Teamwork Makes the Dream Work: TeamSTEPPS® - Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)
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Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) is an evidence based teamwork system aimed at optimizing patient care by improving communication and teamwork skills. TeamSTEPPS® has five key principles which are based on team structure and four teachable-learnable skills
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Teamwork Makes the Dream Work: TeamSTEPPS® - Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS)
- 1. TeamSTEPPS® Team Strategies & Tools to Enhance Performance & Patient Safety
- 2. Objectives • Identify how the TeamSTEPPS® program advances the mandate of SHIFT to Safety • Have fun learning about TeamSTEPPS® and its benefits
- 3. What is TeamSTEPPS®? An evidence-based teamwork system aimed at optimizing patient outcomes by improving communication and other teamwork skills among healthcare professionals; a powerful solution to improve patient safety Goal: To produce highly effective medical teams that optimize the use of information, people, and resources to achieve the best clinical outcomes for our patients
- 5. TeamSTEPPS ® Basic Overview of Key Strategies Team Strategies and Tools to Enhance Performance and Patient Safety Program elements: • Framework and competencies • Tools and strategies • Curriculum modules, courses & other resources
- 6. Shift Towards a Culture of Safety Three Continuous Phases Image source: AHRQ. TeamSTEPPS 2.0 Leadership Brief
- 7. CPSI’s role in TeamSTEPPS® • CPSI is launching TeamSTEPPS® in the fall of 2017 • CPSI is partnering with organizations currently using TeamSTEPPS® to support, measure, and build capacity within the growing TeamSTEPPS® Canadian community • CPSI will partner with Patients for Patient Safety Canada to position patients and families as central team members in the TeamSTEPPS® curricula
- 8. TeamSTEPPS ® Overview Framework and Competencies Knowledge • Shared Mental Model Attitudes • Mutual Trust • Team Orientation Performance • Adaptability • Accuracy • Productivity • Efficiency • Safety Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide
- 9. TeamSTEPPS® Overview Framework and Competencies Multi-Team System for Patient Care Safe and efficient care involves the coordinated activities of a multi-team system. Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide
- 10. TeamSTEPPS® Key principles Team Structure Leadership Situation Monitoring Mutual Support Communication Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide
- 11. TeamSTEPPS® Tools and strategies Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide
- 12. How hazardous is healthcare? Most airline pilots believe they make mistakes. In healthcare, only 30 per cent of providers believe they make mistakes. Source: R.Amaberti & L.Leape
- 13. Teams!
- 14. Why do errors occur? Excessive Professional Courtesy • Giving someone of a higher rank too much respect Halo Effect • Great reputation/experience of a colleague clouds our judgement Passenger Syndrome • Just along for the ride Hidden Agenda • When a team member makes suggestions or decisions based on information/desires, of which the rest of the team is unaware
- 15. Why do errors occur? Complacency • When teams become comfortable with the task at hand – can range from the most routine to the most complex High-risk Phase • A procedure or time when a critical error can occur Task or Target Fixation • Forgetting the big picture – generally occurs with a strong pressure to perform, workload is high, or during a stressful event
- 16. Miracle on the Hudson https://www.youtube.com/wat ch?v=jZPvVwvX_Nc
- 17. Most Frequently Identified Root Causes of Sentinel Events 67% of sentinel events The Joint Commission©. Office of Quality Monitoring
- 19. TeamSTEPPS® exercise #1 Goal: You have 1 minute to build the tallest tower. Roles: Runners and Builders Rules: • Blocks are located in the bins • Runners retrieve blocks from bins but may only take 5 blocks at a time • Builders build the tower using the pattern of 1 large, 3 small blocks, repeat • No two blocks of the same colour may touch • Runners are not allowed to build, builders are not allowed to run • All unused materials must be returned to the bins before ‘TIME’ is called
- 20. Impact of Communications on Team Performance
- 21. TeamSTEPPS® Team Strategies and Tools to Enhance Performance and Patient Safety • Communication is the cornerstone of patient safety • It will take training for good communication techniques to become ingrained in the medical culture and the norm in all settings
- 23. Putting it all together Image source: AHRQ. TeamSTEPPS 2.0. Mod 3: Communication
- 24. TeamSTEPPS® exercise #2 Goal: You have 2 minutes to build the tallest tower. Roles: Runners and Builders Rules: • You have 30 seconds to conduct a brief • Runners retrieve blocks from bins but may only take 5 blocks at a time • You must follow the pattern outlined in the algorithm provided • Runners are not allowed to build, builders are not allowed to run • All unused materials must be returned to the bins before ‘TIME’ is called
- 26. What is this?
- 27. What is this?
- 28. How do we get a shared mental model? When: • Briefs • Huddles • Debriefs • Handoffs How: • SBAR • Call-outs • Check backs
- 30. Tools for leading teams Briefs • Short session prior to start to share the plan • Assign roles, establish expectations, anticipate outcomes Huddles • Ad hoc planning to re-establish/reinforce and assess or adjust plans Debriefs • Information exchange designed to improve team performance
- 31. Handoff The transfer of information (along with authority and responsibility) during transitions in care across the continuum; to include an opportunity to ask questions, clarify, and confirm
- 32. Two challenge rule Invoked when an initial assertion is ignored… It is your responsibility to assertively voice your concern at least two times to ensure that it has been heard. The member being challenged must acknowledge. If the outcome is still not acceptable: • Take a stronger course of action • Use supervisor or chain of command
- 33. Two challenge rule (cont.) Empower any team member to “stop the line” if they sense or discover a breach of safety. This is an action never to be taken lightly, but it requires immediate cessation of the process and resolution of the safety issue.