Crisis Management In Acute Care Settings

Critical situations in acute and emergency care are one of the great clinical challenges because of the uncertainty, high stakes, time pressure, and stress that are involved. This book provides a comprehensive outline of all the human factors issues relevant to patient safety during acute care. Following an initial section discussing the basic principles of human behavior and decision making, the various influences on safe patient care are discussed in depth. These are divided into three interacting groups: individual factors, team factors, and organizational factors. Relevant psychological theories are carefully examined, and case studies and descriptions of proven strategies help to ground these theories in daily practice. This newly revised edition, in which each chapter has been enlarged and updated, will help both physicians and non-physicians to better understand the principles of human behavior and decision making in critical situations and thus to provide safer treatment.

This book is unique in providing a comprehensive overview of the human factors issues relevant to patient safety during acute care. By elucidating the principles of human behavior and decision-making in critical situations and identifying frequent sources of human error, it will help healthcare professionals provide safer, more effective treatment when dealing with emergencies characterized by uncertainty, high stakes, time pressure, and stress. The third edition has emerged from an ongoing synergistic relationship between clinicians and behavioral scientists on both sides of the Atlantic to update and enhance each chapter -- blending the strengths of the two professions into a readily accessible text. Among other improvements, readers will find sharper articulation of concepts and significantly more information on the organizational impact on individual and team performance. Crisis Management in Acute Care Settings is the required reference for all who are learning about, teaching, or providing acute and emergency healthcare. It will be of high value for undergraduate and graduate medical and nursing program and offer a much-needed resource for those who use high-fidelity healthcare simulation to teach teamwork.

This book addresses all issues relevant to error prevention and safe practice in the acute and emergency health-care setting. It begins with the basic principles of human behavior and decision making and then partitions into three sections where the individual, the team, and the organizational influences within the health-care system are discussed in greater depth. Case reports and proven strategies help to ground psychological theory in daily practice. This book has emerged from a long-standing cooperation between clinicians and psychologists and blends the strengths of both professions into a readily accessible text.

In the USA, the COVID-19 crisis came as an unpleasant surprise and a shock to many healthcare systems and hospitals, especially in the crisis epicenter, New York City. The Bronx was one of the hardest hit boroughs of New York City, with significant negative impact of the COVID-19 pandemic on its indigent population. SBH Health System (formerly known as St. Barnabas Hospital) is an integrated system of an acute care hospital, ambulatory care center, trauma center, dialysis center, stroke center and other services and facilities, serving the community of the Bronx. The story of SBH in preparing for and managing the rapidly escalating surge of severely ill patients is a treasure of lessons in health crisis preparedness and management at all levels: clinical, administrative, financial, etc. These lessons can be used for other acute care hospital settings and other potential health crises that may arise in the future. Within a short 3 weeks, SBH increased its in-patient capacity by 50%. However, during the same short time, it increased its critical care capacity by over 500%, providing critical care to severely ill patients on ventilators. This book chronicles the situation step by step and describes how this accomplishment was done. Accounts from the frontline health workers and from the clinical and administrative leaders describe important aspects of crisis management, such as team building, multi-departmental coordination, effective communications, dynamic decision-making in response to rapidly changing situations, keeping up the morale and caring for the healthcare workers and managing the supply chain. The uniqueness of the experience of SBH is enhanced by the fact that SBH is a low budget “safety net” hospital serving the poorest population in New York City. The worldwide trend is toward tighter healthcare budgets with demands for higher efficiency and productivity. There is a lot to be learned from the SBH health crisis management, including how efficient management, team building, management of limited resources and collaborative workplace culture make the foundation of success in the face of the crisis of the century. This unique text serves as a “how to” guide for implementing skills necessary for crisis management. Lessons from the success of SBH in tackling the dramatically fast unfolding crisis are utilized in a clear and concise manner. Such lessons may benefit other health systems and hospitals in planning and preparing for similar crises.

