Tool: Cross-Monitoring
Ongoing cross‐monitoring of the care environment helps everyone recognize risks and errors. It allows individuals and teams to take steps to correct the issue before harm or injury to the patient occurs. As one example, e-ICUs have proven the value of having remote staff cross-monitoring the onsite ICU staff to maximize the safety of critically ill patients. In the community setting, making lab results and clinic visit notes accessible to patients and family caregivers through a patient portal also allows them to cross-monitor key aspects of the diagnosis and treatment plan.
Cross-monitoring is a harm and error reduction strategy that involves:
- Monitoring actions of other team members.
- Providing a safety net within the team.
- Ensuring that mistakes or oversights are caught quickly and easily.
- “Watching each other's back.”
Cross‐monitoring is a form of active patient and family caregiver advocacy that allows team members to check and correct their actions if necessary. When all team members understand each team member’s role (including the patient and possibly a family caregiver) and trust the intentions of their fellow team members, a strong sense of team orientation and a high degree of psychological safety can result.
How To Use Cross-Monitoring Effectively
Cross‐monitoring actions include providing feedback and keeping track of fellow team members’ behaviors to ensure procedures are performed appropriately.
Cross‐monitoring does not mean spying on other team members. Instead, it is a way to provide a safety net or an error prevention or error interruption mechanism for the team, ensuring that mistakes or oversights are prevented or caught early.
TeamSTEPPS: Cross Monitoring (Subacute Care) (28 seconds)
To better understand cross-monitoring, watch this example, set in a subacute care setting (Cross Monitoring (Subacute Care). After watching the video, consider:
- What actions by the nurse manager demonstrated cross-monitoring?
- Would your teams respond positively to the use of cross-monitoring by their members?
