Understanding Multiteam Systems in Emergency Care: One Case at a Time

Abstract

Purpose

Although adverse events are less studied in the prehospital setting, the evidence is beginning to paint an alarming picture. Consequently, improvements in Emergency Medical Services (EMS) demand a paradigm shift regarding the way care is conceptualized. The chapter aims to (1) support the dialogue on near-misses and adverse events as a learning opportunity and (2) to provide insights on applications of multiteam systems (MTSs).

Approach

To offer discussion on near-misses and adverse events and knowledge on how MTSs are applicable to emergency medical care, we review and dissect a complex patient case.

Findings

Throughout this case discussion, we uncover seven pertinent issues specific to this particular MTS: (1) misunderstanding with number of patients and their locations, (2a) lack of context to build a mental model, (2b) no time or resources to think, (3) expertise-facilitated diagnosis, (4) lack of communication contributing to a medication error, (5) treatment plan selection, (6) extended time on scene, and (7) organizational culture impacting treatment plan decisions.

Originality/value

By dissecting a patient case within the prehospital setting, we can highlight the value in engaging in dialogue regarding near-misses and adverse events. Further, we can demonstrate the need to expand the focus from simply teams to MTSs.

Citation

Misasi, P., Lazzara, E.H. and Keebler, J.R. (2014), "Understanding Multiteam Systems in Emergency Care: One Case at a Time", Pushing the Boundaries: Multiteam Systems in Research and Practice (Research on Managing Groups and Teams, Vol. 16), Emerald Group Publishing Limited, Leeds, pp. 157-183. https://doi.org/10.1108/S1534-085620140000016007