Team leadership and coordination in trauma resuscitation

This study investigates team leadership and coordination during a trauma resuscitation. A trauma resuscitation team is an emergency cross- functional medical team, which includes several specialists such as a surgeon, an anesthesia provider, and nurses. The main purpose of the team is to perform a resuscitation; treatment to a patient who experiences a trauma (e.g. car crash, stabbing, gunshot) and has a life-threatening injury. The trauma team can be seen as a type of crisis team since the need for treatment is quite intense and urgent. Team members must treat and stabilize the patient within minutes and without much information about his/her condition and medical history. As a result, this team is working in an intense and highly stressful situation. We used focused ethnography in order to gain an understanding of leadership and coordination during a trauma resuscitation. Over a period of six months, we observed admissions, shadowed teams, and interviewed specialists as a primary data collection method. Our findings suggest that the effectiveness of leadership differs depending on: (1) the severity level of patient condition; and (2) the level of team experience. Directive leadership is more effective when a patient is severely injured, whereas empowering leadership is more effective when a patient is not severely injured. Also, directive leadership is better when a trauma team is inexperienced, but empowering leader- ship is better when a trauma team has a high level of experience.