Communication and Teamwork

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6
Communication and Teamwork
2
Advanced EMT Education Standard

• The AEMT applies fundamental knowledge of the EMS
  system, safety/well-being of the AEMT, and
  medical/legal and ethical issues to the provision
  of emergency care.

3
Multimedia Directory

• Slide 30 Understanding Cultural Perspectives
  Video
• Slide 54 Effective Communication Video

4
Objectives

1. Define key terms introduced in this chapter.
2. Describe the components of the communication
   process, including factors that can interfere
   with effective communication. 24-33
3. Identify the potential impact of the perceptions
   of nonverbal behaviors on communication. 28-29

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Objectives

1. Demonstrate effective communications that promote
   continuity and safety in patient care when
   communicating with EMS crew members, other public
   safety personnel, and receiving hospital
   personnel. 24-31
2. Given a scenario, demonstrate effective
   communication that improves team dynamics. 33-34

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Objectives

• Describe the responsibilities of the Federal
  Communications Commission with respect to EMS
  communication. 35-36
• Discuss the purpose and characteristics of each
  of the following EMS system communication
  components 41
• Base station
• Cellular phones
• Digitized radio equipment
• Interoperability

7
Objectives

• Discuss the purpose and characteristics of each
  of the following EMS system communication
  components 41
• Mobile data terminals
• Mobile radios
• Portable radios
• Repeater
• List the key points in an EMS call at which you
  should communicate, and with whom you should
  communicate. 37-38

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Objectives

1. Demonstrate standard rules of radio
   communications. 42
2. Deliver a concise, organized radio report that
   clearly communicates essential information to
   medical direction or the receiving facility.
   37-44
3. Demonstrate the ability to receive and confirm an
   order for medical treatment over the radio. 37-38

9
Objectives

1. Discuss the advantages and disadvantages of using
   radio codes. 38
2. Convert back and forth between standard clock and
   24-hour (military) time. 39
3. Explain the importance of establishing rapport
   with patients and their families in the
   therapeutic communication process. 45-54

10
Objectives

1. Given a scenario, engage in effective,
   empathetic, culturally sensitive communication.
   45-54

11
Objectives

• Give examples of the appropriate use of the
  following communication behaviors 48-50
• Open-ended questions
• Reflection
• Silence
• Summary

12
Objectives

• Analyze your communication to avoid the pitfalls
  of 51
• Leading or biased questions
• Interrupting the patient
• Talking too much
• Providing false reassurance or inappropriate
  advice
• Implying blame

13
Objectives

• Given a scenario, demonstrate modifications in
  communication for the following situations 52-56
• Communicating with a patients family
• Getting a noncommunicative patient to talk
• Interviewing a hostile patient/using verbal
  defusing strategies

14
Objectives

• Given a scenario, demonstrate modifications in
  communication for the following situations 52-56
• Cross-cultural communication and language
  barriers
• Communicating with children, elderly patients
  with sensory deficits, and patients with
  cognitive impairment
• Explain the purposes and importance of
  documenting patient care. 58

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Objectives

1. Describe the elements of the U.S. Department of
   Transportation (DOT)/National EMS Information
   System (NEMSIS) minimum data set for patient care
   reports (PCR). 58-59

16
Objectives

• Accurately complete the contents of each section
  of a PCR to include 60
• Administrative data
• Patient demographic data and other patient data
• Vital signs
• Narrative
• Treatment

17
Objectives

• Give examples of each of the following types of
  PCR narrative data 60
• Chief complaint
• Pertinent history
• Subjective information
• Objective information
• Explain the importance of using proper
  abbreviations and terminology in the PCR. 60-61

18
Objectives

• Describe the SOAP, CHART, and CHEATED methods of
  PCR narrative documentation. 61
• Explain each of the following legal concerns with
  respect to the PCR 62-63
• Confidentiality
• Documentation of consent and refusal to consent
• Correction of errors
• Falsification of PCR information

19
Objectives

• Discuss how to handle each of the following
  situations with respect to documentation 64
• Transfer of patient care when returning to
  service before the PCR is complete
• Multiple-casualty incidents
• Supplemental reports for special situations, such
  as exposure to infectious disease and injury to a
  patient in the course of treatment and transport

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Introduction

• Not possible to perform roles of EMS provider
  without communication and teamwork.
• Communication required in every phase of EMS
  call.
• AEMT requires teamwork to coordinate efforts and
  achieve high-quality patient care.

