Coordinating Mechanisms Are More Important Than Team Processes for Geographically Dispersed Emergency Dispatch and Paramedic Teams.

Bjørn Helge Johnsen,Roar Espevik,Guttorm Brattebø,Johan Kolstad Jacobsen,Jarle Eid,Øyvind Østerås

doi:10.3389/fpsyg.2022.754855

Bjørn Helge Johnsen, Roar Espevik + Show 4 more

Open Access

https://doi.org/10.3389/fpsyg.2022.754855

Copy DOI

Abstract

In recent decades there has been an increased emphasis on non-technical skills in medical teams. One promising approach that relates teamwork to medical efficiency is the theory of Shared Mental Models (SMM). The aim of the present study was to investigate the suitability of the Shared Mental Model approach for teamwork between operators in emergency medical communication centers and the first line ambulance personnel in real-life settings. These teams collaborate while working from geographically dispersed positions, which makes them distinct from the kinds of teams examined in most previous research on team effectiveness. A pressing issue is therefore whether current models on co-located teams are valid for medical distributed teams. A total of 240 participants from 80 emergency medical teams participated in the study. A team effectiveness model was proposed based on identified team coordinating mechanisms and the “Big five” team processes. Path analyses showed that SMM was positively associated with team effectiveness (i.e., performance satisfaction and situational awareness) and negatively related to mission complexity. Furthermore, the coordinating mechanisms of SMM and Closed Loop Communication was positively related to “Big five” team scores. However, no effects were found for the “Big five” team processes on effectiveness, which could indicate that the model needs to be adjusted for application to geographically dispersed teams. Possible implications for team training of distributed emergency response teams are discussed.

Highlights

Emergency medical organization in Norway is centered around emergency medical communication centers (EMCC)
92% of the missions were coordinated by EMCC-operators with a background as ambulance paramedics, whereas 6% of the missions were coordinated by operators with a dual background as a registered nurse and ambulance paramedic (2% missing data)
The measure of “Big five” team processes showed an alphavalue of 0.593. This low alpha value indicated the multidimensionality of the measure. This is to be expected since the variable is a composite measure of five different team processes

Summary

Introduction

Emergency medical organization in Norway is centered around emergency medical communication centers (EMCC). The role of the EMCC is to provide medical advice to the caller based on the Norwegian Index for Emergency Medical Assistance, a decision support tool (Norwegian Medical Association, 2009). This involves conducting triage, dispatching and directing the ambulances, and acting as a communicationhub between the ambulances, general practitioners, and external entities like the local police operational headquarters or fire and rescue units. One promising strategy for augmenting EMCC operations has been to focus on generic and specific non-technical skills (NTS) to improve teamwork. The NTS of team leadership was stressed by the UK General Medical Council (2016), the Academy of Royal Medical Colleges and the UK National Health Service (2010) in their “Medical Leadership Competency Framework.”

Objectives

Methods

Results

Discussion

Conclusion