ART calls were wandering and physical aggression. Pharmacological sedation was used in 88% of the ART calls, with a range of psychotropics, doses, and routes of administration, including intravenous (19% and, most commonly, midazolam (53%. Complications were documented in 14% of cases where sedation was used. Conclusion: We observed a high frequency of pharmacological sedation among the severely agitated elderly, with significant variance in the choice and dose of sedation and a high rate of complications arising from sedation, which may be an underestimate given the lack of post-sedation monitoring. We recommend the development of guidelines on the management of behavioral emergency in the elderly patients, including de-escalation strategies and standardized psychotropic guidelines. Keywords: aged, aggression

  14. Tools for 'safety netting' in common paediatric illnesses: A systematic review in emergency care

    NARCIS (Netherlands)

    E. De Vos-Kerkhof (Evelien); D.H.F. Geurts (Dorien); M. Wiggers (Mariska); H.A. Moll (Henriëtte); R. Oostenbrink (Rianne)

    2016-01-01

    textabstractContext Follow-up strategies after emergency department (ED) discharge, alias safety netting, is often based on the gut feeling of the attending physician. Objective To systematically identify evaluated safetynetting strategies after ED discharge and to describe determinants of

  15. Report of the ASSET (Assessment of Safety Significant Events Team) mission to the Zaporozhe nuclear power plant in Ukraine 13-24 June 1994 Division of Nuclear Safety. Root cause analysis of operational events with a view to enhancing the prevention of incidents

    International Nuclear Information System (INIS)

    1994-01-01

    The IAEA Assessment of Safety Significant Events Team (ASSET) report presents the results of an ASSET team's assessment of their investigation of the effectiveness of the plant for prevention of incidents since 1990 at Zaporozhe nuclear power plant. The results, conclusions and suggestions presented herein reflect the views of the ASSET experts. They are provided for consideration by the responsible authorities in Ukraine. The ASSET team's views presented in this report are based on visits to the plant, on review of documentation made available by the operating organization and on discussions with utility personnel. The report is intended to enhance operational safety at Zaporozhe by proposing improvements to the policy for the prevention of incidents at the plant. The report includes, as a usual practice, the official response of the operating organization as well as of the regulatory body to the ASSET recommendations. Figs

  16. Issues for the Traveling Team Physician.

    Science.gov (United States)

    Kaeding, Christopher C; Borchers, James

    2016-07-01

    This article outlines the value of having the team physician traveling with athletes to away venues for competitions or training sessions. At present, this travel presents several issues for the team physician who crosses state lines for taking care of the athletes. In this article, these issues and their possible remedies are discussed. A concern for the travelling team physician is practicing medicine while caring for the team in a state where the physician is not licensed. Another issue can be the transportation of controlled substances in the course of providing optimal care for the team athletes. These two issues are regulatory and legislative issues at both the state and federal levels. On the practical side of being a team physician, the issues of emergency action plans, supplies, and when to transport injured or ill patients are also reviewed. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. Dose assessment and approach to the safety for the public in the emergency. Proceedings

    International Nuclear Information System (INIS)

    Nakajima, Toshiyuki

    1994-03-01

    This issue is the collection of the papers presented at the 21st NIRS seminar on Dose Assessment and Approach to the Safety for the Public in the Emergency. The 16 of the presented papers are indexed individually. (J.P.N.)

  18. Associated and Mediating Variables Related to Job Satisfaction among Professionals from Mental Health Teams.

    Science.gov (United States)

    Fleury, Marie-Josée; Grenier, Guy; Bamvita, Jean-Marie; Chiocchio, François

    2018-06-01

    Using a structural analysis, this study examines the relationship between job satisfaction among 315 mental health professionals from the province of Quebec (Canada) and a wide range of variables related to provider characteristics, team characteristics, processes, and emergent states, and organizational culture. We used the Job Satisfaction Survey to assess job satisfaction. Our conceptual framework integrated numerous independent variables adapted from the input-mediator-output-input (IMOI) model and the Integrated Team Effectiveness Model (ITEM). The structural equation model predicted 47% of the variance of job satisfaction. Job satisfaction was associated with eight variables: strong team support, participation in the decision-making process, closer collaboration, fewer conflicts among team members, modest knowledge production (team processes), firm affective commitment, multifocal identification (emergent states) and belonging to the nursing profession (provider characteristics). Team climate had an impact on six job satisfaction variables (team support, knowledge production, conflicts, affective commitment, collaboration, and multifocal identification). Results show that team processes and emergent states were mediators between job satisfaction and team climate. To increase job satisfaction among professionals, health managers need to pursue strategies that foster a positive climate within mental health teams.

  19. Argentine criteria on nuclear safety and emergencies: their impact on the Argos PHWR 380 design

    International Nuclear Information System (INIS)

    Gonzalez, A. J.

    1988-01-01

    This paper describes first the safety criteria of the Argentine regulatory authority with emphasis on the probabilistic safety criteria based on a limitation of individual risks. Then, it is presented a discussion on emergency criteria in relation to evacuation and relocation measures. Finally, the paper briefly describes the design of an Argentine offer for a safer heavy water reactor where these criteria are applied. 9 figs., 1 tab., 46 refs. (author)

  20. Emergency Diesel: Safety-related instrumentation and control with programmable logic controllers

    International Nuclear Information System (INIS)

    Breidenich, G.; Luedtke, M.

    2004-01-01

    This report presents a new concept for the design of emergency diesel equipment protection circuits as a part of the safety related instrumentation in the nuclear power plant Biblis, units A and B. The concept was implemented with state of the art SIMATIC S7/316 programmable logic controllers (PLCs) and can be adapted to any system with high availability requirements (e.g. power plant turbines, aircraft engines, mining pumps etc). (orig.)

  1. Technical safety appraisal of the Idaho Chemical Processing Plant

    International Nuclear Information System (INIS)

    1992-05-01

    On June 27, 1989, Secretary of Energy, Admiral James D. Watkins, US Navy (Retired), announced a 10-point initiative to strengthen environment, safety, and health (ES ampersand H) programs and waste management operations in the Department of Energy (DOE). One of the initiatives involved conducting independent Tiger Team Assessments (TTA) at DOE operating facilities. A TTA of the Idaho National Engineering Laboratory (INEL) was performed during June and July 1991. Technical Safety Appraisals (TSA) were conducted in conjunction with the TTA as its Safety and Health portion. However, because of operational constraints the the Idaho Chemical Processing Plant (ICPP), operated for the DOE by Westinghouse Idaho Nuclear Company, Inc. (WINCO), was not included in the Safety and Health Subteam assessment at that time. This TSA, conducted April 12 - May 8, 1992, was performed by the DOE Office of Performance Assessment to complete the normal scope of the Safety and Health portion of the Tiger Team Assessment of the Idaho National Engineering Laboratory. The purpose of TSAs is to evaluate and strengthen DOE operations by verifying contractor compliance with DOE Orders, to assure that lessons learned from commercial operations are incorporated into facility operations, and to stimulate and encourage pursuit of excellence; thus, the appraisal addresses more issues than would be addressed in a strictly compliance-oriented appraisal. A total of 139 Performance Objectives have been addressed by this appraisal in 19 subject areas. These 19 areas are: organization and administration, quality verification, operations, maintenance, training and certification, auxiliary systems, emergency preparedness, technical support, packaging and transportation, nuclear criticality safety, safety/security interface, experimental activities, site/facility safety review, radiological protection, worker safety and health compliance, personnel protection, fire protection, medical services and natural

  2. Development of a standard communication protocol for an emergency situation management in nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Cheol, E-mail: charleskim@kaeri.re.k [Integrated Risk Assessment Center, Korea Atomic Energy Research Institute, 150, Deokjin-dong, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Park, Jinkyun; Jung, Wondea [Integrated Risk Assessment Center, Korea Atomic Energy Research Institute, 150, Deokjin-dong, Yuseong-gu, Daejeon 305-353 (Korea, Republic of); Kim, Hanjeom; Kim, Yoon Joong [YGN Nuclear Power Division Training Center, Korea Hydro and Nuclear Power Company, 517 Kyemari, Hongnong-eup, Yeongkwang-gun, Chonnam 513-880 (Korea, Republic of)

    2010-06-15

    Correct communication between main control room (MCR) operators is an important factor in the management of emergency situations in nuclear power plants (NPPs). For this reason, a standard communication protocol for the management of emergency situations in NPPs has been developed, with the basic direction of enhancing the safety of NPPs and the standardization of communication protocols. To validate the newly developed standard communication protocol, validation experiments with 10 licensed NPP MCR operator teams was performed. From the validation experiments, it was found that the use of the standard communication protocol required more time, but it can contribute to the enhancement of the safety of NPPs by an operators' better grasp of the safety-related parameters and a more efficient and clearer communication between NPP operators, while imposing little additional workloads on the NPP MCR operators. The standard communication protocol is expected to be used to train existing NPP MCR operators without much aversion, as well as new operators.

  3. Path to 'Stardom' in Globally Distributed Hybrid Teams

    DEFF Research Database (Denmark)

    Sarker, Suprateek; Hove-Kirkeby, Sarah; Sarker, Saonee

    2011-01-01

    recognition that specific individuals within such teams are often critical to the team's performance. Consequently, existing knowledge about such teams may be enhanced by examining the factors that affect the performance of individual team members. This study attempts to address this need by identifying...... individuals who emerge as “stars” in globally distributed teams involved in knowledge work such as information systems development (ISD). Specifically, the study takes a knowledge-centered view in explaining which factors lead to “stardom” in such teams. Further, it adopts a social network approach consistent......Although distributed teams have been researched extensively in information systems and decision science disciplines, a review of the literature suggests that the dominant focus has been on understanding the factors affecting performance at the team level. There has however been an increasing...

  4. Team-Based Care: A Concept Analysis.

    Science.gov (United States)

    Baik, Dawon

    2017-10-01

    The purpose of this concept analysis is to clarify and analyze the concept of team-based care in clinical practice. Team-based care has garnered attention as a way to enhance healthcare delivery and patient care related to quality and safety. However, there is no consensus on the concept of team-based care; as a result, the lack of common definition impedes further studies on team-based care. This analysis was conducted using Walker and Avant's strategy. Literature searches were conducted using PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PsycINFO, with a timeline from January 1985 to December 2015. The analysis demonstrates that the concept of team-based care has three core attributes: (a) interprofessional collaboration, (b) patient-centered approach, and (c) integrated care process. This is accomplished through understanding other team members' roles and responsibilities, a climate of mutual respect, and organizational support. Consequences of team-based care are identified with three aspects: (a) patient, (b) healthcare professional, and (c) healthcare organization. This concept analysis helps better understand the characteristics of team-based care in the clinical practice as well as promote the development of a theoretical definition of team-based care. © 2016 Wiley Periodicals, Inc.

