Lecture 2 - Classifying Teams, Smallpox

Question 1

Why is classification used for teams?

Answer 1

To better understand the function and needs of different types of teams

Question 2

What are the two classifications of teams?

Answer 2

• Management Teams

- Clinical Teams

Question 3

Define Clinical Teams

Answer 3

Clinical team refers to any team that provide clinical care directly through interaction with patients

Question 4

What are the 4 types of classification of clinical teams

Answer 4

– True Teams
– Template Teams
– Knotwork Teams
– Network Teams

Question 5

Defining Characteristics of a Work Team (7)

Answer 5

• Shared team goal
• Shared responsibility for achieving said goal
• Defined membership
• Authority for taking action to achieve the goal
• Interdependency of team members
• Absence of larger sub-groups
• Accountability to a larger organization

Question 6

Define:

True Team

Answer 6

• Technical term for a team that has all of the 7 defining characteristics of the team PLUS STABILITY OF MEMBERSHIP overtime
• Clear leaders
• Provider clinical care over extended periods of time of for repeated time limited episodes

Question 7

Strengths:

True team

Answer 7

• Potential for strong commitment to shared purpose
• Members’ mutual knowledge of each other as team members
• Potential for high levels of trust
• Higher likelihood of mutual accountability
• Strong identification by members of the team
• High levels of interdependence
• Opportunities to fit roles to individuals’ interest and skills
• Lower error rates

Question 8

Weakness/Potential Pitfalls:

True Team

Answer 8

• Effective leadership needed; not all teams may have this
• Decisions must be made in such a fashion as to secure agreement amongst team members
• Those who do not agree with an important decision may feel isolated
• Must be able to resolve intrapersonal conflict

Question 9

Define:

Template Team

Answer 9

• Have the 7 characteristics and a clear leader.
• They DO NOT have stable membership
• Typically provide time limited episodes of healthcare – Think code teams, OB teams
• Changing membership defines template teams
• Every time the team provides clinical care, the roles and procedural routines remain stable/the same

Question 10

Strengths:

Template Team

Answer 10

• Potential for reliable processes and outcomes
• Capacity for swift trust
• Rapid responsiveness to the needs of the patients whom they serve
• Resistance to deterioration of performance due to changes in personnel

Question 11

Weakness/Potential Pitfalls:

Template Team

Answer 11

• Poor Leadership is a risk (Leader will deal with short-term issues as the team is not always assembled in the same fashion)
• Unclear role definitions (If someone is not entirely sure what their role is, the quality of the performed task will suffer)
• Inadequate Training (In order to perform tasks, training must be substantial and reliable)

Question 12

Define:

Knotworks

Answer 12

• Teams that come together temporarily in order to care for a patient; these teams have no clear leader or stable membership
• Provide care for a specific need (Think of physicians working together temporarily together like in a knot)
• DO NOT have the 7 criteria of a true team
• They lack clear leaders and do not have stable membership
• Characteristics it has: shared goal, shared responsibility, authority for taking action, and interdependency of members
• Characteristics it lacks: it has the presence of independent subgroups, not accountable to anyone outside of the knotwork, no defined membership

Question 13

Strengths:

Knotwork

Answer 13

• Flexibility of membership

- Rapid responsiveness to patient and family needs

Question 14

Weakness:

Knotwork

Answer 14

• Poor leadership, often compromised because it is shared
• Lack of agreement on leadership and other roles
• Absence of common expectations for communication

Question 15

Define:

Networks

Answer 15

• Defined as “complexes of links between individuals and organizations, driven largely by the interests of the parties and their recognition of the value of working together”
– Provide information to other physicians to aid patient care

• A looser grouping than those of knotworks
• Have no characteristics of work teams (the 7 characteristics)
• They show cooperation and shared interests
• No defined leaders, membership, or responsibility
• Meet together to further individual goals, which will ultimately help patient care

Question 16

Which Clinical teams have:

All 7 Characteristics of Work Teams

Answer 16

1. True Team

2. Template Team

Question 17

Which Clinical teams have:

Stable Membership

Answer 17

1. True Team

Question 18

Which Clinical teams have:

Clear Leadership

Answer 18

1. True Team

2. Template Team

Question 19

Which Clinical teams have:

Shared Responsibility

Answer 19

1. True Team
2. Template Team
3. Knotwork

Question 20

What are some public health milestone of the 20th century?

