Surgical Team Assessment Training: improving surgical teams during deployment.

BACKGROUND: Simulation and team training are accepted as critical patient safety strategies to improve team performance and can help achieve better outcomes. Standardized and realistic drills conducted by skilled physicians and nurses who demonstrate consistent use of principles which enhance communication and teamwork increase the likelihood of improved clinical outcomes. METHODS: Two, 4-member surgeon/nurse teams traveled to 8 Army surgical resuscitation medical treatment facilities in Iraq during July and August 2011. At each site, a new program called Surgical Team Assessment Training was introduced and implemented to 220 military personnel. Two multi-patient scenarios were designed to test resuscitative and operating room medical decision-making, communication, and co-ordination of care. In addition, 2 hours of didactic instruction emphasized principles of TeamSTEPPS applied to emergency and operating rooms during care of patients with multiple, complex traumatic injuries. Anonymous surveys were completed by participants following the training. RESULTS: Participants were significantly more likely to rate this training as very helpful following training compared with their opinion before participation (53% vs 37%, P < .05). Seventy-seven percent felt that it would improve overall patient outcomes, 78% said it would likely contribute to saving lives in combat, and 98% felt it should be provided to military Emergency Medicine and Surgical residents. CONCLUSIONS: Surgical Team Assessment Training can be successfully implemented in an austere, hostile environment and improve trauma team function by incorporating simulation training models and TeamSTEPPs concepts. Expansion of this program for predeployment and resident training is currently under investigation based on the extremely positive responses.

Disaster management mobile protocols: a technology that will save lives.

Although training and education have long been accepted as integral to disaster preparedness, many currently taught practices are neither evidence based nor standardized. The need for effective evidence-based disaster education for healthcare workers at all levels in the multidisciplinary medical response to major events has been designated by the disaster response community as a high priority. This article describes a disaster management mobile application of systematic evidence-based practice. The application is interactive and comprises portable principles, algorithms, and emergency protocols that are agile, concise, comprehensive, and response relevant to all healthcare workers. Early recognition through clinical assessment versus laboratory and diagnostic procedures in chemical, biological, radiological, and nuclear (CBRNE) exposures grounded in an evidence-based skill set is especially important. During the immediate threat, the clinical diagnosis can get frustrating because CBRNE casualties can mimic everyday healthcare illnesses and initially present with nonspecific respiratory or flu-like symptoms. As there is minimal time in a catastrophic event for the medical provider to make accurate decisions, access to accurate, timely, and comprehensive information in these situations is critical. The CBRNE mobile application is intended to provide a credible source for treatment and management of numerous patients in an often intimidating environment with scarce resources and overwhelming tasks.

Collaboration between civilian and military healthcare professionals: a better way for planning, preparing, and responding to all hazard domestic events.

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial. This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.