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Introduction

• Teamwork and communication do not always come
  naturally.
• Be aware of principles of communication process.
• Understand how to use specialized EMS system
  communication equipment.

22
Think About It

• What additional communication will Rescue 15 need
  to have with dispatch?
• How should Stan and Lucas interact with the
  engine crew, law enforcement officers, and
  bystanders?

23
Think About It

• What actions should the crew take to establish
  rapport with the patient and gain his trust?
• What written documentation must be completed on
  this call?

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Communication

• Communication
• Exchange of messages between sender and receiver.
• Many characteristics of environment, sender,
  receiver, message, channel or medium through
  which message sent.

25
Communication

• Sender characteristics
• Establish credibility, expertise, trustworthiness
• Credentials
• Appearance
• Be easy to talk to
• Convey empathy and respect

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Communication

• Sender characteristics
• Keep an open mind do not make judgments that
  interfere with ability to listen and understand
  the message being sent.
• Maintain composure

27
Communication

• Receiver characteristics
• Personality, intelligence, self-esteem, language,
  stress
• Use active listening
• Exchange information in way that both parties
  understand.

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Communication

• Communication channels
• Verbal or non-verbal
• Interference
• Technical issues (radio or cellular phone)
• Patients malfunctioning hearing aid
• Sloppy handwriting

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Communication

• Interference
• Poor vision poor diction
• Intruding thoughts, feelings environmental noise
• Cultural differences language barriers

30
Understanding Cultural Perspectives Video
http//media.pearsoncmg.com/ph/chet/healthsci_medi
a_library_2/no_intro_CulturalDiversity.html

• Click here to watch a video on the topic of
  cultural perspectives.

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31
Communication

• Feedback
• Information about a systems output that is
  returned to its source to modify further output.
• Be specific to minimize misunderstanding.

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Think About It

• AEMTs communicate
• By radio, cellular phones and text devices
• Using computers and written reports
• By speaking directly with others

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Team Dynamicsand Communication

• Team
• Group of individuals with specific common goals.
• EMS providers form teams to provide prompt, safe,
  efficient, high-quality patient care.
• Common understanding of goal
• Must know roles
• Requires communication

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Think About It

• Effective communications are essential to your
  safety and to your patients outcome.
• Team communications sometimes break down.
• Interpersonal relationships might not always be
  as good as possible.
• How can you contribute toward better teamwork?

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EMS System Communication

• Communication technology rapidly evolving.
• FCC responsible for oversight of EMS radio
  communication.
• Approves equipment standards
• Assigns broadcast frequencies
• Licenses base stations
• Assigns radio call signs
• Issues and enforces regulations

36
EMS System Communication

• Essential to have system maintenance/backup
  systems.
• Important to have interoperability between
  multiple agencies and jurisdictions.

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EMS System Communication

• EMS radio systems operate on assigned radio
  frequencies, or channels.
• Public/private
• Digital
• Push-to-talk (PTT) system
• Button on radio depressed to open channel for
  transmission.

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EMS System Communication

• Traffic
• Messages sent back and forth in radio
  communications (use plain language).

39
EMS System Communication

• What are the three main reasons for documenting
  times?

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EMS System Communication

• Figure 64 An example of a base station radio.

41
EMS System Communication

• Communication equipment
• Base stations
• Mobile radios
• Portable radios
• Repeaters
• Digital equipment
• Cellular telephones

42
EMS System Communication

• Table 6-2 Guidelines for Radio Communication

43
Think About It

• You and your partner are dispatched to a home
  with the report of a person down.
• When you arrive on-scene, you find that two
  people in the home are ill.

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Think About It

• Upon assessment, you determine that both
  individuals require transport.
• At what points during the call do you communicate
  by radio or cellular phone?

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Therapeutic Communicationand Interviewing
Patients

• Figure 68 Cultural differences and language
  barriers can present communication challenges.

