Four key principles for integration of new staff in the stroke team during a health care crisis
| Key Principle | Explanation/Implementation Strategy | Example |
|---|---|---|
| Transfer of key knowledge | New staff members should be primarily taught the key principles of their new working environment; these should be kept as brief and concise as possible in order not to overwhelm new staff | Neuroangiography suite: never walk in the room without a lead apron if a patient is on the table |
| Neuro-ICU: never use a nasogastric tube until proper placement has been confirmed by a clinician (most commonly by a portable chest x-ray) | ||
| Stroke unit: never feed a patient with stroke with dysphagia solid food until a swallow screen has been performed | ||
| Open communication and nonjudgmental atmosphere | New staff members have to feel comfortable telling core members if they do not feel comfortable doing a certain task and should not hesitate to ask for help or advice | A new staff member is told to monitor a patient on an alteplase infusion but does not know what symptoms or signs to look for; he or she explains this to the supervisor who reassigns the patient to a more experienced member and helps train the new member in this important task |
| Strategic task assignment | To avoid mistakes and treatment delays, new team members should execute tasks that are as closely related as possible to their core field of expertise | A nurse from the nephrology ward joins the stroke team; he or she is familiar with management of patient vitals but not with neuroangiography-specific terminology, eg, guidewire, balloon-guide catheter; thus, the task should be focused on management of patient vitals rather than procedure-specific peculiarities |
| Graded responsibility and learning | New staff members should gradually take on new tasks and responsibilities; they should feel comfortable performing a certain task and be capable of executing it safely before they are assigned additional, more complicated tasks | A schedule that pairs shifts of new team members with core team members; new team members are intermixed in new roles, as they have to learn new and complex tasks |