  5. IAEA Leads Operational Safety Mission to Rajasthan Atomic Power Station 3 and 4

    International Nuclear Information System (INIS)

    2012-01-01

    Full text: An international team of nuclear safety experts led by the International Atomic Energy Agency (IAEA) today completed a review of safety practices at Units 3 and 4 of the Rajasthan Atomic Power Station in Rawatbhata. The team noted a series of good practices and made recommendations and suggestions to reinforce safety practices. The IAEA assembled the Operational Safety Review Team (OSART) at the request of the Government of India. Led by the IAEA's Division of Nuclear Installation Safety, the team performed an in-depth operational safety review from 29 October to 14 November 2012. The team was comprised of experts from Canada, Belgium, Finland, Germany, Romania, Slovakia, Slovenia, Sweden and the IAEA. The team conducted an in-depth review of the aspects essential to the safe operation of the Power Plant. The conclusions of the review are based on the IAEA's Safety Standards and good international practices. The review covered the areas of Management, Organization and Administration; Training; Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; Chemistry; Emergency Planning and Preparedness; and Severe Accident Management. The OSART team identified a number of good practices of the plant. These will be shared in due course by the IAEA with the global nuclear industry for consideration. Examples include the following: - The Power Plant's safety culture cultivates a constructive work environment and a sense of accountability among the Power Plant personnel, and gives its staff the opportunity to expand skills and training; - The Power Plant's Public Awareness Programme provides educational opportunities to the local community about nuclear and radiation safety; - The Power Plant has a Management of Training and Authorization system for effective management of training activities; and - The Power Plant uses testing facilities and mockups to improve the quality of maintenance work and to reduce radiation doses. The OSART

  6. Interprofessional communication supporting clinical handover in emergency departments: An observation study.

    Science.gov (United States)

    Redley, Bernice; Botti, Mari; Wood, Beverley; Bucknall, Tracey

    2017-08-01

    Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations. Qualitative data analysis involved content and thematic methods. Four structural components of ED handover processes emerged represented by (ABCD): (1) Antecedents; (2) Behaviours and interactions; (3) Content; and (4) Delegation of ongoing care. Infrequent and ad hoc interprofessional communication and discipline-specific handover content and processes emerged as specific risks to patient safety at change-of-shift handovers. Three themes related to risky and effective practices to support interprofessional communications across the four stages of ED handovers emerged: 1) standard processes and practices, 2) teamwork and interactions and 3) communication activities and practices. Unreliable interprofessional communication can impact the quality of change-of-shift handovers in EDs and poses risk to patient safety. Structured reflective analysis of existing practices can identify opportunities for standardisation, enhanced team practices and effective communication across four stages of the handover process to support clinicians to enhance local handover practices. Future research should test and refine models to support analysis of practice, and identify and test strategies to enhance ED interprofessional communication to support clinical handovers. Copyright © 2017 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  7. Implementation of team training in medical education in Denmark

    DEFF Research Database (Denmark)

    Østergaard, H T; Østergaard, Ditte; Lippert, A

    2008-01-01

    In the field of medicine, team training aiming at improving team skills such as leadership, communication, co-operation, and followership at the individual and the team level seems to reduce risk of serious events and therefore increase patient safety. The preferred educational method for this type...... of training is simulation. Team training is not, however, used routinely in the hospital. In this paper, we describe a framework for the development of a team training course based on need assessment, learning objectives, educational methods including full-scale simulation and evaluations strategies. The use...... of this framework is illustrated by the present multiprofessional team training in advanced cardiac life support, trauma team training and neonatal resuscitation in Denmark. The challenges of addressing all aspects of team skills, the education of the facilitators, and establishment of evaluation strategies...

  8. Game theoretic analysis of congestion, safety and security networks, air traffic and emergency departments

    CERN Document Server

    Zhuang, Jun

    2015-01-01

    Maximizing reader insights into the roles of intelligent agents in networks, air traffic and emergency departments, this volume focuses on congestion in systems where safety and security are at stake, devoting special attention to applying game theoretic analysis of congestion to: protocols in wired and wireless networks; power generation, air transportation and emergency department overcrowding. Reviewing exhaustively the key recent research into the interactions between game theory, excessive crowding, and safety and security elements, this book establishes a new research angle by illustrating linkages between the different research approaches and serves to lay the foundations for subsequent analysis. Congestion (excessive crowding) is defined in this work as all kinds of flows; e.g., road/sea/air traffic, people, data, information, water, electricity, and organisms. Analyzing systems where congestion occurs – which may be in parallel, series, interlinked, or interdependent, with flows one way or both way...

  9. Research teams as complex systems: implications for knowledge management

    NARCIS (Netherlands)

    Vasileiadou, E.

    2012-01-01

    The recent increase in research collaboration creates the need to better understand the interaction between individual researchers and the collaborative team. The paper elaborates the conceptualisation of research teams as complex systems which emerge out of the local interactions of individual

  10. Evaluating the effect of a reader worker program on team performance

    International Nuclear Information System (INIS)

    Hahn, H.A.; Alvarez, Y.P.

    1994-01-01

    When safety, security, or other logistical concerns prevent direct objective assessment of team performance, other evaluation techniques become necessary. In this paper, the effect of a Department of Energy-mandated reader worker program on team performance at a particular DOE facility was evaluated using unstructured observations, informal discussions with technicians, and human reliability analysis. The reader worker program is intended to enhance nuclear explosive safety by improving the reliability of team performance. The three methods used for the evaluation combine to provide a strong indication that team performance is in fact enhanced by a properly implemented reader worker procedure. Because direct quantitative data on dependent variables particular to the task of interest is not available, however, there has been some skepticism regarding the results by staff at the facility

  11. Virtual worlds and team training.

    Science.gov (United States)

    Dev, Parvati; Youngblood, Patricia; Heinrichs, W Leroy; Kusumoto, Laura

    2007-06-01

    An important component of all emergency medicine residency programs is managing trauma effectively as a member of an emergency medicine team, but practice on live patients is often impractical and mannequin-based simulators are expensive and require all trainees to be physically present at the same location. This article describes a project to develop and evaluate a computer-based simulator (the Virtual Emergency Department) for distance training in teamwork and leadership in trauma management. The virtual environment provides repeated practice opportunities with life-threatening trauma cases in a safe and reproducible setting.

  12. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Pohan, Vivi Gusrini Rahmadani; Ancok, Djamaludin

    2010-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  13. Team Learning Ditinjau dari Team Diversity dan Team Efficacy

    OpenAIRE

    Vivi Gusrini Rahmadani Pohan; Djamaludin Ancok

    2015-01-01

    This research attempted to observe team learning from the level of team diversity and team efficacy of work teams. This research used an individual level of analysis rather than the group level. The team members measured the level of team diversity, team efficacy and team learning of the teams through three scales, namely team learning scale, team diversity scale, and team efficacy scale. Respondents in this research were the active team members in a company, PT. Alkindo Mitraraya. The total ...

  14. IAEA Mission Sees Safety Commitment at Finland's New Olkiluoto Reactor Before Planned Start in December

    International Nuclear Information System (INIS)

    2018-01-01

    An International Atomic Energy Agency (IAEA) team of experts observed a commitment to safety by the operator of Unit 3 at Finland’s Olkiluoto Nuclear Power Plant, ahead of the Evolutionary Pressurised Water Reactor’s (EPR) planned connection to the grid in December. The team also identified areas for further enhancements as the operator prepares to put the reactor online. The Pre-Operational Safety Review Team (Pre-OSART) concluded an 18-day mission today to assess operational safety at the 1600 MW reactor, located about 280 km northwest of the capital, Helsinki. Finland has engaged France’s Areva SA together with Germany’s Siemens to construct and commission the unit. The operator is Teollisuuden Voima (TVO). Pre-OSART missions aim to improve operational safety by objectively assessing safety performance using the IAEA’s safety standards and proposing recommendations for improvement where appropriate. The review covered the areas of leadership and management for safety; training and qualification; operations; maintenance; technical support; operating experience; radiation protection; chemistry; emergency preparedness and response; accident management; and commissioning. The team identified a number of good practices that will be shared with the nuclear industry globally, including: • The plant has developed and implemented an efficient system for improving knowledge and skills of staff members. • The plant has developed and validated a unique method for performing suspended solids analysis using a microscope, imaging software and a digital camera. • The plant has introduced a system for systematically assessing nuclear safety culture in the plant supplier organization during construction and commissioning. The mission made several recommendations to improve operational safety, including: • Plant management should set appropriate expectations, communicate them to staff and reinforce them in the field. • The plant should improve the

  15. [Medical rescue of China National Earthquake Disaster Emergency Search and Rescue Team in Lushan earthquake].

    Science.gov (United States)

    Liu, Ya-hua; Yang, Hui-ning; Liu, Hui-liang; Wang, Fan; Hu, Li-bin; Zheng, Jing-chen

    2013-05-01

    To summarize and analyze the medical mission of China National Earthquake Disaster Emergency Search and Rescue Team (CNESAR) in Lushan earthquake, to promote the medical rescue effectiveness incorporated with search and rescue. Retrospective analysis of medical work data by CNESAR from April 21th, 2013 to April 27th during Lushan earthquake rescue, including the medical staff dispatch and the wounded case been treated. The reasonable medical corps was composed by 22 members, including 2 administrators, 11 doctors [covering emergency medicine, orthopedics (joints and limbs, spinal), obstetrics and gynecology, gastroenterology, cardiology, ophthalmology, anesthesiology, medical rescue, health epidemic prevention, clinical laboratory of 11 specialties], 1 ultrasound technician, 5 nurses, 1 pharmacist, 1 medical instrument engineer and 1 office worker for propaganda. There were two members having psychological consultants qualifications. The medical work were carried out in seven aspects, including medical care assurance for the CNESAR members, first aid cooperation with search and rescue on site, clinical work in refugees' camp, medical round service for scattered village people, evacuation for the wounded, mental intervention, and the sanitary and anti-epidemic work. The medical work covered 24 small towns, and medical staff established 3 medical clinics at Taiping Town, Shuangshi Town of Lushan County and Baoxing County. Medical rescue, mental intervention for the old and kids, and sanitary and anti-epidemic were performed at the above sites. The medical corps had successful evacuated 2 severe wounded patients and treated the wounded over thousands. Most of the wounded were soft tissue injuries, external injury, respiratory tract infections, diarrhea, and heat stroke. Compared with the rescue action in 2008 Wenchuan earthquake, the aggregation and departure of rescue team in Lushan earthquake, the traffic control order in disaster area, the self-aid and buddy aid

  16. Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

    Science.gov (United States)

    Hagemann, Vera; Kluge, Annette

    2017-01-01

    Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes), the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high (n = 58) or low (n = 58) collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes such as

  17. Complex Problem Solving in Teams: The Impact of Collective Orientation on Team Process Demands

    Directory of Open Access Journals (Sweden)

    Vera Hagemann

    2017-09-01

    Full Text Available Complex problem solving is challenging and a high-level cognitive process for individuals. When analyzing complex problem solving in teams, an additional, new dimension has to be considered, as teamwork processes increase the requirements already put on individual team members. After introducing an idealized teamwork process model, that complex problem solving teams pass through, and integrating the relevant teamwork skills for interdependently working teams into the model and combining it with the four kinds of team processes (transition, action, interpersonal, and learning processes, the paper demonstrates the importance of fulfilling team process demands for successful complex problem solving within teams. Therefore, results from a controlled team study within complex situations are presented. The study focused on factors that influence action processes, like coordination, such as emergent states like collective orientation, cohesion, and trust and that dynamically enable effective teamwork in complex situations. Before conducting the experiments, participants were divided by median split into two-person teams with either high (n = 58 or low (n = 58 collective orientation values. The study was conducted with the microworld C3Fire, simulating dynamic decision making, and acting in complex situations within a teamwork context. The microworld includes interdependent tasks such as extinguishing forest fires or protecting houses. Two firefighting scenarios had been developed, which takes a maximum of 15 min each. All teams worked on these two scenarios. Coordination within the team and the resulting team performance were calculated based on a log-file analysis. The results show that no relationships between trust and action processes and team performance exist. Likewise, no relationships were found for cohesion. Only collective orientation of team members positively influences team performance in complex environments mediated by action processes

  18. IAEA Concludes Safety Review at Chooz Nuclear Power Plant in France

    International Nuclear Information System (INIS)

    2013-01-01

    Full text: An IAEA-led international team of nuclear safety experts noted good practices and made recommendations to reinforce safety measures during a review of operational safety at France's Chooz Nuclear Power Plant (NPP) that concluded today. The Operational Safety Review Team (OSART) was assembled at the French Government's request. The in-depth review, which began 17 June, focused on aspects essential to the safe operation of the NPP. The team comprised experts from Switzerland, Belgium, Germany, China, India, United Kingdom, Czech Republic, Canada, Hungary and the IAEA. The review covered the areas of management, organization and administration; training and qualification of personnel; operations; maintenance; technical support; operating experience; radiation protection; chemistry; emergency planning and preparedness; and severe accident management. The conclusions of the review are based on the IAEA's Safety Standards. The OSART team identified good plant practices that will be shared with the rest of the nuclear industry for consideration. Examples include: The plant has a professional development programme as part of a joint employment effort shared by the plant and its contractors. This enables trainees to develop professional capability, understand practices and gain experience from other nuclear power plants in terms of work planning and coordination; The plant has built a strong relationship between the on-shift response team of the plant and the local fire brigade to improve firefighting and rescue operations; Self-assessment groups discuss and resolve specific issues within operations, empowering operations personnel to take ownership of improvement programmes; and The plant has improved warnings at entrances to all o range zones , areas of elevated dose rates to which only authorized staff have access. The team identified a number of improvements to operational safety at Chooz NPP. Examples include: The plant should review its process for the

  19. Emergent team roles in organizational meetings: Identifying communication patterns via cluster analysis.

    NARCIS (Netherlands)

    Lehmann-Willenbrock, N.K.; Beck, S.J.; Kauffeld, S.

