ACLS - team dynamics

Specific behaviors that measure teamwork competency include, “shared mental model, mental rehearsal, situational awareness, cross-monitoring, closed-loop communication, open communication, flattened hierarchy, role clarity, and anticipatory response.”

Team Leader

A resuscitation team typically has one leader who is responsible for ensuring that resuscitation efforts flow smoothly and that each task is properly executed. A physician usually takes on this role, but it can be performed by anyone and it entails:

[ ] Organizing and mentoring the team.
[ ] Monitoring the members’ abilities to execute each role.
[ ] Performing any skills that may be necessary.
[ ] Modeling appropriate behaviors.
[ ] Offering feedback as well as individual performance evaluations when the resuscitation effort is over.
[ ] Coaching team members when necessary.
[ ] Focusing on providing exceptional care.

“Accordingly, team members should be assigned specific roles based on their expertise, the scope of their practice, and their training in relation to the required tasks.”

Furthermore, a team member needs to be able to:

[ ] Understand the assigned role in the resuscitation process.
[ ] Perform the assigned tasks efficiently.
[ ] Understand the ACLS guidelines, protocols, and algorithms.
[ ] Contribute to and promote the success of the team.

The efficiency of the team dynamic depends on whether each member can effectively meet the expectations of the assigned role in the team.

Expectation	Team Leader Responsibilities	Team Member Responsibilities
Roles	Know each team member’s skills and expertise	Informs a team leader when a task is beyond the team member’s skill level and asks for assistance to complete a task if the need arises
Communication	Clearly defines each member’s task, verifies that the assignments are properly understood, and confirms the performance of the task	Communicates to the leader that task is understood and informs the leader of task completion
Messages	Speaks clearly and in a formal tone of voice when assigning roles and tasks	Speaks clearly and in a formal tone of voice when acknowledging the assigned roles and tasks; feels comfortable asking for clarification of unclear tasks
Knowledge Sharing	Asks team members for suggestions regarding alternative actions when the need arises	Shares information with other team members, and helps identify actions that may be disrupting the resuscitation effort
Intervention	Quickly but gently intervenes if a team member is about to engage in an improper action or if the member is taking too long to complete a task	Asks the team leader to repeat an assigned task if an error is anticipated and feels comfortable recommending alternative courses of action
Evaluation and Summary	Asks team members for recommendations regarding alternative actions; is constantly aware of a victim’s responses; keeps the team members informed about a victim’s current status and plans to change any actions; provides positive feedback and corrective critiques as needed	Draws the leader’s and other team members’ attention to changes in the victim’s status or response to the treatments

TABLE 2: TEAM DYNAMICS

Task management by Team leader include: