the specialty care gap - texas children's hospital · group of strangers/competitors with...

Building a Bridge with Collaboration

The Specialty Care Gap:

Dionne J.

Walker, MSN,

RNC-OB

Clinical

Specialist,

Women’s

Services

Miranda A.

Rodrigues,

MSN, CNL,

CCRN-K

Clinical

Specialist,

CVICU

Kellie S.

Kainer,

MSN, RNC

Assistant

Clinical

Director,

NICU

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Background

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U.S. Infant Mortality Rate/Causes

Rates Causes

•Birth defects

•Preterm birth (<37 weeks

gestation) & low birth weight

•Maternal complications of

pregnancy

•Sudden Infant Death

Syndrome (SIDS)

• Injuries (e.g., suffocation)

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U.S Maternal Mortality Rate/CausesRates Causes

The cause of death is unknown for 6.1% of all pregnancy-related deaths.

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State of Texas Maternal Deaths

(within 42 days Following End of Pregnancy)

Maternal Mortality Rate

Year

Center for Disease

Control,

National Center for

Statistics

Texas Department of

State Health Services

2010 18.6 18.7

2011 30.2 26.5

2012 38.7 28.8

2013 36.1 32.5

2014 33.8 31.5

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High Risk Obstetrics

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CVOB Partnership was formed

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https://www.youtube.com/watch?v=aU6e33FYgg0

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CollaborationCommunication

CoordinationConflict Resolution

Bridging the Gap

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Collaboration

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Teamwork versus Collaboration

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CollaborationInterdependence

Shared purpose

Group of strangers/competitors with competing

goals

Collaborative leaders emerge during the process

Complicated, emotionally charged, frustrating event

in which innovation is born!

Hard work

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Collaborative Teamwork

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Critical Care Teamwork Checklist

Brindley et al, Journal of Critical Care, 33(2016)

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Recognize that collaboration is a journey

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Communication

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CommunicationKey element of highly functioning team

NASA-Crew Resource Management 1979

United States Army 1980s

United States Air Force 1990s

United States Navy 1998

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1996

MedTeam

Project

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TeamSTEPPS

Developed in 2006 by the U.S.

Department of Defense in

collaboration with the Agency

for Healthcare Research and

Quality to further extend the

military’s research on team

training to the healthcare

industry.

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Coordination

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Coordination defined…

co·or·di·na·tion

1. the organization of the different elements of a

complex body or activity so as to enable them to

work together effectively.

2. cooperative effort resulting in an effective

relationship.

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Basics for Utilization

Relevant to group efforts and not individuals

Continual and Dynamic

Continuous in that it is achieved through process

Dynamic due to stimulation in change as a result

of the process

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Jody Hoffer Gittell’s theory on relational

coordination proses, “that highly interdependent

work is most effectively coordinated through

relationships of shared goals, shared knowledge

and mutual respect, supporting sufficiently

frequent, timely, accurate, problem-solving

communication” (Havens, 2010).

Relational Coordination

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Conflict Resolution

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Recognize this logo?

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Pilots average of 75 simulation hours

before stepping onto an aircraft.

The U.S. Department of Transportation’s Bureau of

Transportation Statistics (BTS) reported today that U.S.

airlines and foreign airlines serving the United States carried

an all-time high of 848.1 million system-wide (domestic and

international) scheduled service passengers in 2014

In 2014, there

were 1320 deaths

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Healthcare Providers have no required simulation hours

In 2013, the number of U.S. hospital admissions was

reported to be around 35.4 million.

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“SBTT* and debriefing is an evolving educational strategy that

encourages work-based learning,

collaboration, and teamwork, and

improves communication”

‐Severson (2014)

*Simulation Based Team Training

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Debriefing

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Lavoi, Pepin & Boyer (2013) Reflective debreifing to promote clinical judgement after high-fidelity clinical simulation

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OB

CVICU NICU

ONE

AMAZING

TEAM!!!

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Thank you!

the specialty care gap - texas children's hospital · group of strangers/competitors with...

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