    2016-01-01

    Previous team role taxonomies have largely relied on self-report data, have focused on functional roles and have described individual predispositions or personality traits. Instead, this study takes a communicative approach and proposes that team roles are produced, shaped and sustained in

  20. A dynamical approach toward understanding mechanisms of team science: change, kinship, tension, and heritage in a transdisciplinary team.

    Science.gov (United States)

    Lotrecchiano, Gaetano R

    2013-08-01

    Since the concept of team science gained recognition among biomedical researchers, social scientists have been challenged with investigating evidence of team mechanisms and functional dynamics within transdisciplinary teams. Identification of these mechanisms has lacked substantial research using grounded theory models to adequately describe their dynamical qualities. Research trends continue to favor the measurement of teams by isolating occurrences of production over relational mechanistic team tendencies. This study uses a social constructionist-grounded multilevel mixed methods approach to identify social dynamics and mechanisms within a transdisciplinary team. A National Institutes of Health-funded research team served as a sample. Data from observations, interviews, and focus groups were qualitatively coded to generate micro/meso level analyses. Social mechanisms operative within this biomedical scientific team were identified. Dynamics that support such mechanisms were documented and explored. Through theoretical and emergent coding, four social mechanisms dominated in the analysis-change, kinship, tension, and heritage. Each contains relational social dynamics. This micro/meso level study suggests such mechanisms and dynamics are key features of team science and as such can inform problems of integration, praxis, and engagement in teams. © 2013 Wiley Periodicals, Inc.

  1. The role of the emergency medical dispatch centre (EMDC) and prehospital emergency care safety: results from an incident report (IR) system.

    Science.gov (United States)

    Mortaro, Alberto; Pascu, Diana; Zerman, Tamara; Vallaperta, Enrico; Schönsberg, Alberto; Tardivo, Stefano; Pancheri, Serena; Romano, Gabriele; Moretti, Francesca

    2015-07-01

    The role of the emergency medical dispatch centre (EMDC) is essential to ensure coordinated and safe prehospital care. The aim of this study was to implement an incident report (IR) system in prehospital emergency care management with a view to detecting errors occurring in this setting and guiding the implementation of safety improvement initiatives. An ad hoc IR form for the prehospital setting was developed and implemented within the EMDC of Verona. The form included six phases (from the emergency call to hospital admission) with the relevant list of potential error modes (30 items). This descriptive observational study considered the results from 268 consecutive days between February and November 2010. During the study period, 161 error modes were detected. The majority of these errors occurred in the resource allocation and timing phase (34.2%) and in the dispatch phase (31.0%). Most of the errors were due to human factors (77.6%), and almost half of them were classified as either moderate (27.9%) or severe (19.9%). These results guided the implementation of specific corrective actions, such as the adoption of a more efficient Medical Priority Dispatch System and the development of educational initiatives targeted at both EMDC staff and the population. Despite the intrinsic limits of IR methodology, results suggest how the implementation of an IR system dedicated to the emergency prehospital setting can act as a major driver for the development of a "learning organization" and improve both efficacy and safety of first aid care.

  2. Integrating team resource management program into staff training improves staff's perception and patient safety in organ procurement and transplantation: the experience in a university-affiliated medical center in Taiwan.

    Science.gov (United States)

    Hsu, Ya-Chi; Jerng, Jih-Shuin; Chang, Ching-Wen; Chen, Li-Chin; Hsieh, Ming-Yuan; Huang, Szu-Fen; Liu, Yueh-Ping; Hung, Kuan-Yu

    2014-08-11

    The process involved in organ procurement and transplantation is very complex that requires multidisciplinary coordination and teamwork. To prevent error during the processes, teamwork education and training might play an important role. We wished to evaluate the efficacy of implementing a Team Resource Management (TRM) program on patient safety and the behaviors of the team members involving in the process. We implemented a TRM training program for the organ procurement and transplantation team members of the National Taiwan University Hospital (NTUH), a teaching medical center in Taiwan. This 15-month intervention included TRM education and training courses for the healthcare workers, focused group skill training for the procurement and transplantation team members, video demonstration and training, and case reviews with feedbacks. Teamwork culture was evaluated and all procurement and transplantation cases were reviewed to evaluate the application of TRM skills during the actual processes. During the intervention period, a total of 34 staff members participated the program, and 67 cases of transplantations were performed. Teamwork framework concept was the most prominent dimension that showed improvement from the participants for training. The team members showed a variety of teamwork behaviors during the process of procurement and transplantation during the intervention period. Of note, there were two potential donors with a positive HIV result, for which the procurement processed was timely and successfully terminated by the team. None of the recipients was transplanted with an infected organ. No error in communication or patient identification was noted during review of the case records. Implementation of a Team Resource Management program improves the teamwork culture as well as patient safety in organ procurement and transplantation.

  3. 'Present nuclear emergency responses in India: tracing requirements and guidelines suggested after Fukushima accident in regards to public and plant safety

    International Nuclear Information System (INIS)

    Jawale, Priyanka M.

    2014-01-01

    In this poster the primary initiative is to educate the public at large and instill confidence about the present Emergency Response Systems of DAE and the imminent agencies in India. Poster attempts to analyse present regulatory and safety systems, mechanisms like plant and site emergency response plans are in place to handle radiation emergencies and how public will not be affected in any manner. In India also we needed some supplementary provisions to cope up with major disasters in Nuclear Power Plants (NPP) apart from the existing one. Some of the NPPs are not under the UN safeguards, which can not import Uranium also need extra care and protection. Regulatory and safety functions of Atomic Energy in India are carried out by the Atomic Energy Regulatory Board (Atomic Energy Regulatory Board), the poster attempts to explain the present regulatory and safety mechanism under Atomic Energy Regulatory Board. We have the plant and site emergency response plans in place. The well planned functioning of these is demonstrated here. India is equipped with detail plans of emergency response system, to handle the radiation emergencies in public domain even at the locations where DAE facility is not available

  4. Children's safety initiative: a national assessment of pediatric educational needs among emergency medical services providers.

    Science.gov (United States)

    Hansen, Matthew; Meckler, Garth; Dickinson, Caitlyn; Dickenson, Kathryn; Jui, Jonathan; Lambert, William; Guise, Jeanne-Marie

    2015-01-01

    Emergency medical services (EMS) providers may have critical knowledge gaps in pediatric care due to lack of exposure and training. There is currently little evidence to guide educators to the knowledge gaps that most need to be addressed to improve patient safety. The objective of this study was to identify educational needs of EMS providers related to pediatric care in various domains in order to inform development of curricula. The Children's Safety Initiative-EMS performed a three-phase Delphi survey on patient safety in pediatric emergencies among providers and content experts in pediatric emergency care, including physicians, nurses, and prehospital providers of all levels. Each round included questions related to educational needs of providers or the effect of training on patient safety events. We identified knowledge gaps in the following domains: case exposure, competency and knowledge, assessment and decision making, and critical thinking and proficiency. Individual knowledge gaps were ranked by portion of respondents who ranked them "highly likely" (Likert-type score 7-10 out of 10) to contribute to safety events. There were 737 respondents who were included in analysis of the first phase of the survey. Paramedics were 50.8% of respondents, EMT-basics/first responders were 22%, and physicians 11.4%. The top educational priorities identified in the final round of the survey include pediatric airway management, responder anxiety when working with children, and general pediatric skills among providers. The top three needs in decision-making include knowing when to alter plans mid-course, knowing when to perform an advanced airway, and assessing pain in children. The top 3 technical or procedural skills needs were pediatric advanced airway, neonatal resuscitation, and intravenous/intraosseous access. For neonates, specific educational needs identified included knowing appropriate vital signs and preventing hypothermia. This is the first large-scale Delphi

  5. Emergency response plan for accidents in Saudi Arabia

    International Nuclear Information System (INIS)

    Al-Solaiman, K.M.; Al-Arfaj, A.M.; Farouk, M.A.

    2000-01-01

    This paper presents a brief description of the general emergency plan for accidents involving radioactive materials in the Kingdom of Saudi Arabia. Uses of radioactive materials and radiation sources and their associated potential accident are specified. Most general accident scenarios of various levels have been determined. Protective measures have been specified to reduce individual and collective doses arising during accident situations. Intervention levels for temporary exposure situations, as established in the IAEA's basic safety standards for protection against ionising radiation and for the safety of radiation sources, are adopted as national intervention levels. General procedures for implementation of the response plan, including notification and radiological monitoring instrumentation and equipment, are described and radiation monitoring teams are nominated. Training programs for the different parties which may be called upon to respond are studied and will be started. (author)

  6. Propofol for procedural sedation and analgesia reduced dedicated emergency nursing time while maintaining safety in a community emergency department.

    Science.gov (United States)

    Reynolds, Joshua C; Abraham, Michael K; Barrueto, Fermin F; Lemkin, Daniel L; Hirshon, Jon M

    2013-09-01

    Procedural sedation and analgesia is a core competency in emergency medicine. Propofol is replacing midazolam in many emergency departments. Barriers to performing procedural sedation include resource utilization. We hypothesized that emergency nursing time is shorter with propofol than midazolam, without increasing complications. Retrospective analysis of a procedural sedation registry for two community emergency departments with combined census of 100,000 patients/year. Demographics, procedure, and ASA physical classification status of adult patients receiving procedural sedation between 2007-2010 with midazolam or propofol were analyzed. Primary outcome was dedicated emergency nursing time. Secondary outcomes were procedural success, ED length of stay, and complication rate. Comparative statistics were performed with Mann-Whitney, Kruskal-Wallis, chi-square, or Fisher's exact test. Linear regression was performed with log-transformed procedural sedation time to define predictors. Of 328 procedural sedation and analgesia, 316 met inclusion criteria, of which 60 received midazolam and 256 propofol. Sex distribution varied between groups (midazolam 3% male; propofol 55% male; P = 0.04). Age, procedure, and ASA status were not significantly different. Propofol had shorter procedural sedation time (propofol 32.5 ± 24.2 minutes; midazolam 78.7 ± 51.5 minutes; P differences between complication rates (propofol 14%; midazolam 13%; P = 0.88) or emergency department length of stay (propofol 262.5 ± 132.8 minutes; midazolam 288.6 ± 130.6 minutes; P = 0.09). Use of propofol resulted in shorter emergency nursing time and higher procedural success rate than midazolam with a comparable safety profile. Copyright © 2013 Emergency Nurses Association. Published by Mosby, Inc. All rights reserved.

  7. Should they stay or should they go now? Exploring the impact of team familiarity on interprofessional team training outcomes.

