CMS | Center for Medical Simulation

DTBR #2: Ready to Declare a Case Has Gone Wrong

Christian Balmer, an anesthesiologist and critical care doctor from Switzerland, joins us to look at the readiness of surgical teams in his organization to recognize and deal with cases that have gone beyond the capacity of the peripheral center to handle.

Far from being a readiness plan around technical skills, the team discovers that it is the gray areas between intersecting teams and intersection institutions where the process of caring for the patient breaks down. Do the ICU teams at both hospitals agree about when is the right time to transfer the patient? Do the surgeons have training on stepping back and declaring that there is a crisis that needs to be managed via transport? Are there communication plans in place to make sure that the ICU has available beds, and to help the main hospital trust that when the peripheral group sends a patient, that patient has a real need for the ICU bed?

Finally, we discuss aligning training programs from healthcare schools all the way to the hospital—if health systems are looking for teams that can talk to one another, work with patients, and provide care in a particular way, how can we make sure that the schools that are training future healthcare workers are in communication and prioritizing the skills and ability to learn that they will need to be ready for the job?

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Host & Co-Producer: Chris Roussin, PhD, Senior Director, CMS-ALPS (https://harvardmedsim.org/chris-roussin/)

Producer: James Lipshaw, MFA, EdM, Assistant Director, Media (https://harvardmedsim.org/james-lipshaw/)

Consulting and readiness with CMS-ALPS: https://harvardmedsim.org/alps-applied-learning-for-performance-and-safety

Readiness Planning in Advances in Simulation: https://advancesinsimulation.biomedcentral.com/articles/10.1186/s41077-024-00317-z

Dare to Be Ready on Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Dare to Be Ready on Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

This week on Curious Now we’re introducing a tool to help us bring the approach of understanding why people did what they did and helping them change the underlying analysis that got them into trouble, called the FAR or Frames, Actions, Results tool.

Where has your team gotten stuck or glitchy, and what were the underlying frames that got your team intro trouble or got the job done great?

Spotify: https://open.spotify.com/show/72gzzWGegiXd9i2G6UJ0kP

Apple Podcasts: https://podcasts.apple.com/us/podcast/the-center-for-medical-simulation/id1279266822

Leadership Coaching from Jenny Rudolph: https://harvardmedsim.org/personal-leadership-coaching-with-jenny-rudolph/