Transcript Executive Briefing

Leadership Briefing
What is TeamSTEPPSTM?
 An evidence-based teamwork system
 Designed to improve:

Quality

Safety

Efficiency of health care
 Practical and adaptable
 Provides ready-to-use materials for training and
ongoing teamwork
Mod 1 2.0 Page 2
TEAMSTEPPS 05.2
Why Use TeamSTEPPS?
 Goal: Produce highly effective medical teams that
optimize the use of information, people and
resources to achieve the best clinical outcomes
 Teams of individuals who communicate effectively
and back each other up dramatically reduce the
consequences of human error
 Team skills are not innate; they must be trained
Mod 1 2.0 Page 3
TEAMSTEPPS 05.2
Why Invest in TeamSTEPPS?
 Cost of TeamSTEPPS is minimal compared to
savings
 Annual cost is approximately 98,000 lives and $17-29
billion
 Errors can be reduced by changes to the health care
system; specifically by providing interdisciplinary
team training
Reference: Kohn LT, Corrigan, JM, Donaldson, MS. Eds. To err is human: Building a safer health system.
Washington, DC: Committee on Quality of Health Care in American, Institute of Medicine, National
Academy Press, 2000.
Mod 1 2.0 Page 4
TEAMSTEPPS 05.2
What Can TeamSTEPPS Do for
Us?
Emergency Department1
Clinical Units in a Medical Center2
After implementation of multiple medical
team training programs:
• Improved observed team behaviors.
• Enhanced staff attitudes toward
teamwork.
• Reduced observed clinical errors.
After implementation of SBAR to improve
communication among clinical caregivers:
• Reduced rate of adverse drug
events (from 30 to 18 per 1,000
patient days).
• Improved medication reconciliation
at patient admission from 72% to
88% and at discharge from 53% to
89%.
1.Morey, JC, Simon, R, Jay GD, et al. Error reduction and performance
improvement in the emergency department through formal teamwork training:
Evaluation results of the MedTeams project. Health Serv Res. 37:1553-1581,
2002
2.Haig, K., Sutton S, Whittington, J. SBAR: A shared mental model for
improving communication between clinicians. JL Comm J Qual Patient Saf
32(3):167-75, March 2006.
Mod 1 2.0 Page 5
TEAMSTEPPS 05.2
What Can TeamSTEPPS Do for
Us?
Labor and Delivery Units1
After implementation of multiple teamwork strategies and tools:
- A 50% reduction in the Weighted Adverse Outcome Score (WAOS). The WAOS
describes the adverse event score per delivery.
- A 50% decrease in the Severity Index, which measures the average severity of each
delivery with an adverse event.
Intensive Care Units (ICU)2
After implementation of a “Patient Daily Goals” form to facilitate staff communication:
• A 50% decrease in mean ICU length of stay from 2.2 days to 1.1 days.
Mod 1 2.0 Page 6
1.
Mann, S, Marcus, R, Sachs, B. Lessons from the cockpit: How team training can reduce errors on L&D (Grand
Rounds) Contemporary OB/Gyn v51 i1:34(8), January 2006.
2.
Pronovost, P, Berenholtz, S, Dorman, T, Lipsett, PA., Simmonds, T, Haraden, C. Improving communication in the
ICU using daily goals. J Cri Care 18(2):71-5, Jun 2003.
TEAMSTEPPS 05.2
What Can TeamSTEPPS Do For
Us?
Interprofessional Training/Education1
After participating in an interprofessional TeamSTEPPS training during neonatal
resuscitation in a simulated environment:
• Nurses who challenged a scripted medication order error increased from 38 percent
before the training to 77 percent post-training.
• The team’s ability to detect and correct inadequate chest compressions increased from
61.5 to 84.6 percent after the training
1. Sawyer, T, Laubach, V A, Hudak, J, Yamamura, K, & Pocrnich, A. Improvements in teamwork
during neonatal resuscitation after interprofessional TeamSTEPPS training. Neonatal Network 32(1):
26-33, 2013.
Mod 1 2.0 Page 7
TEAMSTEPPS 05.2
What Can TeamSTEPPS Do For
Us?
Interprofessional Training/Education1
After participating in an interprofessional TeamSTEPPS training during neonatal
resuscitation in a simulated environment:
• Nurses who challenged a scripted medication order error increased from 38 percent
before the training to 77 percent post-training.
• The team’s ability to detect and correct inadequate chest compressions increased from
61.5 to 84.6 percent after the training
1. Sawyer, T, Laubach, V A, Hudak, J, Yamamura, K, & Pocrnich, A. Improvements in teamwork
during neonatal resuscitation after interprofessional TeamSTEPPS training. Neonatal Network 32(1):
26-33, 2013.
Mod 1 2.0 Page 8
TEAMSTEPPS 05.2
What Can TeamSTEPPS Do for
Us?
Operating Rooms (OR)
After implementation of a “pre-op” brief:
•
Increased OR communication.1,2
•
Increased administration of properly timed prophylactic antibiotics prior to
incision from 84% to 95%.1
•
Increased pre-op deep vein thrombosis prophylaxis prior to induction from
92% to 100%.1
•
Error avoidance: Pre-op brief revealed seven patients (3.3%) with
previously unidentified severe surgical risks — surgery cancelled.1
•
A 16% reduction in nursing turnover rate.2
•
A 19% increase in OR employee satisfaction.2
1. Awad, SS, Fagan, SP, Bellows, C., Albo, D, et al. Bridging the communication gap in the operating room with
medical team training. Am J Surg 190(5): 770-4, Nov 2005.
2. Leonard, M,, Graham, S, Bonacum, D. The human factor: The critical importance of effective teamwork and
communication in providing safe care. Qual Saf Health Care 13 Suppl 1:i85-90, Oct 2004.
Mod 1 2.0 Page 9
TEAMSTEPPS 05.2
What Makes TeamSTEPPS
Different?
 Evidence-based and field-tested
 Comprehensive
 Customizable
 Easy-to-use teamwork tools and strategies
 Publicly available
Mod 1 2.0 Page 10
TEAMSTEPPS 05.2
What Will Our Teams Learn?
Mod 1 2.0 Page 11
TEAMSTEPPS 05.2
How Does TeamSTEPPS Work?
 I. Assessment
Clearly define the need
 II. Planning, Training, and Implementation
 Plan to sustain the effort
 Train individuals
 Implement and test the strategies
 III. Sustainment
 Integrate into daily practice
 Monitor and measure programs