    Science.gov (United States)

    Joshi, Kavita; Hernandez, Jessica; Martinez, Joseph; AbdelFattah, Kareem; Gardner, Aimee K

    2018-02-01

    Although simulation is an effective method for enhancing team competencies, it is unclear how team familiarity impacts this process. We examined how team familiarity impacted team competencies. Trainees were assigned to stable or dynamic teams to participate in three simulated cases. Situation awareness (SA) data was collected through in-scenario freezes. The recorded performances were assessed for clinical effectiveness (ClinEff) and teamwork. All data are reported on a 1-100% (100% = perfect performance) scale. Forty-six trainees (23 General Surgery; 23 Emergency Medicine) were randomized by specialty into stable (N = 8) or dynamic (N = 7) groups. Overall changes from Sim 1 to Sim3 were 12.2% (p teams reflecting improvements in ClinEff (15.2%; p team ClinEff improvement (8.7%) was not significant. Both groups demonstrated improvements in teamwork (stable = 9%, p Teams who continued to work together demonstrated increased improvements in clinical effectiveness and teamwork, while dynamic teams only demonstrated improvements in teamwork. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Nuclear safety

    International Nuclear Information System (INIS)

    2014-01-01

    The Program on Nuclear Safety comprehends Radioprotection, Radioactive Waste Management and Nuclear Material Control. These activities are developed at the Nuclear Safety Directory. The Radioactive Waste Management Department (GRR) was formally created in 1983, to promote research and development, teaching and service activities in the field of radioactive waste. Its mission is to develop and employ technologies to manage safely the radioactive wastes generated at IPEN and at its customer’s facilities all over the country, in order to protect the health and the environment of today's and future generations. The Radioprotection Service (GRP) aims primarily to establish requirements for the protection of people, as workers, contractors, students, members of the general public and the environment from harmful effects of ionizing radiation. Furthermore, it also aims to establish the primary criteria for the safety of radiation sources at IPEN and planning and preparing for response to nuclear and radiological emergencies. The procedures about the management and the control of exposures to ionizing radiation are in compliance with national standards and international recommendations. Research related to the main activities is also performed. The Nuclear Material Control has been performed by the Safeguard Service team, which manages the accountability and the control of nuclear material at IPEN facilities and provides information related to these activities to ABACC and IAEA. (author)

  9. Nuclear safety

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-07-01

    The Program on Nuclear Safety comprehends Radioprotection, Radioactive Waste Management and Nuclear Material Control. These activities are developed at the Nuclear Safety Directory. The Radioactive Waste Management Department (GRR) was formally created in 1983, to promote research and development, teaching and service activities in the field of radioactive waste. Its mission is to develop and employ technologies to manage safely the radioactive wastes generated at IPEN and at its customer’s facilities all over the country, in order to protect the health and the environment of today's and future generations. The Radioprotection Service (GRP) aims primarily to establish requirements for the protection of people, as workers, contractors, students, members of the general public and the environment from harmful effects of ionizing radiation. Furthermore, it also aims to establish the primary criteria for the safety of radiation sources at IPEN and planning and preparing for response to nuclear and radiological emergencies. The procedures about the management and the control of exposures to ionizing radiation are in compliance with national standards and international recommendations. Research related to the main activities is also performed. The Nuclear Material Control has been performed by the Safeguard Service team, which manages the accountability and the control of nuclear material at IPEN facilities and provides information related to these activities to ABACC and IAEA. (author)

  10. Criteria for Use in Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Guide (Spanish Edition)

    International Nuclear Information System (INIS)

    2013-01-01

    This Safety Guide presents a coherent set of generic criteria (expressed numerically in terms of radiation dose) that form a basis for developing the operational levels needed for decision making concerning protective and response actions. The set of generic criteria addresses the requirements established in IAEA Safety Standards Series No. GS-R-2 for emergency preparedness and response, including lessons learned from responses to past emergencies, and provides an internally consistent foundation for the application of radiation protection. The publication also proposes a basis for a plain language explanation of the criteria for the public and for public officials. Contents: 1. Introduction; 2. Basic considerations; 3. Framework for emergency response criteria; 4. Guidance values for emergency workers; 5. Operational criteria; Appendix I: Dose concepts and dosimetric quantities; Appendix II: Examples of default oils for deposition, individual monitoring and contamination of food, milk and water; Appendix III: Development of EALs and example EALs for light water reactors; Appendix IV: Observables at the scene of a nuclear or radiological emergency

  11. Criteria for Use in Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Guide (Russian Ed.)

    International Nuclear Information System (INIS)

    2012-01-01

    This Safety Guide presents a coherent set of generic criteria (expressed numerically in terms of radiation dose) that form a basis for developing the operational levels needed for decision making concerning protective and response actions. The set of generic criteria addresses the requirements established in IAEA Safety Standards Series No. GS-R-2 for emergency preparedness and response, including lessons learned from responses to past emergencies, and provides an internally consistent foundation for the application of radiation protection. The publication also proposes a basis for a plain language explanation of the criteria for the public and for public officials. Contents: 1. Introduction; 2. Basic considerations; 3. Framework for emergency response criteria; 4. Guidance values for emergency workers; 5. Operational criteria; Appendix I: Dose concepts and dosimetric quantities; Appendix II: Examples of default oils for deposition, individual monitoring and contamination of food, milk and water; Appendix III: Development of EALs and example EALs for light water reactors; Appendix IV: Observables at the scene of a nuclear or radiological emergency.

  12. Criteria for Use in Preparedness and Response for a Nuclear or Radiological Emergency. General Safety Guide (Arabic Edition)

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-11-01

    This Safety Guide presents a coherent set of generic criteria (expressed numerically in terms of radiation dose) that form a basis for developing the operational levels needed for decision making concerning protective and response actions. The set of generic criteria addresses the requirements established in IAEA Safety Standards Series No. GS-R-2 for emergency preparedness and response, including lessons learned from responses to past emergencies, and provides an internally consistent foundation for the application of principles of radiation protection. The publication also provides a basis for a plain language explanation of the criteria for the public and for public officials. Contents: 1. Introduction; 2. Basic considerations; 3. Framework for emergency response criteria; 4. Guidance values for emergency workers; 5. Operational criteria; Appendix I: Dose concepts and dosimetric quantities; Appendix II: Examples of default OILs for deposition, individual contamination and contamination of food, milk and water; Appendix III: Development of EALs and example EALs for light water reactors; Appendix IV: Observables on the scene of a radiological emergency.

  13. IAEA Leads Operational Safety Mission to Armenian Nuclear Power Plant

    International Nuclear Information System (INIS)

    2011-01-01

    . The conclusions of the review are based on the IAEA's Safety Standards and proven good international practices. The review covered the areas of Management, Organization and Administration; Training, Operations; Maintenance; Technical Support; Operating Experience; Radiation Protection; and Transition from Operations to Decommissioning. The OSART team has identified good plant practices which will be shared with the rest of the nuclear industry for consideration of their application. Examples include: During the last number of years, several important safety systems have been updated using resources of the plant's staff. This unique approach resulted in staff acquiring deep knowledge and skills to successfully operate and maintain new equipment; A plant simulator utilizing instrumentation and control panels and components from the turbine systems of shutdown Unit 1 has been introduced for training plant staff. The simulator, which is located within the turbine hall, fully replicates the plant conditions that both operations and maintenance staff will be exposed to; and The plant has developed a specific, comprehensive system supported by procedure to mitigate the consequences of a station black-out by providing power to systems and components necessary for cooling the reactor in emergency conditions. Operation personnel are regularly trained to use this system in order to reinforce their capability to put it in operation during an accident. The team has made recommendations and suggestions related to areas where operational safety of the ANPP could be improved. Examples include: Management should comprehensively establish, communicate and reinforce expectations for eliminating or signposting industrial safety risks and using personal protective equipment; The operator's rounds within the plant should be improved in order to better identify equipment deficiencies; and The plant maintenance work practices including adherence to procedures and use of proper tools should

  14. Distributed Cognition in Sports Teams: Explaining Successful and Expert Performance

    Science.gov (United States)

    Williamson, Kellie; Cox, Rochelle

    2014-01-01

    In this article we use a hybrid methodology to better understand the skilful performance of sports teams as an exemplar of distributed cognition. We highlight key differences between a team of individual experts (an aggregate system) and an expert team (an emergent system), and outline the kinds of shared characteristics likely to be found in an…

  15. Study protocol for a framework analysis using video review to identify latent safety threats: trauma resuscitation using in situ simulation team training (TRUST).

    Science.gov (United States)

    Fan, Mark; Petrosoniak, Andrew; Pinkney, Sonia; Hicks, Christopher; White, Kari; Almeida, Ana Paula Siquiera Silva; Campbell, Douglas; McGowan, Melissa; Gray, Alice; Trbovich, Patricia

    2016-11-07

    Errors in trauma resuscitation are common and have been attributed to breakdowns in the coordination of system elements (eg, tools/technology, physical environment and layout, individual skills/knowledge, team interaction). These breakdowns are triggered by unique circumstances and may go unrecognised by trauma team members or hospital administrators; they can be described as latent safety threats (LSTs). Retrospective approaches to identifying LSTs (ie, after they occur) are likely to be incomplete and prone to bias. To date, prospective studies have not used video review as the primary mechanism to identify any and all LSTs in trauma resuscitation. A series of 12 unannounced in situ simulations (ISS) will be conducted to prospectively identify LSTs at a level 1 Canadian trauma centre (over 800 dedicated trauma team activations annually). 4 scenarios have already been designed as part of this protocol based on 5 recurring themes found in the hospital's mortality and morbidity process. The actual trauma team will be activated to participate in the study. Each simulation will be audio/video recorded from 4 different camera angles and transcribed to conduct a framework analysis. Video reviewers will code the videos deductively based on a priori themes of LSTs identified from the literature, and/or inductively based on the events occurring in the simulation. LSTs will be prioritised to target interventions in future work. Institutional research ethics approval has been acquired (SMH REB #15-046). Results will be published in peer-reviewed journals and presented at relevant conferences. Findings will also be presented to key institutional stakeholders to inform mitigation strategies for improved patient safety. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. Acute cardiac events and deployment of emergency medical teams and automated external defibrillators in large football stadiums in the Netherlands.

    Science.gov (United States)

    van de Sandt, Femke; Umans, Victor

    2009-10-01

    The incidence of acute cardiac events - including out-of-hospital cardiac arrest - may be increased in visitors of large sports stadiums when compared with the general population. This study sought to investigate the incidence of acute cardiac events inside large Dutch football stadiums, as well as the emergency response systems deployed in these stadiums and the success rate for in-stadium resuscitation. Retrospective cohort study using a questionnaire sent to the 20 Dutch stadiums that hosted professional matches during the 2006-2007 and 2007-2008 football seasons. Stadium capacity ranged from 3600 to 51 600 spectators. Nearly 13 million spectators attended 686 'Eredivisie' (Honorary Division) and European football matches. All stadiums distribute multiple emergency medical teams among the spectators. Eighty-five percent of the stadiums have an ambulance standby during matches, 95% of the stadiums were equipped with automated external defibrillators (AEDs) during the study period. On an average, one AED was available for every 7576 spectators (range 1800-29 600). Ninety-three cardiac events were reported (7.3 per 1 million spectators). An AED was used 22 times (1.7 per 1 million spectators). Resuscitation was successful in 18 cases (82%, 95% confidence interval: 61-93). The incidence of out-of-hospital cardiac arrest inside large football stadiums in the Netherlands, albeit increased when compared with the general population, is low. The success rate for in-stadium resuscitation by medical teams equipped with AEDs is high. Dutch stadiums appear vigilant in regard to acute cardiac events. This report highlights the importance of adequate emergency medical response systems (including AEDs) in large sports venues.

  17. Securing the second front: achieving first receiver safety and security through competency-based tools.

    Science.gov (United States)

    Jones, Jamal; Staub, Judith; Seymore, Andrew; Scott, Lancer A

    2014-12-01

    Limited research has focused on the safety and security of First Responders and Receivers, including clinicians, hospital workers, public safety officials, community volunteers, and other lay personnel, during public health emergencies. These providers are, in some cases, at greater peril during large-scale disasters due to their lack of training and inadequate resources to handle major influxes of patients. Exemplified in the 1995 Tokyo sarin gas attacks and the 2008 Wenchuan earthquakes, lack of training results in poor outcomes for both patients and First Receivers. The improvement of knowledge and comfort level of First Receivers preparing for a medical disaster via an affordable, repeatable emergency preparedness training (EPT) curriculum. A 5-hour EPT curriculum was developed including nine learning objectives, 18 competencies, and 34 performance objectives. Following brief didactic and small group sessions, interprofessional teams of four to six trainees were observed in a large patient simulator designed to recreate environmentally challenging (ie, flood evacuation), multi-patient scenarios using a novel technique developed to utilize trainees as actors. Trained observers assessed successful completion of 16 individual and 18 team performance objectives. Prior to training, team members completed a 24-question knowledge assessment, a demographic survey, and a comfort level self-assessment. Following training, trainees repeated the 24 questions, self-assessment, and course assessment. One hundred ninety-five participants completed the course between November 2012 and August 2013. One hundred ninety-one (98.5%), 150 (76.9%), and 66 (33.8%) participants completed the pretest, post-test, and course assessment, respectively. The mean (SD) percentage of correct answers between the pretest and post-test increased from 46.3 (13.4) to 75.3 (12.2), P safety and security of the "Second Front.

  18. New and recently finalised activities within the NKS Programmes for Nordic cooperation on nuclear reactor safety and emergency preparedness

    DEFF Research Database (Denmark)

    Andgren, Karin; Andersson, Kasper Grann; Magnússon, Sigurður M.

    2015-01-01

    Over the years, NKS has provided funding for hundreds of research activities in fields comprising reactor safety, decommissioning, nuclear and radiological emergency preparedness, and management of radioactive waste. Advanced technologies and methods developed under the NKS framework have been used...... within the Nordic countries as well as internationally. Two programme areas are defined under the NKS platform: The NKS-R programme on nuclear reactor safety and the NKS-B programme on emergency preparedness. Three articles, giving an introduction to NKS and its two programmes, were published...

  19. [Use of complementary tests in emergencies and their relation with patient safety incidents].

    Science.gov (United States)

    Alcaraz-Martínez, J; Aranaz-Andrés, J M; Cantero-Sandoval, A; Piñera-Salmerón, P; Mas-Luzón, J; Serrano-Martínez, J A; González Garro, E

    2018-03-10

    To analyse the use of complementary tests and their relationship with safety incidents in hospital emergency departments. An analysis was performed on 935 patients seen in the 9 hospital emergency departments. The source of data used for the detection of incidents were: emergency department clinical record and reports, together with face-to-face observation in the department, plus a telephone survey of the patient or family member at one week after the care. Statistical tests used: The Student t test for quantitative variables, Chi squared test for qualitative variables, and the ANOVA test. A peripheral venous catheter was used in 397 patients (42.4% (95% CI; 39.3-45.5%)), with a variability with significant differences between hospitals (P<.01), with a range of use from 37% to 81.8%. It was also observed that in 23.4% (95% CI; 19.2-27.6%) of the cases, the catheter was not used after the first blood draw. Radiological tests were requested for 351 patients, 37.7% (95% CI; 34.6-40.8%), also with significant differences between hospitals (P<.01), ranging from 24.6 to 65, 1%. Incidents were detected in 95 (10.2%) patients (95% CI; 8.3-12.1%) in the all the study centres. A higher proportion of safety incidents have been observed in patients where peripheral venous catheter has been used (12.8%) than in those in whom they had not been used (8.5%) (P=.03), as well as in patients on whom an x-ray was requested (12.8%) compared to those who did not (8.64%) (P=.04). A longer stay was also observed in cases with an incident (mean 248.9minutes) than in those where there were none (mean 164.1minutes) (P<.001). No statistically significant differences were found in the other parameters studied. A relationship was observed between the use of a peripheral venous catheter (many of them without use) and radiological tests and the occurrence of safety incidents in the Emergency Departments. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. ELECTRICAL SAFETY IMPROVEMENT PROJECT A COMPLEX WIDE TEAMING INITIATIVE

    Energy Technology Data Exchange (ETDEWEB)

    GRAY BJ

    2007-11-26

    This paper describes the results of a year-long project, sponsored by the Energy Facility Contractors Group (EFCOG) and designed to improve overall electrical safety performance throughout Department of Energy (DOE)-owned sites and laboratories. As evidenced by focused metrics, the Project was successful primarily due to the joint commitment of contractor and DOE electrical safety experts, as well as significant support from DOE and contractor senior management. The effort was managed by an assigned project manager, using classical project-management principles that included execution of key deliverables and regular status reports to the Project sponsor. At the conclusion of the Project, the DOE not only realized measurable improvement in the safety of their workers, but also had access to valuable resources that will enable them to do the following: evaluate and improve electrical safety programs; analyze and trend electrical safety events; increase electrical safety awareness for both electrical and non-electrical workers; and participate in ongoing processes dedicated to continued improvement.

  1. The Role of the Facilitator on Total Quality Management Teams.

    Science.gov (United States)

    Eakin, William L.

    1993-01-01

    As Total Quality Management teams work to improve organizational processes, several types of facilitators emerge: the director, the workhorse, and the cheerleader. Experience at the University of Kansas illustrates how different facilitator styles can affect team learning. (MSE)

  2. HUG sets up an emergency operations centre on the CERN site

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    Discussions between CERN and the Hôpitaux universitaires de Genève (HUG), under the aegis of the Swiss authorities, have resulted in the setting-up of an emergency operations centre on the CERN site. This will be the operations base for an emergency doctor, a medical emergency vehicle and a driver. Located on the Swiss part of the Meyrin site, close to Building 57, it will be inaugurated on 20 May.   SMUR team based at CERN. CERN’s medical staff and fire-fighters dispense first aid but in medical emergencies they are obliged to call on outside services to treat and transfer patients to hospital. In the Canton of Geneva, this service is provided by HUG via the 144 emergency line. But HUG is based on the eastern side of Geneva, a long way from CERN, and response times can be substantial. In order to improve the safety of the growing number of people on the site, CERN asked Switzerland, as one of its Host States, to help it reduce the medical emergency response t...

  3. Definition and means of maintaining the emergency notification and evacuation system portion of the Plutonium Finishing Plant safety envelope

    International Nuclear Information System (INIS)

    White, W.F.

    1997-01-01

    The Emergency Evacuation and Notification System provides information to the PFP Building Emergency Director to assist in determining appropriate emergency response, notifies personnel of the required response, and assists in their response. The report identifies the equipment in the Safety Envelope (SE) for this System and the Administrative, Maintenance, and Surveillance Procedures used to maintain the SE Equipment

  4. IAEA team to report on Kashiwazaki Kariwa Nuclear Power Plant examination

    International Nuclear Information System (INIS)

    2007-01-01

    Full text: The Kashiwazaki Kariwa Nuclear Power Plant in Japan, affected by a strong earthquake on 16 July, shut down safely and damage appears less than expected, a fact finding mission of international nuclear safety experts has concluded. The six member expert team of the International Atomic Energy Agency was dispatched upon the request of the Japanese authorities. The mission report will be issued within a few days. The Director General of the IAEA, Mohamed ElBaradei, said today that he welcomed the cooperation and transparency the team had received from the Japanese authorities. The mission's findings and the Japanese analyses of the event include important lessons learned - both positive and negative - that will be relevant to other nuclear plants worldwide, he said. The team conducted a three day physical examination covering the complex of seven units, as well as analysis of instrument logs and other records from the time of the event. It has concluded that plant safety features performed as required during the earthquake. The team's review of plant operator records and analyses support the Japanese authorities' conclusion that the very small amount of radioactivity released was well below the authorized limits for public health and environmental safety. Damage from the earthquake appears to be limited to those sections of the plant that would not affect the reactor or systems related to reactor safety. Detailed checks and inspections by the operator and Japanese authorities are ongoing. According to the IAEA team, significant work, such as detailed examination of the reactor vessels, cores and fuel elements, has still to be performed. Physical stresses resulting from the earthquake could affect the long term safe operation of some plant components, the team said. Additional engineering analysis of such components would be an important consideration for future examination, to determine whether they should be replaced earlier than otherwise anticipated. The

  5. Radiation safety - an IAEA perspective

    International Nuclear Information System (INIS)

    Persson, L.

    1993-01-01

    The activities of the IAEA relating to radiation safety cover: The preparation of International Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources - it is expected that the new Basic Safety Standards will be adopted by the sponsoring organizations in 1994. The radiological consequences of the Chernobyl accident: the thyroid cancer controversy - the hypothesis that must be tested is whether the reported increased incidence of thyroid cancer due to exposure to radioactive iodine released in the Chernobyl accident, and there are several questions that must be answered before a firm conclusion can be reached. Emergency Response Services (ERS): In March 1993, at the request of Viet Nam, which invoked the Energency Assistance Convention, a medical team organized by the IAEA went to Hanoi and assisted in arranging for an overexposed person to be transferred from Viet Nam to Paris for specialized medical treatment. In April 1993, the ERS was used to inform Member States of the consequences of an explosion at the Tomsk 7 fuel reprocessing plant in Siberia, Russia, which caused a radiation leak. Reassessing the long range transport of radioactive material through the environment: Data from the Chernobyl accident have been used for model validation in the Atmospheric Transport Model Evaluation Study (ATMES). A follow-up programme, the European Tracer Experiment (ETEX) with experimental studies of long range atmospheric movements over Europe has been established in order to increase knowledge and prediction capability. As part of the programme, a non-toxic atmospheric tracer will be released under suitable conditions in 1994. The Radiation Protection Advisory Teams Service (RAPAT): In many of the developing countries visited, the lack of an adequate infrastructure for radiation protection is the main obstacle to improved radiation protection. Strengthening radiation and nuclear safety infrastructures in successor states of the USSR: The

  6. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction

    Directory of Open Access Journals (Sweden)

    Gausvik C

    2015-01-01

    Full Text Available Christian Gausvik,1 Ashley Lautar,2 Lisa Miller,2 Harini Pallerla,3 Jeffrey Schlaudecker4,5 1University of Cincinnati College of Medicine, 2The Christ Hospital, Cincinnati, OH, USA; 3Department of Family and Community Medicine, 4Division of Geriatric Medicine, University of Cincinnati, Cincinnati, OH, USA; 5Geriatric Medicine Fellowship Program, University of Cincinnati/The Christ Hospital, Cincinnati, OH, USA Abstract: Efficient, accurate, and timely communication is required for quality health care and is strongly linked to health care staff job satisfaction. Developing ways to improve communication is key to increasing quality of care, and interdisciplinary care teams allow for improved communication among health care professionals. This study examines the patient- and family-centered use of structured interdisciplinary bedside rounds (SIBR on an acute care for the elderly (ACE unit in a 555-bed metropolitan community hospital. This mixed methods study surveyed 24 nurses, therapists, patient care assistants, and social workers to measure perceptions of teamwork, communication, understanding of the plan for the day, safety, efficiency, and job satisfaction. A similar survey was administered to a control group of 38 of the same staff categories on different units in the same hospital. The control group units utilized traditional physician-centric rounding. Significant differences were found in each category between the SIBR staff on the ACE unit and the control staff. Nurse job satisfaction is an important marker of retention and recruitment, and improved communication may be an important aspect of increasing this satisfaction. Furthermore, improved communication is key to maintaining a safe hospital environment with quality patient care. Interdisciplinary team rounds that take place at the bedside improve both nursing satisfaction and related communication markers of quality and safety, and may help to achieve higher nurse retention and safer

  7. The emergency organization of the Federal Institute for Reactor Research

    International Nuclear Information System (INIS)

    Brunner, H.; Huerlimann, T.

    1977-01-01

    The organization and means of the emergency organization of the Federal Institute for Reactor Research (EIR), the eldest and largest nuclear installation in Switzerland, are described. It consists of a central command group and the following emergency teams: fire brigade, radiation protection, first aid, control, operating teams (reactors, hot laboratory etc.). The radiation protection team is formed by the Health Physics Division and is discussed in detail. A description of the alarm system and the first actions to be taken in case of an emergency is given. The importance of frequent and well-planned exercises and of radio communication between the teams and the command group is stressed and the emergency training programme of the EIR School for Radiation Protection, operated by the Health Physics Division, is presented. A fortunate lack of incidents at EIR is partly compensated for by experience gained from emergency team assistance operations during incidents outside the Institute. (author)

  8. Building Productivity in Virtual Project Teams

    Directory of Open Access Journals (Sweden)

    Bill Hamersly

    2015-04-01

    Full Text Available The steady increase in project failure rates is leaving businesses searching for better integration techniques to virtualize their project environments. Through virtualization, organizations may have positive impacts on communities across geographical boundaries and resource constraints. The focus of this phenomenological study was to explore, via the experiences of successful project management practitioners, best practice strategies for integrating virtual project teams through data analysis. The conceptual framework included von Bertalanffy’s general systems theory, decomposition model of business process and project management frameworks, and the recomposition approach. Twenty-two senior project managers with more than 5 years of experience managing virtual project environments participated in semistructured telephone interviews. The van Kaam process employing normalization and bracketing approaches in data analysis resulted in the emergence of 34 thematic categories. The 10 most common themes culminated in the identification of strategies relevant for virtual project teams. The major themes pertained to 3 broad areas: (a structure that accommodates skills and technology for virtual team success, (b governance leading to efficient virtual project team management, and (c collaboration practices across diverse environments. This study involved the exploration of the experiences of the participants. Using the van Kaam method for normalization of the data and clustering like experiences into thematic statements, the study provided a plethora of new information concentrated on 10 themes that emerged.

