Theme | PCP | DISCERN |
---|---|---|
Items identified as done well | ||
Communication | “excellent closed loop communication” “direct [and] focus[ed]” “summarize[d] plan” “procedure pause prior to intubation” | “clear communication about meds needed” “people talking loud enough for recorder to hear” “closed loop communication” “calm in the room” |
Team Function | “shared mental model of priorities” “clear instructions, loud succinct team leader” “utilized interdisciplinary team” | “organize resuscitation, all roles were assigned” “clear leader, documenter knew what was happening” “quick team assembled” |
Quality of Care | “respectful of cultural practice” “able to get family in” | “updating parents throughout” “advocated for patient to have dad present” “mom’s request being honoured by the ED team” |
Equipment | “quick provision of meds [and] equipment”, “adequate equipment” | “use of language line…code blue button use” “use of FAST” “CT quick” |
Preparation | “early identification of a sick patient” “good anticipation” “quick, effective recognition of [a] critical situation” | “initiated quickly, appropriate assessment of intervention” “everyone aware prior to patient arrival…plan in place prior…” “very rapid response by the code team” “prompt treatment” |
Support | “support each other” “respected student[s]” “juniors well supported” | “bedside teaching awesome” “respected the space for learners” “junior learner: well supported, good educational value” |
Identified areas of improvement | ||
Communication | “communication between attendings not clean” “better closed loop communication” “better system available to communicate for OR and ISR” “SBAR to PICU” “too noisy at the nursing station, nurses & MDs talking outside room” “speak up if something not as it should be (front line person)” | “More vocalization” “[remember] close loop and clear who lead is” “recap presentation for others” “more closed loop communication in terms of plan & future interventions” |
Team Function | “better documentation of orders” “[involvement] of security to help manage crowd” “PACE very disorganized” “more clear role description of resus leader” “clear team leader” | “EMS blocking head of bed” “the leader role was not clear” “clear role definition” “way to identify ER staff/position for PICU coming in to assist” |
Quality of Care | “cultural awareness…access to ethics” “assign 1 person to communicate with parents” “ongoing updating to the family during resuscitation…who’s role?” | “child life should have been allowed in” “parents could’ve been brought in sooner” “mom should have been filled in prior [to] coming into room” “support for mom” |
Equipment | “curved blade would have been helpful” “computer to chart would have been handy” “no 3% saline nebs in the trauma rooms” | “no emergency UVC kit on code card” “improvement with implementing epileptic order set” “trouble getting team paged” “code pink not announced officially by button” |
Preparation | “delay in consult service arrival” “plan to give alert for exchange [transfusion] to make sure everything is ready so when we need blood, will be ready” “call code whenever team wants” “BP/temp sooner” “move to resus sooner” | “ > 2 h prep time [for exchange transfusion]…next time to initiate earlier” “prepare all emergency medications…anticipating for the worst” “delayed identification of clinical status” |
Support | “Not to be afraid, hesitant to activate [code]” “continue to provide support to rotating learners” | “positioning of learners” “recognized learners in situation” |