Answer 20

• Immunizations
• Control of Infectious Diseases
• Fluoridation of drinking water
• Motor vehicle safety
• Tabacco Control
• Preventing Birth Defects

Question 21

In the last century, these interventions have led to the addition of ____ years to the lifespan of the average adult in the USA

Answer 21

30 years

22 years in other parts

Question 22

When was the first attempt to protect against smallpox?

Answer 22

China in 6th century

Question 23

Define:

Variolation

Answer 23

inoculation of matter taken from smallpox pustules through a scratch in an arm or vein

(Goal get small infection and recover with immunity)

Question 24

Poxvirus

Answer 24

– Largest type of virus, almost visible with light microscopy

– Includes variola (smallpox), molluscum contagiosum, cowpox, monkey pox

• Many poxviruses are only present in animals
– These share common antigenic components with small pox which allow for the
production of a vaccine

Question 25

T/F | Smallpox virus is only found in humans

Answer 25

True | only found in humans

Question 26

How is smallpox spread

Answer 26

Spread mainly by viral shedding -> coughing, sneezing

Question 27

What happens after inhalation of smallpox

Answer 27

1. Reproduces in respiratory tract 2. Disseminates through blood (viremia) and lymphatic to replicate - Spread to organs and skin

Question 28

What is the incubation period of smallpox?

Answer 28

Roughly 12 days | Infected but symptom free

Question 29

What happens after the incubation period and symptoms such as high fever, backache start...

Answer 29

- Characteristic red rash (red spots) that starts in the mouth (these break open and spread virus.. contagious here) - Rash appears on skin and spreads to all parts of the body within 24 hours - Day 3 rash becomes raised bumps Day 4 - Bumps have thick fluid and a depressed center - Bumpts become raised pustules with white cloudy liquid --> pustules scab --> scabs fall off leaving pitted scars --> PERSON IS CONTAGIOUS UNTIL ALL SCABS FALL OFF

Question 30

Smallpox vs. Chickenpox: | Fever onset

Answer 30

Smallpox: 2-4 days before rash Chickenpox: At time of rash

Question 31

Smallpox vs. Chickenpox: | Rash Apperance

Answer 31

Smallpox: Pocks at same stage Chickenpox: Several stages

Question 32

Smallpox vs. Chickenpox: | Development

Answer 32

Smallpox: Slow Chickenpox: Rapid

Question 33

Smallpox vs. Chickenpox: | Distribution

Answer 33

Smallpox: More on arms & legs Chickenpox: More on body

Question 34

Smallpox vs. Chickenpox: | On palms & Soles

Answer 34

Smallpox: Usually present Chickenpox: Usually absent

Question 35

Smallpox vs. Chickenpox: | Death

Answer 35

Smallpox: More than 10% Chickenpox: Very uncommon

Question 36

People with smallpox are at an extreme risk of death in ____________ form

Answer 36

Hemorrhagic

Question 37

The clinical definition of smallpox:

Answer 37

- is an illness with acute onset of fever equal to or greater than 38.3 °C (101 °F) - followed by a rash characterized by firm, deep seated vesicles or pustules in the same stage of development without other apparent cause

Question 38

Smallpox eradication time line

Answer 38

1959 - WHO declares mission 1971 - Western hemisphere free 1977 - last endemic case recorded in Somalia 1980 - Eradication declared

Question 39

Four unique factors regarding smallpox eradication:

Answer 39

– Human beings were the only known reservoir for the virus – No asymptomatic carrier state existed – An effective vaccine was available – Vaccination of contacts resulted in prevention or modification of disease

Question 40

Strategies used for smallpox eradication

Answer 40

- Direct vaccination - Actively seeking cases - Quaranine - Increased efficiency of delivery - Specialized vehicles to reach off road areas

Question 41

Smallpox Eradication Breaking down the 7 characteristics - Team Goal: - Shared Responsibility - Defined Membership - Authority for taking action: - Interdependency of members - Absence of subgroup - Accountability to larger organization

Answer 41

– Team Goal: Provide the means and plans to eradicate smallpox – Shared Responsibility: SEU was primary organization and composed of these 10 people – Defined Membership: members specifically appointed to group – Authority for taking action: WHO responded to requests from group – Interdependency of Members: would travel to different areas and respond to reports – Absence of Subgroup: no additional staff was hired for the most part – Accountability to larger organization: to the WHO