A 52 year old male was brought in by the ambulance after a monoplane crash. He had an open forehead, broken tibia, and several other injuries but he was conscious and stable. As the patient was rushed in, the orthopedic surgeon was asking about pain while maneuvering the patient’s leg. The patient had not yet been transferred to a hospital bed and surrounded by medical personnel trying to do their jobs.
“Would you wait a minute? Let’s move the patient off the ambulance cot first.”
“Didn’t you ask for an orthopedic surgeon? Do you want me here or not?”
The trauma surgeon and orthopedic surgeon argued briefly before the orthopedic surgeon stormed off, clearly upset that his time was wasted.
Dr. Atul Gawande, surgeon and author, gave a commencement speech at Harvard Medical School a few years ago about teamwork. Although he did not specifically refer to an emergency trauma situation, he makes some really important points about working together in the medical field. With the medical advances and specializations, physicians can no longer act independently to care for the patients. He argues that medical personnel should work like pit crews, each using their specialty to work in coordination toward a common goal of helping the patient. He lists 3 skill sets required to achieve this unified system.
- Recognizing successes and failures: using this data to understand performance
- Devising solutions: to problems that arise or are uncovered by experience and data
- Implement at scale: coordinating the entire chain of care into a system
I do not know how the story ends as I left with the anesthesiologist, with whom I was working that day. But it seems as though the trauma team could have used Dr. Gawande’s advice on teamwork.