Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand; Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand.
Centre of Excellence in Critical Care, Apollo Hospitals Group, Chennai, India; Department of Anaesthesia and Intensive Care, University of Nottingham, Nottingham, UK.
Br J Anaesth. 2024 Apr;132(4):771-778. doi: 10.1016/j.bja.2023.12.035. Epub 2024 Feb 2.
Healthcare today is the prerogative of teams rather than of individuals. In acute care domains such as anaesthesia, intensive care, and emergency medicine, the work is complex and fast-paced, and the team members are diverse and interdependent. Three decades of research into the behaviours of high-performing teams provides us with clear guidance on team training, demonstrating positive effects on patient safety and staff wellbeing. Here we consider team performance through the lens of situation awareness. Maintaining situation awareness is an absolute requirement for safe and effective patient management. Situation awareness is a dynamic process of perceiving cues in the environment, understanding what they mean, and predicting how the situation may evolve. In the context of acute clinical care, situation awareness can be improved if the whole team actively contributes to monitoring the environment, processing information, and planning next steps. In this narrative review, we explore the concept of situation awareness at the level of the team, the conditions required to maintain team situation awareness, and the relationship between team situation awareness, shared mental models, and team performance. Our ultimate goal is to help clinicians create the conditions required for high-functioning teams, and ultimately improve the safety of clinical care.
当今的医疗保健是团队的特权，而不是个人的特权。在麻醉、重症监护和急诊医学等急性护理领域，工作复杂且节奏快，团队成员多样化且相互依存。三十年来，对高绩效团队行为的研究为我们提供了关于团队培训的明确指导，证明了对患者安全和员工健康的积极影响。在这里，我们通过情境意识的视角来考虑团队绩效。保持情境意识是安全有效地进行患者管理的绝对要求。情境意识是一个动态的过程，即感知环境中的线索，理解它们的含义，并预测情况可能如何发展。在急性临床护理的背景下，如果整个团队积极参与环境监测、信息处理和下一步计划，那么情境意识就可以得到提高。在这篇叙述性综述中，我们探讨了团队层面的情境意识概念、维持团队情境意识所需的条件，以及团队情境意识、共享心理模型和团队绩效之间的关系。我们的最终目标是帮助临床医生创造高功能团队所需的条件，最终提高临床护理的安全性。
