������Ƶ

What Task Assistance Is

Task assistance includes both asking for assistance when needed and offering assistance to team members when the opportunity arises. Task assistance is guided by situation monitoring, because situation monitoring allows team members to effectively identify when they, or other team members, need assistance.

In addition, when it is recognized that a team member needs assistance, offering to help should be a cultural norm. When offering assistance, share information verbally so that each team member has a shared understanding of what will be done and by whom. Offering assistance may include:

• Helping team members perform their tasks, 
• Correcting task performance when needed, 
• Shifting workload by redistributing tasks to other team members, 
• Delaying or rerouting work so an overburdened team member can recover, and
• Filling in for overburdened team members when needed.

Practical examples of assistance include:

• Medical assistant helping front desk staff with patient registrations so all radiology reports can be logged in and reported to key clinical staff (timeliness and accuracy). 
• Front desk staff alerting a provider to a patient in the waiting room exhibiting atypical confusion to avoid an emergency (patient‐centered communication). 
• Nurse practitioner offering to see a patient scheduled for a physician colleague who is unexpectedly detained (timeliness, patient‐centeredness). 
• Staff members connecting a patient experiencing a prolonged or difficult diagnostic journey with a patient advocate or a member of the patient‐family advisory council to provide emotional and social support (patient-centeredness).

Several factors are involved in task assistance:

1. Type of situation: Some team members react differently to offers and requests for help during emergent versus routine situations. Effective teams place all offers and requests for assistance in the context of patient safety and progress toward team goals, regardless of the situation.
2. Attitudes and beliefs: Some attitudes or group norms restrict team members from offering or requesting assistance. People in some professions, people of color, and more junior staff may feel that offers of assistance are condescending and imply that they are less capable. Conversely, some people in positions of authority may feel that they should never admit they need help from others. Creating a cultural norm that encourages all team members, including patients to both offer help and accept help from any other team member—regardless of their profession, sex, race, or ethnicity—can overcome these barriers and foster mutual trust and respect.
3. Style of communication: Personal style can greatly influence the team’s supportive actions. A person’s tone of voice or use of avoidance behaviors (e.g., being inaccessible or elusive) may inhibit others from asking for help. Effective teams demonstrate a willingness to engage in supportive behaviors wherever the need arises, and they communicate the information needed to achieve that objective.

To expand your understanding of assistance, consider the following scenario:

Two members of the gastrointestinal laboratory are assessing an older patient who has just had conscious sedation for a colonoscopy. The monitor shows supraventricular tachycardia at a rate of 150 and blood pressure of 76/48. The nurse calls out the vital signs while the physician continues to monitor the rhythm. A nurse passing by the room hears the call-out.

• How would you offer assistance in this example?
• How would you request assistance in this example?
• How well would your team handle a scenario like this one?

Why Task Assistance Matters

• To a certain degree, some of us have been conditioned to avoid asking for help because we fear it suggests a lack of knowledge or confidence. Many people refuse to seek assistance when overwhelmed or unsure of tasks. 
• Teams are at risk whenever they are over- or underloaded. The reason? They lose their situation awareness and in doing so they drop or abandon the plan. Task assistance rebalances the workloads of team members to reduce this risk. 
• Vulnerability to error is increased when people are under stress, are in high-risk situations, and are fatigued. One of the most important concepts to remember about task assistance is that it should be actively offered and given whenever there is a concern for patient safety related to workload.

As you consider the importance of task assistance for the teams you are part of, ask yourself these questions:

• When is the last time you offered a colleague assistance? Given the ideas in this section, how might you do it even better in the future?
• When is the last time you were offered assistance? How did you respond? Did your response reinforce the need for assistance and an affirming culture in your teams?
• How well do your teams offer assistance to patients and family caregivers and accept it from them? While some tasks must be performed by trained staff, patients and family caregivers can be valuable sources of information needed for diagnosis and for status updates. 

How To Provide Effective and Affirming Task Assistance

Task assistance completes an activity or solves a problem. To provide effective task assistance:

• Always frame offers of assistance based on what is observable about the other’s activities (e.g., "I've noticed you haven't been able to take your break yet") instead of based on the other's characteristics (e.g., "Since you're inexperienced, I wasn't sure you knew how to do this").
• Communicate clear and specific availability of time and skills when offering assistance.
• Offer to complete a specific task if appropriate.
• Foster a climate supportive of task assistance—helping each other may create a virtuous cycle. 
• Use common courtesy when asking for or offering help.
• Close the loop on task communication—ensure the task was completed correctly.
• Account for experience level.
• Foster a climate in which it is expected that assistance will be actively sought and offered to reduce the occurrence of error: 
  • "I need a hand." 
  • "Can I give you a hand?"