Mod 1 2.0 Page 12
TEAMSTEPPS 05.2
What Do We Need to Make This
Work?
 Clearly define the need
 Focus on enhancing teamwork and establishing a
teamwork and safety culture
 Support from senior leadership
 Allocate sufficient resources

Personnel

Time

Resources
 Measure success
 Reward and reinforce teamwork
Mod 1 2.0 Page 13
TEAMSTEPPS 05.2
What Does Training Cost?
Key to Table Figures
 $A = Trainer preparation costs - Trainers’ time x trainers’ hourly rate
 $B = Travel costs related to any of the train the trainer sessions
 $C = Trainer costs to conduct training - Trainers’ time x trainer






hourly rate
$D = Trainee costs - Number of staff to be trained x (number of
training hours) x staff hourly rate
$E = Other training expenses - Food, senior leadership time for
kickoff, etc.
$F = Trainer costs for ongoing support - Number of “areas”
participating X (hours of support) x trainer/coach hourly rate
$G = Optional cost for staff time discussions - As normal course of
business
$H = Other ongoing support costs
$I, $J, $K = Total - The estimated costs at bottom of each column
Mod 1 2.0 Page 14
TEAMSTEPPS 05.2
What Does Training Cost?
Trainer
Mod 1 2.0 Page 15
Staff
Other
Costs
Preparing
Trainers
$A
Conducting
Training
$C
$D
$E
ongoing Support
$F
$G
$H
TOTAL
$I
$J
$K
TEAMSTEPPS 05.2
$B
How Do We Start?
1. Create a sense of urgency
2. Pull together the guiding team
3. Formulate a change vision and strategy
4. Communicate your vision for understanding and
buy-in
5. Send trainers to one of the TeamSTEPPS National
Implementation Regional Training Centers
Mod 1 2.0 Page 16
TEAMSTEPPS 05.2
Training for the Guiding Team
 Training is available on a “first come – first served”
basis

http://www.teamsteppsportal.org/teamstepps-master-trainingcourse
 Contact the TeamSTEPPS National Implementation
Team with questions



Mod 1 2.0 Page 17
www.teamsteppsportal.org
312-422-2609
[email protected]
TEAMSTEPPS 05.2
Backup Slides
 The following slides (16 – 21) are slides that can
support the briefing and may be integrated into slides
1 – 14 as appropriate.
Mod 1 2.0 Page 18
TEAMSTEPPS 05.2
National Teamwork Initiatives
 Accreditation Council for Graduate Medical Education (ACGME)
and the Association for American Medical Colleges (AAMC)
include aspects of communication, coordination, and
collaboration in physician competencies
 National Quality Forum (NQF) included teamwork training, skill
building and teamwork interventions in Safe Practices for Better
Health Care: A Consensus Report (2006 Update)
 The Joint Commission has increasingly included elements of
teamwork in their National Patient Safety Goals and
accreditation standards
 Centers for Medicare & Medicaid Services (CMS) included
TeamSTEPPS in the 9th Scope of Work
Mod 1 2.0 Page 19
TEAMSTEPPS 05.2
Importance of Communication
 Communication failure has been identified as the
leading root cause of sentinel events over the past 10
years (Joint Commission)
 Communication failure is a primary contributing factor
in almost 80% of more than 6000 root cause
analyses of adverse events and close calls (VA
Center for Patient Safety)
Mod 1 2.0 Page 20
TEAMSTEPPS 05.2
What Does it Cost?
 Costs can be modified by obtaining materials and
having trainers teach themselves
 Based on the National Implementation of
TeamSTEPPS Project, we estimate that a Change
Team Member will spent 10% FTE (200 hrs) on this
effort
Mod 1 2.0 Page 21
TEAMSTEPPS 05.2
Resources Available
TeamSTEPPS resources include:

Three teamwork training curricula

Course Management Guide

Multimedia course materials

TeamSTEPPS Implementation Guide

Measurement tools
Website for updated resources and information:
http://www.ahrq.gov/professionals/education/curriculu
m-tools/teamstepps/index.html
Mod 1 2.0 Page 22
TEAMSTEPPS 05.2