  9. Engineering thinking in emergency situations: A new nuclear safety concept.

    Science.gov (United States)

    Guarnieri, Franck; Travadel, Sébastien

    2014-11-01

    The lessons learned from the Fukushima Daiichi accident have focused on preventive measures designed to protect nuclear reactors, and crisis management plans. Although there is still no end in sight to the accident that occurred on March 11, 2011, how engineers have handled the aftermath offers new insight into the capacity of organizations to adapt in situations that far exceed the scope of safety standards based on probabilistic risk assessment and on the comprehensive identification of disaster scenarios. Ongoing crises in which conventional resources are lacking, but societal expectations are high, call for "engineering thinking in emergency situations." This is a new concept that emphasizes adaptability and resilience within organizations-such as the ability to create temporary new organizational structures; to quickly switch from a normal state to an innovative mode; and to integrate a social dimension into engineering activities. In the future, nuclear safety oversight authorities should assess the ability of plant operators to create and implement effective engineering strategies on the fly, and should require that operators demonstrate the capability for resilience in the aftermath of an accident.

  10. Team Building e a enfermagem Team Building e enfermería Team Building and nursing

    Directory of Open Access Journals (Sweden)

    Filipa Homem

    2012-07-01

    : profundizar los conocimientos sobre Team Building, contextualizar el Team Building y reflexionar sobre su utilidad del Team Building en su contexto dentro de las prestaciones de atención de enfermería. De este modo, se realizaron búsquedas en la base de datos electrónica EBSCO, y se consultó la literatura relacionada con la psicología organizacional. Con esta investigación se concluyó que la estrategia de dinamización de equipo es útil aplicada a la enfermería, puede incluso mejorar la comunicación y las relaciones interpersonales, identificar fortalezas y debilidades de los equipos, proporcionar una mayor satisfacción en el trabajo y así, mejorar la calidad la atención sanitaria prestada.In this environment of growing dissatisfaction and unpredictability in nursing, it is increasingly important to motivate teams, giving them personal, relational, and communicative competencies and, above all, to build team working and thus improve productivity. Team Building emerges as an effective strategy to achieve positive results within organizations. Because it is a strategy not yet widely used in Portugal, we decided to look into the issue and reflect on its relevance and potential in nursing teams with the following objectives: to deepen knowledge about Team Building, to frame Team Building within the context of organizational theories, to describe different models of Team Building and to reflect on the usefulness of Team Building for the quality of nursing care. Articles were searched in EBSCO electronic databases, and organizational psychology literature was consulted. With this research, we conclude that Team Building applied to nursing can improve communication and interpersonal relationships, identify strengths and weaknesses of teams, provide greater job satisfaction and thus enhance the quality of health care provided.

  11. International nuclear safety experts conclude IAEA peer review of China's regulatory system

    International Nuclear Information System (INIS)

    2010-01-01

    , industrial and medical radioactive sources and the nuclear and radiation accident emergency centre. The IRRS team reviewed the following regulatory areas: the government's responsibilities and functions in the nuclear safety regime; the responsibilities and functions of the regulatory body and its management system; the activities of the regulatory body including authorizations; review and assessment; inspection and enforcement processes; and the development of regulations and guides. The IAEA's IRRS coordinator Gustavo Caruso said, ''This mission was a big challenge for the Agency because of the significant expansion of China's nuclear programme in the context of the nation's current regulatory activities.'' The IRRS team identified particular strengths in the Chinese regulatory system, including: - Leadership's expression of a high-level commitment to nuclear safety and its regulation; - The cultural environment that turns such commitment into practical activities; - The extensive use of IAEA Safety Standards in the development of China's legislative framework; and - At a more detailed level, the system of registering a cadre of high level nuclear safety engineers. The safety leadership in China has been seen in many areas and levels, the Government, regulatory body and utilities, providing confidence in the effectiveness of the Chinese safety regulatory system and the future safety of the vast expanding nuclear industry. The IRRS team also made recommendations to improve the overall performance of China's regulatory system. Examples include: - Nuclear safety-related legislation and policies should be further enhanced for all nuclear activities, including radioactive waste management; - Regulatory bodies should be provided with greater flexibility and resources, both financial and human, to keep pace with the China's nuclear development programme; - As part of its strategy to achieve high standards of safety during a period of rapid growth, greater capability to access

  12. Instrument for assessing the quality of mobile emergency pre-hospital care: content validation

    Directory of Open Access Journals (Sweden)

    Rodrigo Assis Neves Dantas

    2015-06-01

    Full Text Available OBJECTIVES To validate an instrument to assess quality of mobile emergency pre-hospital care. METHOD A methodological study where 20 professionals gave their opinions on the items of the proposed instrument. The analysis was performed using Kappa test (K and Content Validity Index (CVI, considering K> 0.80 and CVI ≥ 0.80. RESULTS Three items were excluded from the instrument: Professional Compensation; Job Satisfaction and Services Performed. Items that obtained adequate K and CVI indexes and remained in the instrument were: ambulance conservation status; physical structure; comfort in the ambulance; availability of material resources; user/staff safety; continuous learning; safety demonstrated by the team; access; welcoming; humanization; response time; costumer privacy; guidelines on care; relationship between professionals and costumers; opportunity for costumers to make complaints and multiprofessional conjunction/actuation. CONCLUSION The instrument to assess quality of care has been validated and may contribute to the evaluation of pre-hospital care in mobile emergency services.

  13. Definition and means of maintaining the emergency notification and evacuation system portion of the plutonium finishing plant safety envelope

    International Nuclear Information System (INIS)

    WHITE, W.F.

    1999-01-01

    The Emergency Evacuation and Notification System provides information to the Plutonium Finishing Plant (PFP) Building Emergency Director to assist in determining appropriate emergency response, notifies personnel of the required response, and assists in their response. The report identifies the equipment in the Safety Envelope (SE) for this System and the Administrative, Maintenance, and Surveillance Procedures used to maintain the SE Equipment

  14. Analysis and development of the automated emergency algorithm to control primary to secondary LOCA for SUNPP safety upgrading

    International Nuclear Information System (INIS)

    Kim, V.; Kuznetsov, V.; Balakan, G.; Gromov, G.; Krushynsky, A.; Sholomitsky, S.; Lola, I.

    2007-01-01

    The paper presents the results of the study conducted to support planned modernization of the South Ukraine nuclear power plant. The objective of the analysis has been to develop the automated emergency control algorithm for primary to secondary LOCA accident for SUNPP WWER-1000 safety upgrading. According to the analyses performed in the framework of safety assesment report, given accident is the most complex for control and has the largest contribution into the core damage frequency value. This is because of initial event diagnostics is difficult, emergency control is complicated for personnel, time available for decision making and actions performing is limited with coolant inventory for make-up, probability of steam dump valves on affected steam generator non-closing after opening is high, and as a consequence containment bypass, irretrievable loss of coolant and radioactive materials release into the environment are possible. Unit design modifications are directed on expansion of safety systems capabilities to overcome given accident and to facilitate the personnel actions on emergency control. Safety systems modification according to developed algorithm will allow to simplify accident control by personnel and enable to control the ECCS discharge limiting pressure below the affected steam generator steam dump valve opening pressure, and decrease the probability of the containment bypass sequences. The analysis of the primary-to-secondary LOCA thermal-hydraulics has been conducted with RELAP5/Mod 3.2, and involved development of the dedicated analytical model, calculations of various plant response accident scenarios, conducting of plant personnel intervention analyses using full-scale simulator, development and justification of the emergency control algorithm aimed on the minimization of negative consequences of the primary-to-secondary LOCA (Authors)

  15. Maximizing Team Performance: The Critical Role of the Nurse Leader.

    Science.gov (United States)

    Manges, Kirstin; Scott-Cawiezell, Jill; Ward, Marcia M

    2017-01-01

    Facilitating team development is challenging, yet critical for ongoing improvement across healthcare settings. The purpose of this exemplary case study is to examine the role of nurse leaders in facilitating the development of a high-performing Change Team in implementing a patient safety initiative (TeamSTEPPs) using the Tuckman Model of Group Development as a guiding framework. The case study is the synthesis of 2.5 years of critical access hospital key informant interviews (n = 50). Critical juncture points related to team development and key nurse leader actions are analyzed, suggesting that nurse leaders are essential to maximize clinical teams' performance. © 2016 Wiley Periodicals, Inc.

  16. Medical students' situational motivation to participate in simulation based team training is predicted by attitudes to patient safety.

    Science.gov (United States)

    Escher, Cecilia; Creutzfeldt, Johan; Meurling, Lisbet; Hedman, Leif; Kjellin, Ann; Felländer-Tsai, Li

    2017-02-10

    Patient safety education, as well as the safety climate at clinical rotations, has an impact on students' attitudes. We explored medical students' self-reported motivation to participate in simulation-based teamwork training (SBTT), with the hypothesis that high scores in patient safety attitudes would promote motivation to SBTT and that intrinsic motivation would increase after training. In a prospective cohort study we explored Swedish medical students' attitudes to patient safety, their motivation to participate in SBTT and how motivation was affected by the training. The setting was an integrated SBTT course during the surgical semester that focused on non-technical skills and safe treatment of surgical emergencies. Data was collected using the Situational Motivation Scale (SIMS) and the Attitudes to Patient Safety Questionnaire (APSQ). We found a positive correlation between students' individual patient safety attitudes and self-reported motivation (identified regulation) to participate in SBTT. We also found that intrinsic motivation increased after training. Female students in our study scored higher than males regarding some of the APSQ sub-scores and the entire group scored higher or on par with comparable international samples. In order to enable safe practice and professionalism in healthcare, students' engagement in patient safety education is important. Our finding that students' patient safety attitudes show a positive correlation to motivation and that intrinsic motivation increases after training underpins patient safety climate and integrated teaching of patient safety issues at medical schools in order to help students develop the knowledge, skills and attitudes required for safe practice.

  17. Mutual goals as essential for the results of team coaching

    DEFF Research Database (Denmark)

    Pedersen, Louise Møller

    2015-01-01

    Background: Facilitated by an external coach, team coaching has been introduced as a method to increase team competency, effectiveness, and learning mainly at the middle manager level (named coachees). However, team coaching also has some pitfalls which will be explored in this chapter. Intervent......, organizational changes can interrupt the implementation of team coaching interventions. Clear communication and resolution of conflict s are essential for the process and results of team coaching and should be integrated into the theory of team coaching.......Background: Facilitated by an external coach, team coaching has been introduced as a method to increase team competency, effectiveness, and learning mainly at the middle manager level (named coachees). However, team coaching also has some pitfalls which will be explored in this chapter....... Intervention: A 13 month team coaching intervention focusing on team safety-related competences, effectiveness, and learning was conducted in three department teams (team X, Y and Z) in a medium-sized Danish company (Company A). However, at the end of the intervention results between the three teams varied...

  18. IAEA Team Concludes Peer Review of Sweden's Nuclear Regulatory Framework, 17 February 2012, Stockholm, Sweden

    International Nuclear Information System (INIS)

    2012-01-01

    issues warranting attention or in need of improvement. These include, though they are not limited to, the following: A strategy should be developed to ensure that Sweden's regulatory framework (legislation, regulations and guides) is consistent with IAEA Safety Standards. At present, regulations and general advice documents do not cover all topics as required; SSM's internal guidance regarding its regulatory practices should be standardized; SSM should re-evaluate its staffing and competence needs and seek appropriate resources; and The inspection programme in many technical areas needs strengthening. In a preliminary report, the IAEA has conveyed the team's main conclusions to SSM. A final report will be submitted to the authority in about three months. SSM has informed the team that it will make the report public. The IAEA encourages nations to invite a follow-up IRRS mission about two years after the mission has been completed. Background. The IRRS team carried out a review of the full spectrum of Sweden's nuclear legal and regulatory framework. Special attention was given to the review of the regulatory implications for Sweden of the TEPCO Fukushima Daiichi accident. The review addressed all facilities and activities regulated by SSM including 10 nuclear power units, a fuel fabrication facility, spent fuel and waste management facilities and users of radioactive sources. The mission included site visits to facilities to observe inspections and a series of interviews and discussions with SSM staff and other organizations. In addition, the IRRS team observed an emergency exercise which was conducted with representatives from multiple organizations, government and industry. The mission took place from 6 to 17 February 2012 at the SSM's headquarters in Stockholm. A Press Conference was conducted at the end of the mission on 17 February. The IRRS team consisted of 18 senior regulatory experts from 16 IAEA Member States and 6 IAEA staff members. Quick Facts. Sweden has 10

  19. Eighth ITER technical meeting on safety and environment

    International Nuclear Information System (INIS)

    Gordon, C.; Raeder, J.

