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构建有韧性的医疗团队:从蚂蚁、蜜蜂和其他社会性昆虫的社会生物学类比中获得的启示。

Building Resilient Healthcare Teams: Insights from Analogy to the Social Biology of Ants, Honey Bees and Other Social Insects.

机构信息

Dept. of Surgery and Centre for Education Research & Innovation (CERI), The University of Western Ontario, Canada.

Department of Biology, Faculty of Science, The University of Western Ontario, Canada.

出版信息

Perspect Med Educ. 2023 Jun 26;12(1):253-260. doi: 10.5334/pme.1051. eCollection 2023.

Abstract

The resilience of a healthcare system hinges on the adaptability of its teams. Thus far, healthcare teams have relied on well-defined scopes of practice to fulfill their safety mandate. While this feature has proven effective when dealing with stable situations, when it comes to disruptive events, healthcare teams find themselves navigating a fine balance between safety and resilience. Therefore, a better understanding of how the safety vs resilience trade-off varies under different circumstances is necessary if we are to promote and better train for resilience in modern healthcare teams. In this paper, we aim to bring awareness to the sociobiology analogy that healthcare teams might find useful during moments when safety and adaptability have the potential to conflict. Three principles underpin the sociobiology analogy: communication, decentralization, and plasticity. Of particular interest in this paper is plasticity whereby swapping roles or tasks becomes an adaptive, rather than a maladaptive, response teams could embrace when facing disruptive situations. While plasticity has naturally evolved in social insects, infusing plasticity in healthcare teams requires intentional training. Inspired by the sociobiology analogy, such training must value the ability: a) to read each other's cues and miscues, b) to step aside when others had the necessary skills, even if outside their scope, c) to deviate from protocols, and d) to foster cross-training. If the goal is to increase a team's behavioural flexibility and boost their resilience, this training mindset should become second nature.

摘要

医疗体系的弹性取决于其团队的适应能力。到目前为止,医疗团队依靠明确的实践范围来履行其安全职责。虽然在处理稳定情况时,这一特点已被证明是有效的,但在面对破坏性事件时,医疗团队发现自己在安全和弹性之间需要取得微妙的平衡。因此,如果我们要在现代医疗团队中促进和更好地培训弹性,就有必要更好地了解在不同情况下安全与弹性的权衡是如何变化的。在本文中,我们旨在让医疗团队意识到,在安全和适应性有可能发生冲突的时刻,社会生物学类比可能会有所帮助。社会生物学类比有三个基本原则:沟通、去中心化和可塑性。在本文中特别感兴趣的是可塑性,即当面临破坏性情况时,团队可以通过交换角色或任务来适应,而不是不适应。虽然可塑性在社会性昆虫中自然进化,但在医疗团队中注入可塑性需要有目的的培训。受社会生物学类比的启发,这种培训必须重视以下能力:a)能够读懂彼此的暗示和误解,b)在他人具备必要技能时主动让贤,即使技能不在其职责范围内,c)偏离常规,d)培养交叉培训。如果目标是提高团队的行为灵活性并增强其弹性,那么这种培训思维方式应该成为一种习惯。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/97d6/10312249/40419c677d7f/pme-12-1-1051-g1.jpg

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