title: Six habits to enhance MET performance under stress: A discussion paper reviewing team mechanisms for improved patient outcomes.
abstract: Effective team decision making has the potential to improve the quality of health care outcomes. Medical Emergency Teams (METs), a specific type of team led by either critical care nurses or physicians, must respond to and improve the outcomes of deteriorating patients. METs routinely make decisions under conditions of uncertainty and suboptimal care outcomes still occur. In response, the development and use of Shared Mental Models (SMMs), which have been shown to promote higher team performance under stress, may enhance patient outcomes. This discussion paper specifically focuses on the development and use of SMMs in the context of METs. Within this process, the psychological mechanisms promoting enhanced team performance are examined and the utility of this model is discussed through the narrative of six habits applied to MET interactions. A two stage, reciprocal model of both nonanalytic decision making within the acute care environment and analytic decision making during reflective action learning was developed. These habits are explored within the context of a MET, illustrating how applying SMMs and action learning processes may enhance team-based problem solving under stress. Based on this model, we make recommendations to enhance MET decision making under stress. It is suggested that the corresponding habits embedded within this model could be imparted to MET members and tested by health care researchers to assess the efficacy of this integrated decision making approach in respect to enhanced team performance and patient outcomes.
authors: School of Psychology and Counselling, University of Southern Queensland, Toowoomba, Australia. Electronic address: Erich.Fein@usq.edu.au.
authors: Erich C
authors: EC
authors: Fein
authors: School of Nursing and Midwifery, University of Southern Queensland, Toowoomba, Australia; Griffith Health Institute (GHI) & Institute for Resilient Regions (IRR), Australia.
authors: Benjamin
authors: B
authors: Mackie
authors: School of Behavioural Sciences, Netanya Academic College, Netanya, Israel.
authors: Lily
authors: L
authors: Chernyak-Hai
authors: University of Queensland, Brisbane, Australia.
authors: C Richard V
authors: CR
authors: O'Quinn
authors: School of Business and Law, Central Queensland University, Melbourne, Australia.
authors: Ezaz
authors: E
authors: Ahmed
mesh_terms: D002983:Clinical Competence; D003422:Critical Care; D003657:Decision Making; D057209:Hospital Rapid Response Team / Q000458:organization & administration*; D006801:Humans; D033183:Interdisciplinary Communication; D008505:Medical Staff, Hospital / Q000523:psychology*; D061214:Patient Safety; D058996:Quality Improvement
keywords: Action learning; Clinical judgement; Cognitive Schema; Critical care; Decision making; Knowledge structures; Medical Emergency Teams; Patient safety; Reflection; Shared Mental Models