    2000-01-01

    From November 27 to 30, 2000 the Eighth ITER Technical Meeting on Safety and Environment was held by the ITER Joint Central Team (JCT) at the Garching Joint Work Site, which also hosts the ITER Safety, Environment and Health Group (SEHG). At this meeting, safety experts from the Home Teams (HT) worked together with the SEHG members towards the following main objectives: review of Generic Site Safety Report (GSSR) results and drafts; review of the Plant Design Description (PDD) summary of safety; update on the status of the R and D tasks contributing to GSSR

  20. Nuclear emergency preparedness. Final report of the Nordic Nuclear Safety Research Project BOK-1

    DEFF Research Database (Denmark)

    Lauritzen, B.

    2002-01-01

    Final report of the Nordic Nuclear Safety Research project BOK-1. The BOK-1 project, “Nuclear Emergency Preparedness”, was carried out in 1998-2001 with participants from the Nordic and Baltic Sea regions. The project consists of six sub-projects:Laboratory measurements and quality assurance (BOK-1.......1); Mobile measurements and measurement strategies (BOK-1.2); Field measurements and data assimilation (BOK-1.3); Countermeasures in agriculture and forestry (BOK-1.4); Emergency monitoring in theNordic and Baltic Sea countries (BOK-1.5); and Nuclear exercises (BOK-1.6). For each sub-project, the project...

  1. Cannabis Hyperemesis Syndrome in the Emergency Department: How Can a Specialized Addiction Team Be Useful? A Pilot Study.

    Science.gov (United States)

    Pélissier, Fanny; Claudet, Isabelle; Gandia-Mailly, Peggy; Benyamina, Amine; Franchitto, Nicolas

    2016-11-01

    Chronic cannabis users may experience cyclical episodes of nausea and vomiting and learned behavior of hot bathing. This clinical condition, known as cannabis hyperemesis syndrome, was first reported in 2004. Our aim was to promote early recognition of this syndrome in emergency departments (EDs) and to increase referral to addiction specialists. Cannabis abusers were admitted to the ED for vomiting or abdominal pain from June 1, 2014 to January 1, 2015 and diagnosed with cannabis hyperemesis syndrome by a specialized addiction team. Then, medical records were examined retrospectively. Seven young adults were included. Their mean age was 24.7 years (range 17-39 years) and the majority were men (male-to-female ratio 1.2). Biological and toxicological blood samples were taken in all patients. Tetrahydrocannabinol blood level was measured in 4 patients, with a mean blood concentration of 11.6 ng/mL. Radiographic examination including abdominal computed tomography and brain imaging were negative, as was upper endoscopy. Five patients compulsively took hot baths in an attempt to decrease the symptoms. Treatment was symptomatic. Five patients have started follow-up with the specialized addiction team. Cannabis hyperemesis syndrome is still under-diagnosed 10 years after it was first described. Physicians should be aware of this syndrome to avoid repeated hospitalizations or esophageal complications. Greater awareness should lead to prompt treatment and prevention of future recurrence through cannabis cessation. Addiction specialists, as well as medical toxicologists, are experts in the management of cannabis abusers and can help re-establish the role of medical care in this population in collaboration with emergency physicians. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. [Rapid Response obstetrics Team at Instituto Mexicano del Seguro Social,enabling factors].

    Science.gov (United States)

    Dávila-Torres, Javier; González-Izquierdo, José de Jesús; Ruíz-Rosas, Roberto Aguli; Cruz-Cruz, Polita Del Rocío; Hernández-Valencia, Marcelino

    2015-01-01

    There are barriers and enablers for the implementation of Rapid Response Teams in obstetric hospitals. The enabling factors were determined at Instituto Mexicano del Seguro Social (IMSS) MATERIAL AND METHODS: An observational, retrospective study was conducted by analysing the emergency obstetric reports sent by mobile technology and e-mail to the Medical Care Unit of the IMSS in 2013. Frequency and mean was obtained using the Excel 2010 program for descriptive statistics. A total of 164,250 emergency obstetric cases were reported, and there was a mean of 425 messages per day, of which 32.2% were true obstetric emergencies and required the Rapid Response team. By e-mail, there were 73,452 life threatening cases (a mean of 6 cases per day). A monthly simulation was performed in hospitals (480 in total). Enabling factors were messagés synchronisation among the participating personnel,the accurate record of the obstetrics, as well as the simulations performed by the operational staff. The most common emergency was pre-eclampsia-eclampsia with 3,351 reports, followed by obstetric haemorrhage with 2,982 cases. The enabling factors for the implementation of a rapid response team at IMSS were properly timed communication between the central delegation teams, as they allowed faster medical and administrative management and participation of hospital medical teams in the process. Mobile technology has increased the speed of medical and administrative management in emergency obstetric care. However, comparative studies are needed to determine the statistical significance. Published by Masson Doyma México S.A.

  3. How do we capture the emergency nurse practitioners' contribution to value in health service delivery?

    Science.gov (United States)

    Jennings, Natasha; Lutze, Matthew; Clifford, Stuart; Maw, Michael

    2017-03-01

    The emergency nurse practitioner is now a well established and respected member of the healthcare team. Evaluation of the role has focused on patient safety, effectiveness and quality of care outcomes. Comparisons of the role continue to focus on cost, with findings based on incomplete and almost impossible to define, recognition of contribution to service delivery by paralleled practitioners. Currently there is no clear definition as to how nurse practitioners contribute to value in health service delivery. Robust and rigorous research needs to be commissioned taking into consideration the unique hybrid nature of the emergency nurse practitioner role and focusing on the value they contribute to health care delivery.

  4. Emergency preparedness for nuclear power plants in the USA

    International Nuclear Information System (INIS)

    Schwartz, S.A.

    1986-01-01

    In the case of an operating reactor, if it is determined that there are such deficiencies that a favourable NRC finding is not warranted and if the deficiencies are not corrected within four months of that determination, the Commission will determine whether the reactor should be shut down or whether some other enforcement action is appropriate. In any case, where the Commission believes that the public health, safety, or interest so requires, the plant will be required to shut down immediately. Emergency planning considerations must be extended to emergency planning zones, and these shall consist of an area of about 10 miles in radius for exposure to the radioactive plume that might result from an accident in a nuclear power reactor and an area of about 50 miles in radius for food that might become contaminated. To evaluate the effectiveness of the licensee programme to implement their emergency plan, a 'management oversight and risk tree' (MORT) approach was developed and used by NRC appraisal teams at all operating facilities and those close to licensing. Since April 1981, over 250 emergency preparedness exercises have been observed and annual inspections conducted at US commercial nuclear power generating facilities. As a result of this experience, licensees have generally progressed from a basic ability to implement their plan to a systematic demonstration of their emergency preparedness capabilities. Almost five years have elapsed since the inception of the upgraded emergency preparedness regulatory programme, and the NRC is evaluating the resources committed to the programme to determine if modifications are appropriate. Our goal is to ensure continued adequate readiness capability to protect the public health and safety in the event of an accident

  5. OntoEmergePlan: variability of emergency plans supported by a domain ontology

    NARCIS (Netherlands)

    Ferreira, Maria I.G.B; Moreira, João; Campos, Maria Luiza M.; Braga, Bernardo F.B; Sales, Tiago P.; de Cordeiro, Kelli F.; Borges, Marcos R.S.

    2015-01-01

    The preparation of high quality emergency plans to guide operational decisions is an approach to mitigate the emergency management complexity. In such multidisciplinary scenario, teams with different perspectives need to collaborate towards a common goal and interact within a common understanding.

  6. Case Study on Economic Return on Investments for Safety and Emergency Lighting in Road Tunnels

    Directory of Open Access Journals (Sweden)

    Ferdinando Salata

    2015-07-01

    Full Text Available While planning a double-hole road tunnel with a length higher than one km, it is important to pay attention to the safety factor if an accident occurs. If there is a power outage, in order to avoid critical situations that could jeopardize the safety of the people present (facilitating the stream coming out from the tunnel and the arrival of the emergency personnel, it is really important to guarantee uninterrupted lighting of roadways, mandatory emergency lay-bys, and ways of escape. Uninterrupted service of the lighting systems supply must be guaranteed, in accordance with the current regulations, through the exertion of UPS (Uninterruptible Power Supply and power units. During tunnel construction, such devices represent a cost that must be amortized. In this case study, which takes into consideration a section of a road tunnel characterized by emergency lay-bys and ways of escape, emergency and security lighting were planned and installation and management costs were evaluated. The goal of this research was the creation of a cash flow thanks to the energy generated by photovoltaic panels, in a way that the service life of the system (25 years coincided with the amortization of the costs of the backup electrical equipment installation (complying with the regulations. The possibility of over-dimensioning the UPS and providing it with a proper photovoltaic panel surface (235 kWp to generate and exchange electric energy with the grid was taken into consideration.

  7. Using Contemporary Leadership Skills in Medication Safety Programs.

    Science.gov (United States)

    Hertig, John B; Hultgren, Kyle E; Weber, Robert J

    2016-04-01

    The discipline of studying medication errors and implementing medication safety programs in hospitals dates to the 1970s. These initial programs to prevent errors focused only on pharmacy operation changes - and not the broad medication use system. In the late 1990s, research showed that faulty systems, and not faulty people, are responsible for errors and require a multidisciplinary approach. The 2013 ASHP Statement on the Role of the Medication Safety Leader recommended that medication safety leaders be integrated team members rather than a single point of contact. Successful medication safety programs must employ a new approach - one that embraces the skills of all health care team members and positions many leaders to improve safety. This approach requires a new set of leadership skills based on contemporary management principles, including followership, team-building, tracking and assessing progress, storytelling and communication, and cultivating innovation, all of which promote transformational change. The application of these skills in developing or changing a medication safety program is reviewed in this article.

  8. Ninth ITER technical meeting on safety and environment

    International Nuclear Information System (INIS)

    Raeder, J.; Gordon, C.

    2001-01-01

    The ninth ITER Technical Meeting on safety and environment, the last in the course of the ITER Engineering Design Activities (EDA), was held at the ITER Garching Joint Work site, 8 to 10 May 2001. At this Meeting, safety experts from the House Teams worked together with the members of the Safety, Environment and Health Groups (SEHG) of the ITER Joint Central Team (JCT) in the following areas: finalization of the Generic Site Safety report (GSSR) which is considered to be the most important objective of the present work; summary of the safety related R and D work done by the Home Teams for ITER during EDA; review of verification and validation work done on computer codes being applied for Safety and Environment (S and E) analyses; outline of work considered necessary for improving the S and E database, quantifying uncertainties of the code results and preparing the adaptation of ITER to a specific site

  9. The art of communication: strategies to improve efficiency, quality of care and patient safety in the emergency department

    International Nuclear Information System (INIS)

    Krug, Steven E.

    2008-01-01

    The practice of pediatric emergency medicine (PEM) has been supported by wonderful advancements in diagnostic testing, particularly in medical imaging. One of the most remarkable has been CT, which has arguably become our most valuable diagnostic tool in the emergency department (ED). PEM specialists have grown increasingly aware of quality and safety concerns in the care of children in emergency medical settings, spurred in part by a rapid growth in ED utilization and significant overcrowding. In the midst of this comes the revelation that one of our most valued diagnostic tools might place our youngest patients at a significant risk for the development of fatal cancer. This article reinforces the fundamental importance of communication and teamwork as a means to promote patient care quality and safety in the ED, and it offers partnership strategies for PEM and pediatric radiology specialists to consider as they address these important concerns. (orig.)

