Task saturation in critical care teams (hospital, patient care) plays a crucial role in patient outcomes. Therefore, teamwork is an essential element in the delivery of effective, safe patient care.
When it comes to safety, carrier aviators have it down to a science. With zero tolerance for error, we rely on every crew member, regardless of rank, to work as a team and always maintain safety awareness. The standards of carrier aviation include simple, rigorous checklists; a culture that doesn’t tolerate safety lapses; sound decision-making skills; clear communication; and a model that requires collaboration to be successful.
In short, the same kind of teamwork is needed to eliminate preventable, life-ending mistakes in hospitals.
And yet, as the pace of work increases and the patient-care-giver ratio increases, effective teamwork and the ability of patient-care teams to respond effectively in dynamic situations is faltering.
Non-stop changing technology, task requirements, task saturation, and turnover overwhelm even the most dedicated medical professionals.
Behind the Scenes, the Disastrous Impact of Task Saturation on Patient Safety and Loss
The absence of fundamental patient safety measures and the breakdown of teamwork due to task saturation and ego in operating rooms yield catastrophic consequences.
In 2008, my Dad paid the ultimate price. Had a culture of patient safety, teamwork, and communication been prevalent in the operating room, I would not be recounting this tragic story. Patient safety and risk management concerns should deeply resonate with us all.
Each year, lapses in patient safety rob us of our loved ones—spouses, parents, grandparents, children, and friends.
My Dad was a former United States Marine Corps aviator and a Delta pilot for thirty-six years.
He lived and breathed all the concepts of aviation safety. He was a true professional. Safety was always his number one concern.
The average traveler has the casual assumption that they’ll arrive at the destination safely; few people give it a second thought.
And yet the safety of my dad’s crew and passengers was not a responsibility he took lightly.
As a child, I would ask him about when things got bad in the airplane, be it weather or mechanical issues. Did he ever worry about getting his passengers home safely? His reply was simple yet profound: “As long as we know our procedures cold, continue to fly the airplane, and talk to each other, the two of us up front will be okay—and that means everyone onboard will be okay too. And they love their families as much as I do.”
He was one of the most humble men I’ve ever met.
Task Overload and Patient Safety: A Call to Action for Healthcare Professionals
In today’s military and commercial aviation communities, stringent processes have achieved a staggering 99.9996 percent accident-free record. These processes encompass teamwork, effective communication, discipline, collaboration, standardized protocols, self-incident reporting procedures, and sound decision-making.
In the aviation industry, the concept of “crew resource management” empowers anyone on the flight deck to challenge a pilot if they see a potentially fatal blunder in the making.
Naturally, zero safety errors are the goal.
Regrettably, a fragile culture persists in some operating rooms, resulting in devastating consequences.
And it cost my Dad his life.
Egos can get in the way, task overload overwhelms, and surgeons are often treated with unwavering and unchallenged deference because of their sophisticated skill sets.
Consequently, nurses and other staff members hesitate to speak up, even when they see a problem. These invaluable teammates often fear being labeled “insubordinate” if they question or disagree with a doctor’s course of care.
These dynamics create a vast divide between quality care and the goal of a well-functioning, high-performing operating team.
Understandably, the atmosphere in an operating room can be tense. It is a high-stress environment with tons of patient turnover. But tolerating a certain number of fatalities as the cost of doing business is simply unacceptable.
Barriers to effective teamwork: Communication and Coordination
The combination of ever-changing technology, staff turnover, high workload, sophisticated patient monitoring equipment, fast-moving environments—ego—all conspire to derail a positive patient outcome.
Among these barriers, poor communication between support staff nurses and surgeons is the leading cause of avoidable surgical errors. Enhancing communication, collaboration, and teamwork among physicians, nurses, staff, and patients emerges as a critical leadership imperative.
Effecting change in the culture and systems within US hospitals necessitates fearless leadership.
Teamwork, trust, and mutual support are at the most significant risk, followed closely by equipment expertise, procedural skill, and task management. Addressing these challenges is vital to prevent the loss of our loved ones.
The Hidden Risk of Task Saturation
When you or your team is task saturated, danger lurks.
Adverse outcomes are significantly associated with task saturation, as it hampers decision-making abilities under pressure when resources are limited and fatigue sets in.
Implementing straightforward techniques routinely used in the cockpit, such as preflight briefings (analogous to preoperative briefings), checklists, the ability to call a time-out or a “knock it off” when concerns arise, and routine debriefs, can substantially reduce error rates and save lives.
Solutions to Overcoming Task Saturation in Critical Care Environments
Mitigating and minimizing task saturation in critical care environments requires the adoption of various solutions, including:
- Implementing standardized checklists for intake and surgical briefings
- Enhancing situation assessment capabilities
- Establishing shared plans
- Incorporating simulated critical event training, following the standard protocol in commercial and military aviation
- Employing a standardized communication process
Set Your Ego Aside
The field of health care is becoming ever more sophisticated. With continual advances in technology and equipment, surgeons and physicians can’t know everything, and no one can always perform perfectly. Nonetheless, we can do a lot better in our hospitals than we are now.
Drawing from my experience in the Navy, I have contemplated and shared invaluable lessons. To include the necessity for top performers to set aside egos and communicate effectively with their teammates.
When you start to feel entitled to respect because of your position—and when you no longer feel the need to ask for input from your teammates—the consequences can be catastrophic. Outside of aviation, nowhere is this more apparent than in the realm of patient safety in hospitals.
Success in healthcare requires a united team, clear communication, conflict management, and a profound understanding that each member’s role in the operating room holds immense value.
While terms like patient outcome, patient experience, and workload management are often thrown around, they hold significance when the team works cohesively, and egos are kept in check.
Failure to manage teammates with inflated egos or remove them from the equation can poison the culture and jeopardize patient safety.
Avoiding Catastrophe by Unraveling the Task Saturation Puzzle in Patient Care
The repercussions of task saturation on patient safety and outcomes are profound and cannot be overlooked.
To provide our medical teams, professionals, and loved ones with a fighting chance, it is crucial to prioritize specific training that alleviates task saturation, improves team communication, and enhances care providers’ performance.
By understanding the detrimental impact of task overload on effective teamwork, communication, and decision-making, healthcare professionals can take proactive measures to mitigate this risk.
Implementing standardized protocols, fostering a culture of open communication and collaboration, and prioritizing patient safety are essential steps toward reducing the adverse effects of task saturation.
Only by acknowledging and actively addressing this issue can we ensure the well-being and lives of our loved ones, fostering a healthcare environment where patient safety remains the utmost priority.
Robert Dunai, USMC Aviator
