Big brother is watching

By Staff Sgt. Andrea Merritt | Army Reserve Medical Command | April 12, 2016

April 11, 2016 — In order to combat communication errors in military healthcare systems, the Department of Defense adopted the Team Strategies and Tools to Enhance Performance and Patient Safety, or TeamSTEPPS, framework, which enhances patient outcomes by improving communication and teamwork skills among military healthcare professionals.

Soldiers from the Medical Readiness and Training Command, Army Reserve Medical Command, trained and evaluated Army Reserve Soldiers from the 399th Combat Support Hospital, 804th Medical Brigade, 3rd Medical Command (Deployment Support), on their implementation of TeamSTEPPS during an exercise conducted April 1-3 at the Mayo Clinic Multidisciplinary Simulation Center in Rochester, Minnesota.
 “The training offered at the MMSC provides participating units with an opportunity to improve their team efficiencies and communication in a simulated combat environment, utilizing the tools and strategies inherent within the TeamSTEPPS framework,” explained Army Reserve Col. Todd Traver, the clinical training officer for the MRTC, ARMEDCOM, based out of San Antonio, Texas.

Although military training events are geared toward replicating the stresses Soldiers would experience in a real combat environment, the exercise at the MMSC placed some additional pressures onto the 399th CSH Soldiers.

Not only were the watchful eyes of the MRTC observer-controller/trainers, or OC/Ts, monitoring them from the floor, but cameras mounted in the rooms at the facility recorded their every word and their every move as they worked through the scenarios.

Meanwhile, another group of OC/Ts monitored the images from a secluded area referred to as the crow’s nest, which is an observation deck located behind one-way glass panes.

Big brother was watching.

“Before we came here, everybody was nervous because we knew we were going to be tested, and we knew we were going to be taped,” said Army Reserve Sgt. Amy Lynch, a medic with the 399th Combat Support Hospital, 804th Medical Brigade. “But after a while, it wasn’t a big deal. We were just doing our jobs.”

Since the OC/Ts are also trained medical professionals, they were able to monitor the 399th CSH Soldiers on their delivery of patient care, but the overall goal was to observe and evaluate the teams on their use of the five key TeamSTEPPS principles: leadership, communication, team structure, mutual support and situation monitoring.
The technology available at the MMSC facilitated the OC/Ts capturing critical moments in the scenarios and allowed them to manipulate the scenarios as well.
At certain points in the exercise, OC/Ts in the crow’s nest would have an MMSC technician crash patient vital signs as the teams were assessing and providing treatment to their simulated casualties.
This was done in an effort to stress the teams and maximize opportunities for them to use TeamSTEPPS to care for the patients, Traver said.
“The capabilities of this simulation lab and taping and overseeing of what we are doing is not like anything I have ever experienced,” said Army Reserve Sgt. James Howard, a Boston native and X-ray technician with the 399th Combat Support Hospital, 804th Medical Brigade. “It’s awesome. It really helps you get into the mindset that this is real and to take it seriously.”
After each phase in training, the OC/Ts conducted an after-action review with the 399th CSH. It was at this time, the video footage was played back for the unit so they could see what they did well and in which areas they needed to improve.
The training event culminated with a mass casualty scenario, in which the teams had to provide care to an overwhelming number of casualties at one time.
To add to the realism of the scenario, mannequins ornamented in special effects make up that replicated common combat injuries poured into the facility.

Some of the mannequins bled as real casualties would, and if interventions were applied incorrectly, they would continue to bleed out.
Although the pace of the scenario was faster than in previous phases, the goal remained the same – provide care to patients using the TeamSTEPPS framework in order to minimize threats to patient safety via miscommunication.
 “The 399th's performance was outstanding,” Traver said. “They exceeded the expectations and demonstrated exceptional growth in their application of the TeamSTEPPS strategies over the course of the weekend exercise.”
Three more combat support hospitals – the 345th CSH and 405th CSH, both of the 3rd Medical Command (Deployment Support), and the 328th CSH, 807th Medical Command (Deployment Support) out of Salt Lake City, Utah – are scheduled to conduct training at the MMSC later this year.
When their time comes, the ever-watchful eyes of the OC/Ts of the MRTC will closely scrutinize their every move because it is a necessary step in ensuring the high quality of care military medical professionals are expected to provide to warfighters at home and abroad.
“What we do is take care of the ill and the injured of our fellow Soldiers,” said Ravenna, Nebraska, native Maj. Gen. Mary E. Link, commanding general of ARMEDCOM. “We give them back to their families – their mothers, their fathers, their kids, their spouses – that’s what we do.”

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