Core Team Members' Impact on Outcomes and Process Improvement in the Initial Resuscitation of Trauma Patients

Abstract

Genesis Trauma Center is an American College of Surgeons-The Committee on Trauma-verified Level III facility located in Southeastern Ohio. Process improvement and patient safety showed inconsistencies in trauma documentation and comfort level of the nursing staff. In February 2014, Genesis implemented a trauma nurse leader program to provide a core team of trauma nurses for the initial resuscitation. The overall goal of implementing a trauma nurse leader (TNL) program was to focus education on a core team, providing an increased level of skill of experience to oversee trauma patient care. The TNL program has shown promise in the pilot phase by decreasing emergency department length of stay and improving trauma documentation.

Shared Leadership in Healthcare Action Teams: A Systematic Review

“…Twelve articles described shared leadership as an IP, that is, team leadership input was structured with more than one designated leadership position with defined leadership tasks 13,68–78 . In some cases, it was explicit that a single leader retained hierarchical authority over other leaders.…”

“…Twelve articles described shared leadership as an IP, that is, team leadership input was structured with more than one designated leadership position with defined leadership tasks. 13,[68][69][70][71][72][73][74][75][76][77][78] In some cases, it was explicit that a single leader retained hierarchical authority over other leaders. The purpose of leadership sharing in these cases seemed to be sharing for task load distribution.…”

“…Seven studies reported team performance outcomes related to shared leadership. 8,54,69,70,72,74,75 Two articles considered the results of SC, one reporting clinical performance, the other teamwork skills. Künzle et al 54 studied anesthesia teams (nurse/resident dyads) and found that greater spontaneous sharing of leadership was associated with improved clinical performance during a crisis.…”

“…Improvements in documentation and length of stay in the emergency department were observed, but no change in time to obtain computed tomography or focused assessment with sonography for trauma (FAST) scan was seen after introduction of a trauma nurse leader in trauma teams. 69,70 These nurse team leaders also contributed to other quality improvement activities within the department, so the effect of their participation during the trauma resuscitation may not have contributed to the improvements seen. Lomas When a team was present (team defined as including a nurse and doctor leader) clinical performance was better than when there was no or only a partial team.…”

Team leader coaching intervention: An investigation of the impact on team processes and performance within a surgical context.

“…Further, finding that coaching a single individual had benefits that extended to the team raises questions about whether team-related interventions should be delivered to team leaders, intact teams, or individual members. Beyond team leaders, can coaching a strategic core (Humphrey, Morgeson, & Mannor, 2009) or specific team member (e.g., circulating nurse; Geyer et al, 2016) affect team outcomes? It is also unclear if the benefit of coaching interventions extends beyond the OR (Tesluk, Farr, Mathieu, & Vance, 1995) to benefit other team assignments.…”