The influenza pandemic caused by the 2009 H1N1 virus underscores the immediate and critical need to prepare for a public health emergency in which thousands, tens of thousands, or even hundreds of thousands of people suddenly seek and require medical care in communities across the United States. Guidance for Establishing Crisis Standards of Care for Use in Disaster Situations draws from a broad spectrum of expertise-including state and local public health, emergency medicine and response, primary care, nursing, palliative care, ethics, the law, behavioral health, and risk communication-to offer guidance toward establishing standards of care that should apply to disaster situations, both naturally occurring and man-made, under conditions in which resources are scarce. This book explores two case studies that illustrate the application of the guidance and principles laid out in the report. One scenario focuses on a gradual-onset pandemic flu. The other scenario focuses on an earthquake and the particular issues that would arise during a no-notice event. Outlining current concepts and offering guidance, this book will prove an asset to state and local public health officials, health care facilities, and professionals in the development of systematic and comprehensive policies and protocols for standards of care in disasters when resources are scarce. In addition, the extensive operations section of the book provides guidance to clinicians, health care institutions, and state and local public health officials for how crisis standards of care should be implemented in a disaster situation.

Psychological Crisis Intervention: The SAFER-R Model is designed to provide the reader with a simple set of guidelines for the provision of psychological first aid (PFA). The model of psychological first aid (PFA) for individuals presented in this volume is the SAFER-R model developed by the authors. Arguably it is the most widely used tactical model of crisis intervention in the world with roughly 1 million individuals trained in its operational and derivative guidelines. This model of PFA is not a therapy model nor a substitute for therapy. Rather it is designed to help crisis interventionists stabile and mitigate acute crisis reactions in individuals, as opposed to groups. Guidelines for triage and referrals are also provided. Before plunging into the step-by-step guidelines, a brief history and terminological framework is provided. Lastly, recommendations for addressing specific psychological challenges (suicidal ideation, resistance to seeking professional psychological support, and depression) are provided.

The number of natural and man-made disasters has risen dramatically over the last decade. Natural disasters, industrial accidents and terrorist attacks represent major incidents, often involving multiple casualties. In such cases, health professionals face multiple challenges because the type of medical care required differs from what is taught and provided in their everyday hospital duties. The aim of this book is to inform and prepare healthcare professionals for the challenges posed by major incidents, so that they can act effectively in medical teams sent on humanitarian missions or into conflict zones. It offers a holistic and horizontal approach covering all stages of the disaster management cycle. The book is divided into 5 sections: section 1: prehospital emergency services; section ii: hospital response; section iii: management of incidents; section iv: after the disaster; and section v: evaluation, ethical issues, education and research. Healthcare providers will find essential information on the special medical considerations in both prehospital and hospital disaster settings, medical management of disaster response, recovery, mitigation and preparedness. The book offers an interdisciplinary and interprofessional approach, and was written by prominent researchers and experienced practitioners.

During a wide-reaching catastrophic public health emergency or disaster, existing surge capacity plans may not be sufficient to enable health care providers to continue to adhere to normal treatment procedures and follow usual standards of care. This is a particular concern for emergencies that may severely strain resources across a large geographic area, such as a pandemic influenza or the detonation of a nuclear device. Under these circumstances, it may be impossible to provide care according to the standards of care used in non-disaster situations, and, under the most extreme circumstances, it may not even be possible to provide basic life sustaining interventions to all patients who need them. Although recent efforts to address these concerns have accomplished a tremendous amount in just a few years, a great deal remains to be done in even the most advanced plan. This workshop summary highlights the extensive work that is already occurring across the nation. Specifically, the book draws attention to existing federal, state, and local policies and protocols for crisis standards of care; discusses current barriers to increased provider and community engagement; relays examples of existing interstate collaborations; and presents workshop participants' ideas, comments, concerns, and potential solutions to some of the most difficult challenges.