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Library & Knowledge Services: Models of Team-Based Care

Models of Team-Based Care and Supporting Surge Capacity

Grey Literature

GREY LITERATURE

SELECTED ARTICLES - title links to full-text (must be logged into network or email ClinicalLibrary@cw.bc.ca):

Phillips J, et al. Surge Planning and Implementation: A Required Competency for Today's Nurse Leaders. J Nurs Adm. 2021 Nov 1;51(11):573-578. 

  • Article describes application of American Organization of Nurse Leaders (AONL) Nurse Executive Competencies with respect to health crises.
  • "Barbisch and Koening6 outlined 4 elements of surge planning, including staff (trained personnel), stuff (equipment, supplies, and medicine), structure (facilities and space), and systems (policies and procedures)." [Supportive Services is added to this; see Table 2 for complete list of Surge Elements] (p.576)

Anderson BR, et al. Breaking Silos: The Team-Based Approach to Coronavirus Disease 2019 Pandemic Staffing. Crit Care Explor. 2020 Nov 3;2(11):e0265. 

  • Transparent frequent communication improves team structure and anxiety (p.2)
  • "In our units, we noticed a few operational characteristics that exacerbated or alleviated moral distress. Teams expressed greater moral distress in “pop-up” units in which the physical layouts (combined with the need to conserve personal protective equipment) resulted in the isolation of our teams. They were also more likely to describe moral distress when the team composition changed frequently or they were rotated from one unit to another. Teams that included nurses with more inpatient and ICU experience/oversight also described lower levels of moral distress." (p.3)

Kelley, Christina,  et al. Implementation and Evaluation of a Healthcare System’s Approach to Surge Staffing and Training. Journal for Nurses in Professional Development, vol. 38, no. 4, July/August 2022, pp. 215-222. 

  • Roles & responsibilities: RN Team Leader, RN Extender, Senior/Graduates Nurses (p. 218)
  • "To ensure a system-wide and consistent approach to the orientation process for RN extenders, NPD practitioners created a Crisis Response RN Temporary Reassignment Orientation Pathway outlining the minimum regulatory and other educational requirements." (p. 218)
  • "The SST (Surge Staff & Training) Task Force’s crisis action plan created effective orientation and training that established confidence among surge nurses who learned and operationalized new roles. This healthcare system’s response demonstrated the effectiveness of one approach to support staffing using RN extenders in a team nursing model and can assist other organizations in creating and adopting their strategy for meeting surge staffing needs." (p. 222)

Jones KL et al. Rapid Deployment of Team Nursing During a Pandemic: Implementation Strategies and Lessons Learned. Crit Care Nurse. 2022 Jun 1;42(3):27-36. 

  • "...a 4-hour training session was developed and implemented a week into the pilot program. During this "boot camp," an experienced ICU preceptor provided hands-on demonstration of nursing skills frequently used in the pilot ICU that were within the general care nurses' scope of practice (Figure 1)." (p. 29)
  • "Not far into the pilot program, we recognized the need to enhance cohesion and trust between the ICU nurses and the general care nurses. The literature supports this phenomenon: Brown et al[15] reported that "more skilled" clinical team members can be reluctant to share responsibility and delegate to team members owing to perceived lack of competence. To enrich these relationships, the ICU nursing leadership team issued a call for "team nursing champions." (p. 32)
  • "...we recommend that a learning needs assessment first be conducted to identify nurses' strengths and areas that may require additional training (Figure 6). Needs assessment and application of the team nursing model should involve early and frequent open dialogue involving key stakeholders. Staff nurses' involvement in decision-making will reduce barriers more easily identified by frontline staff, improve their sense of control in a difficult situation, and enhance implementation and application. Nursing leaders should identify clear objectives and routinely evaluate and swiftly address patient safety issues, scope of practice concerns, and communication barriers. If objectives are not being met, leaders should advocate for discontinuing this approach and pursuing other interventions to mitigate staffing shortages." (p.34)