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Therapeutic Communicationand Interviewing
Patients

• Be aware of cultural diversity
• Differences in perception
• Examine biases or stereotypes
• Language barriers
• First impressions
• Convey respect and empathy

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Therapeutic Communicationand Interviewing
Patients

• Provide patient privacy
• Control noise
• Non-verbal communication
• Posture, gestures, facial expressions
• Personal space considerations
• Touch can be a sensitive issue

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Therapeutic Communicationand Interviewing
Patients

• Verbal communication
• Active listening
• Be available
• Open ended questions
• Do not have limited range of options
• Closed ended questions
• Narrow range of expected responses
• Leading questions
• Suggest answer to patients

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Therapeutic Communicationand Interviewing
Patients

• Verbal communication
• Check understanding
• Clarify information
• Confrontation
• Point out inconsistencies in the patients
  communication

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Therapeutic Communicationand Interviewing
Patients

• Verbal communication
• Facilitate
• Reflect
• Silence
• Summarize

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Therapeutic Communicationand Interviewing
Patients

• Pitfalls in communication
• Multitasking dividing your attention
• Requesting explanation implying blame or
  disapproval
• Overloading patient with information or questions
• Giving advice and opinions
• Changing subject interrupting
• False reassurances

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Therapeutic Communicationand Interviewing
Patients

• Special patient communication situations
• Age-related psychosocial characteristics
• Sensory deficits
• Cognitive impairment
• Begin by communicating with the patient directly.

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Therapeutic Communicationand Interviewing
Patients

• Do not assume the patient cannot communicate.
• Verify/obtain information from family/caregivers.
• Assist in obtaining hearing aids, dentures,
  eyeglasses.

54
Effective Communication Video
http//media.pearsoncmg.com/ph/chet/healthsci_medi
a_library/no_intro_communicate.html

• Click here to watch a video on the topic of
  effective communication.

Back to Directory
55
Therapeutic Communicationand Interviewing
Patients

• Involve family members in communication.
• Do not let family members answer for the patient
  who can answer for himself.

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Therapeutic Communicationand Interviewing
Patients

• Protect your safety when dealing with hostile
  patients stay calm and professional.
• Many reasons the patient may be uncommunicative.

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Think About It

• Consider a time that you were uncomfortable
  sharing information with a health care provider.
• Why were you uncomfortable?
• What was it about the health care provider that
  made you reluctant to share information?
• How can you avoid creating a similar situation
  for your patients?

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Documentation

• Patient care report (PCR) documents patient care
  (paper or electronic)
• Continuity of care
• Information for billing, insurance claims,
  statistical information
• Legal documents
• Data for research and education

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Documentation

• Standardized data collection
• Types of patients who seek EMS
• Types of care provided
• Outcomes of patients
• National EMS Information System (NEMSIS)
• Patient information
• Administration information

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Documentation

• Sections of patient care report
• Administrative information
• Patient demographic data
• Vital signs
• Narrative report of call
• Treatment provided

61
Documentation

• Table 6-6 Patient Care Report Narrative Formats

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Documentation

• Figure 612 Correct errors on PCR.

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Documentation

• Legal considerations in documentation
• PCRs legal medical records protected by HIPAA
• Correcting error on written PCR
• Draw single line through error
• Initial it
• Write correct information

64
Documentation

• Special documentation circumstances
• Return to service before completing PCR
• Multiple-casualty incidents
• Patient refuses care
• Documentation outside scope of PCR

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Think About It

• You and your partner are beginning the primary
  assessment of an elderly man whose daughter
  called 911.
• The man is agitated and refuses care.
• Your attempts to convince him are not successful.
• How do you document his refusal of care?

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Chapter Summary

• Effective communication essential to every aspect
  of EMS providers job.
• Be aware of your verbal and non-verbal
  communication.
• Strive to improve communication and teamwork.

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Chapter Summary

• Establish rapport with patients and use
  therapeutic communication techniques.
• Be proficient in use of EMS communication
  equipment and adhere to guidelines.
• Breakdowns in communication can jeopardize your
  safety and your patients.