  10. The art of communication: strategies to improve efficiency, quality of care and patient safety in the emergency department

    Energy Technology Data Exchange (ETDEWEB)

    Krug, Steven E. [Northwestern University, Children' s Memorial Hospital, Feinberg School of Medicine, Chicago, IL (United States)

    2008-11-15

    The practice of pediatric emergency medicine (PEM) has been supported by wonderful advancements in diagnostic testing, particularly in medical imaging. One of the most remarkable has been CT, which has arguably become our most valuable diagnostic tool in the emergency department (ED). PEM specialists have grown increasingly aware of quality and safety concerns in the care of children in emergency medical settings, spurred in part by a rapid growth in ED utilization and significant overcrowding. In the midst of this comes the revelation that one of our most valued diagnostic tools might place our youngest patients at a significant risk for the development of fatal cancer. This article reinforces the fundamental importance of communication and teamwork as a means to promote patient care quality and safety in the ED, and it offers partnership strategies for PEM and pediatric radiology specialists to consider as they address these important concerns. (orig.)

  11. A root cause analysis project in a medication safety course.

    Science.gov (United States)

    Schafer, Jason J

    2012-08-10

    To develop, implement, and evaluate team-based root cause analysis projects as part of a required medication safety course for second-year pharmacy students. Lectures, in-class activities, and out-of-class reading assignments were used to develop students' medication safety skills and introduce them to the culture of medication safety. Students applied these skills within teams by evaluating cases of medication errors using root cause analyses. Teams also developed error prevention strategies and formally presented their findings. Student performance was assessed using a medication errors evaluation rubric. Of the 211 students who completed the course, the majority performed well on root cause analysis assignments and rated them favorably on course evaluations. Medication error evaluation and prevention was successfully introduced in a medication safety course using team-based root cause analysis projects.

  12. Improving patient safety: patient-focused, high-reliability team training.

    Science.gov (United States)

    McKeon, Leslie M; Cunningham, Patricia D; Oswaks, Jill S Detty

    2009-01-01

    Healthcare systems are recognizing "human factor" flaws that result in adverse outcomes. Nurses work around system failures, although increasing healthcare complexity makes this harder to do without risk of error. Aviation and military organizations achieve ultrasafe outcomes through high-reliability practice. We describe how reliability principles were used to teach nurses to improve patient safety at the front line of care. Outcomes include safety-oriented, teamwork communication competency; reflections on safety culture and clinical leadership are discussed.

  13. How emergency nurse practitioners view their role within the emergency department: A qualitative study.

    Science.gov (United States)

    Lloyd-Rees, Johanna

    2016-01-01

    The Emergency Nurse Practitioner (ENP) role has become established over the last two decades within emergency care. This role has developed to meet the rising demands of healthcare, combat the continuing medical workforce shortfall and address targets around healthcare delivery within emergency care. The ENP role has been widely evaluated in terms of patient satisfaction, safety and outcome. To date there is no published literature exploring what drives senior nurses to undertake this role which involves additional clinical responsibility and educational preparation for no increase in pay. This research seeks to explore how Emergency Nurse Practitioners view their role within the Emergency Department and Emergency Care Team. A qualitative approach was utilised in order to gain greater in-depth understanding of ENPs' perspectives. A purposive sample of eight ENPs was chosen and semi-structured interviews were digitally recorded. The transcribed interviews were subjected to thematic analysis to look for any recurrent themes. Following analysis of the data, four main themes emerged with a total of eight sub themes. The findings suggested that whilst the role had been accepted amongst doctors within the ED, there was still a lack of understanding of the role outside the ED and conflict still existed amongst junior nurses. ENPs were motivated to undertake the role in order to gain greater job satisfaction. The findings also highlighted the concerns regarding financial remuneration for the role, lack of standardisation of the role and educational preparation. The study concludes that education has a key role in the development and acceptance of the role and that ENPs are disappointed with the lack of financial remuneration for the role. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Important Non-Technical Skills in Video-Assisted Thoracoscopic Surgery Lobectomy: Team Perspectives.

    Science.gov (United States)

    Gjeraa, Kirsten; Mundt, Anna S; Spanager, Lene; Hansen, Henrik J; Konge, Lars; Petersen, René H; Østergaard, Doris

    2017-07-01

    Safety in the operating room is dependent on the team's non-technical skills. The importance of non-technical skills appears to be different for minimally invasive surgery as compared with open surgery. The aim of this study was to identify which non-technical skills are perceived by team members to be most important for patient safety, in the setting of video-assisted thoracoscopic surgery (VATS) lobectomy. This was an explorative, semistructured interview-based study with 21 participants from all four thoracic surgery centers in Denmark that perform VATS lobectomy. Data analysis was deductive, and directed content analysis was used to code the text into the Oxford Non-Technical Skills system for evaluating operating teams' non-technical skills. The most important non-technical skills described by the VATS teams were planning and preparation, situation awareness, problem solving, leadership, risk assessment, and teamwork. These non-technical skills enabled the team to achieve shared mental models, which in turn facilitated their efforts to anticipate next steps. This was viewed as important by the participants as they saw VATS lobectomy as a high-risk procedure with complementary and overlapping scopes of practice between surgical and anesthesia subteams. This study identified six non-technical skills that serve as the foundation for shared mental models of the patient, the current situation, and team resources. These findings contribute three important additions to the shared mental model construct: planning and preparation, risk assessment, and leadership. Shared mental models are crucial for patient safety because they enable VATS teams to anticipate problems through adaptive patterns of both implicit and explicit coordination. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Fire and evacuation drills make the CERN safety plans work

    CERN Multimedia

    Antonella Del Rosso

    2013-01-01

    Regular drills are a way of making sure that we are ready and able to react in the event of a fire or other adverse event. They are also a demanding test of all the technical and organisational measures in place to allow the quick and safe evacuation of buildings. Recently, large-scale drills took place in Building 40 and at Point 5 underground.   Group photo at Point 5, after the common evacuation drill. The ability to react to unexpected, adverse events relies in particular on training. This is why CERN’s safety teams organise regular drills. One of the most recent exercises took place on 26 March in Building 40. “Building 40 is a modern building fully equipped against fire, with two emergency exits in the central atrium. We also have 29 emergency guides distributed on each floor to guide people out of their offices,” says Kate Richardson, Territorial Safety Officer of the building. “The drills are very useful for testing the building's insta...

  16. Improving patient safety in radiology: a work in progress

    International Nuclear Information System (INIS)

    Sze, Raymond W.

    2008-01-01

    The purpose of this paper is to share the experiences, including successes and failures, as well as the ongoing process of developing and implementing a safety program in a large pediatric radiology department. Building a multidisciplinary pediatric radiology safety team requires successful recruitment of team members, selection of a team leader, and proper and ongoing training and tools, and protected time. Challenges, including thorough examples, are presented on improving pediatric radiology safety intradepartmentally, interdepartmentally, and institutionally. Finally, some major challenges to improving safety in pediatric radiology, and healthcare in general, are presented along with strategies to overcome these challenges. Our safety program is a work in progress; this article is a personal account and the reader is asked for tolerance of its occasional subjective tone and contents. (orig.)

  17. Statistical Analysis of the Worker Engagement Survey Administered at the Worker Safety and Security Team Festival

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Adam Christopher [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-08-25

    The Worker Safety and Security Team (WSST) at Los Alamos National Laboratory holds an annual festival, WSST-fest, to engage workers and inform them about safety- and securityrelated matters. As part of the 2015 WSST-fest, workers were given the opportunity to participate in a survey assessing their engagement in their organizations and work environments. A total of 789 workers participated in the 23-question survey where they were also invited, optionally, to identify themselves, their organization, and to give open-ended feedback. The survey consisted of 23 positive statements (i.e. “My organization is a good place to work.”) with which the respondent could express a level of agreement. The text of these statements are provided in Table 1. The level of agreement corresponds to a 5-level Likert scale ranging from “Strongly Disagree” to “Strongly Agree.” In addition to assessing the overall positivity or negativity of the scores, the results were partitioned into several cohorts based on the response meta-data (self-identification, comments, etc.) to explore trends. Survey respondents were presented with the options to identify themselves, their organizations and to provide comments. These options suggested the following questions about the data set.

  18. Study on team evaluation. Team process model for team evaluation

    International Nuclear Information System (INIS)

    Sasou Kunihide; Ebisu, Mitsuhiro; Hirose, Ayako

    2004-01-01

    Several studies have been done to evaluate or improve team performance in nuclear and aviation industries. Crew resource management is the typical example. In addition, team evaluation recently gathers interests in other teams of lawyers, medical staff, accountants, psychiatrics, executive, etc. However, the most evaluation methods focus on the results of team behavior that can be observed through training or actual business situations. What is expected team is not only resolving problems but also training younger members being destined to lead the next generation. Therefore, the authors set the final goal of this study establishing a series of methods to evaluate and improve teams inclusively such as decision making, motivation, staffing, etc. As the first step, this study develops team process model describing viewpoints for the evaluation. The team process is defined as some kinds of power that activate or inactivate competency of individuals that is the components of team's competency. To find the team process, the authors discussed the merits of team behavior with the experienced training instructors and shift supervisors of nuclear/thermal power plants. The discussion finds four team merits and many components to realize those team merits. Classifying those components into eight groups of team processes such as 'Orientation', 'Decision Making', 'Power and Responsibility', 'Workload Management', 'Professional Trust', 'Motivation', 'Training' and 'staffing', the authors propose Team Process Model with two to four sub processes in each team process. In the future, the authors will develop methods to evaluate some of the team processes for nuclear/thermal power plant operation teams. (author)

  19. A systematic review of team-building interventions in non-acute healthcare settings.

    Science.gov (United States)

    Miller, Christopher J; Kim, Bo; Silverman, Allie; Bauer, Mark S

    2018-03-01

    Healthcare is increasingly delivered in a team-based format emphasizing interdisciplinary coordination. While recent reviews have investigated team-building interventions primarily in acute healthcare settings (e.g. emergency or surgery departments), we aimed to systematically review the evidence base for team-building interventions in non-acute settings (e.g. primary care or rehabilitation clinics). We conducted a systematic review in PubMed and Embase to identify team-building interventions, and conducted follow-up literature searches to identify articles describing empirical studies of those interventions. This process identified 14 team-building interventions for non-acute healthcare settings, and 25 manuscripts describing empirical studies of these interventions. We evaluated outcomes in four domains: trainee evaluations, teamwork attitudes/knowledge, team functioning, and patient impact. Trainee evaluations for team-building interventions were generally positive, but only one study associated team-building with statistically significant improvement in teamwork attitudes/knowledge. Similarly mixed results emerged for team functioning and patient impact. The evidence base for healthcare team-building interventions in non-acute healthcare settings is much less developed than the parallel literature for short-term team function in acute care settings. Only one intervention we identified has been tested in multiple non-acute settings by distinct research teams. Positive findings regarding the utility of team-building interventions are tempered by a lack of control conditions, inconsistency in outcome measures, and high probability of bias. Considering these results alongside the well-recognized costs of poor healthcare teamwork suggests that additional research is sorely needed to develop the evidence base for team-building in non-acute settings.

  20. Appraisal of Fire Safety Management Systems at Educational Buildings

    Directory of Open Access Journals (Sweden)

    Nadzim N.

    2014-01-01

    Full Text Available Educational buildings are one type of government asset that should be protected, and they play an important role as temporary communal meeting places for children, teachers and communities. In terms of management, schools need to emphasize fire safety for their buildings. It is well known that fires are not only a threat to the building’s occupants, but also to the property and the school environment. A study on fire safety management has been carried out on schools that have recently experienced fires in Penang. From the study, it was found that the school buildings require further enhancement in terms of both active and passive fire protection systems. For instance, adequate fire extinguishers should be provided to the school and the management should inspect and maintain fire protection devices regularly. The most effective methods to increase the level of awareness on fire safety are by organizing related programs on the management of fire safety involving all staff, teachers and students, educational talks on the dangers of fire and important actions to take in the event of an emergency, and, lastly, to appoint particular staff to join the management safety team in schools.