Transcript Slide 1

TeamSTEPPS Simulations: A
Practical Manual
James Battles, PhD
Heidi King, MS, FACHE
Stephen Hines, PhD
Barb Edson, RN, MBA, MHA
David Baker, PhD
What's Next? Leveraging Current Tools to
Support Implementation
TeamSTEPPS
Presenters
James
Battles, PhD
Social
Science
Analyst for
Patient
Safety,
AHRQ
Mod 1 05.2 Page 3
Heidi King,
MS, FACHE
Acting
Director
Department
of Defense
Patient
Safety
Program
Stephen
Hines, PhD
Chief
Research
Officer,
HRET
TEAMSTEPPS 05.2
Barb Edson,
RN, MBA,
MHA
VP of Clinical
Quality,
HRET
David Baker,
PhD
Senior Vice
President,
Health
Division,
IMPAQ
International
TeamSTEPPS
Objectives
 Consider how TeamSTEPPS work influences
other patient safety initiatives
 Discuss new TeamSTEPPS variations
 Lay out current and future plans for TeamSTEPPS
national implementation
Mod 1 05.2 Page 4
TEAMSTEPPS 05.2
TeamSTEPPS
Where Have We Been and Where
Do We Go From Here?
James Battles, PhD
AHRQ
Mod 1 05.2 Page 5
TEAMSTEPPS 05.2
TeamSTEPPS
What TeamSTEPPS® Does
Mod 1 05.2 Page 6
TEAMSTEPPS 05.2
TeamSTEPPS
Combat Tested
 Been to war in IRAQ and Afghanistan
Mod 1 05.2 Page 7
TEAMSTEPPS 05.2
TeamSTEPPS
Hurricane Tested
 Played a critical role in Hurricane Sandy & other
emergencies
Mod 1 05.2 Page 8
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS® goes International
Canada
All 50 States
Great
Britain
Netherlands
Germany
Switzerland
Italy
China
Korea
Peru
Taiwan
Brazil
Singapore
Australia
Mod 1 05.2 Page 9
Japan
TEAMSTEPPS 05.2
TeamSTEPPS
Integrating TeamSTEPPS®
 CUSP for CLASBI
 CUSP for CAUTI in hospitals and long term care
 CUSP for VAP\VAC
 Safe Surgery in Hospitals and Ambulatory
Surgery Centers
 Perinatal Safety Improvement Program
 Medical Liability projects
Mod 1 05.2 Page 10
TEAMSTEPPS 05.2
TeamSTEPPS
Where to From Here?
 Discussions with WHO about a region-by-region
implementation of TeamSTEPPS®
 Need to create new modules dealing with virtual
teams and coordination of care between units
within healthcare facilities and across care
settings
Mod 1 05.2 Page 11
TEAMSTEPPS 05.2
TeamSTEPPS
Where to From Here?
 Meeting growing demand for TeamSTEPPS ®
training and implementation strategies in primary
care
 New on-line Master Team Training to be
developed
Mod 1 05.2 Page 12
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS New Tools and
Resources from the Department of
Defense
Heidi King, MS, FACHE
Department of Defense Patient
Safety Program
Mod 1 05.2 Page 13
TEAMSTEPPS 05.2
TeamSTEPPS
DoD TeamSTEPPS: Where Have We Been?
 Utilizing over 5000 (and climbing) Master Instructors
 Training and implementation in 90% of Military Treatment
Facilities
 Over 70,000 continuing education credits awarded
 Using simulation and coaching as adjunct to training
 Spread throughout medical/trauma teams in Theatre of
Operations: Iraq and Afghanistan
 Partnering with various federal agencies to leverage TeamSTEPPS
integration
Foundational to achieving culture change
Mod 1 05.2 Page 14
TEAMSTEPPS 05.2
TeamSTEPPS
DoD TeamSTEPPS: Where Are We Heading?
We needed a new sustainable model!





A E IOU
Align with patient safety and quality improvement initiatives
Encourage Innovation
Involve, Integrate, Impact: patients, staff, programs, outcomes
Overcoming challenges
Utilizing coaching and simulation for experiential learning
TeamSTEPPS is part of our DNA…
Mod 1 05.2 Page 15
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Resources: Integration!
Patient Activation
Resource Guide
Coaching
SBAR Toolkit
Simulation-based
Training (Centers and
In-situ)
Professional Conduct
Toolkit
Briefs, Huddles,
Debrief Toolkits
TeamSTEPPS and
Partnership
for Patients
TeamSTEPPS Tip
Sheets and
Scenarios
TEA
MTPAT
Learning Circles and
Workshops
Team UP
DoD Website
eBulletin and Learning
Update
Facebook
Patient Safety
Learning Center
(Protected)
http://www.health.mil/dodpatientsafety
Mod 1 05.2 Page 16
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS National
Implementation Overview
Barb Edson, RN, MBA, MHA
HRET
Mod 1 05.2 Page 17
TEAMSTEPPS 05.2
TeamSTEPPS
Goals
 To provide TeamSTEPPS Master Training to
health care organizations interested in improving
teamwork to enhance performance and patient
safety
 To grow the national cadre of TeamSTEPPS
Master Trainers
 To support TeamSTEPPS users
 To evolve and advance the TeamSTEPPS
program
Mod 1 05.2 Page 18
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Master Training
 Two-day training course
 Train-the-trainer approach
 Prepares you to serve as a TeamSTEPPS
Master Trainer by


Providing instruction on TeamSTEPPS tools and
strategies
Providing an opportunity to develop and plan your
TeamSTEPPS implementation
 Prepares you to serve as a leader for
implementing TeamSTEPPS within your
organization
Mod 1 05.2 Page 19
TEAMSTEPPS 05.2
TeamSTEPPS
Regional Training Centers
University of Washington TRC
Minnesota -TRC
UCLA TRC
North Shore Long
Island Jewish TRC
Duke TRC
Tulane University TRC
Mod 1 05.2 Page 20
TEAMSTEPPS 05.2
TeamSTEPPS
Regional Training Centers
 North Shore Long Island Jewish Health System in New Hyde
Park, New York (NSLIJ)

Implemented TeamSTEPPS system-wide
 Duke Medical Center, Durham, North Carolina (Duke)
 Includes patients as part of TeamSTEPPS Master Training
 Tulane University, New Orleans, Louisiana (Tulane)

Integrates simulation into TeamSTEPPS Master Training
 University of Minnesota Fairview Medical Center, Minneapolis,
Minnesota (UM)

Integrates TeamSTEPPS into inter-professional education (IPE)
 University of Washington Medicine, Seattle, Washington (UW)
 Integrates simulation into TeamSTEPPS Master Training
 University of California Los Angeles, Los Angeles, California
(UCLA)

Mod 1 05.2 Page 21
New center launching in fall/winter of 2013
TEAMSTEPPS 05.2
TeamSTEPPS
2012 Accomplishments
 766 people trained via:
15 basic trainings
 1 training each focusing on IPE and Patient Engagement
 4 trainings with a special focus on central line associated
blood stream infections
 395 attendees at the National Conference where:
 99 attendees took part in a 1-day blended online and inperson Master Training course
 Conference topics spanned





Mod 1 05.2 Page 22
System-wide implementation
Specific clinical usage
Different training and educational models
Networking opportunities mixed military and civilian
champions of TeamSTEPPS
TEAMSTEPPS 05.2
TeamSTEPPS
How do we support our
participants?
Mod 1 05.2 Page 23
TEAMSTEPPS 05.2
TeamSTEPPS
Pre-Training Support
 Leadership Brief
 Provides a C-suite perspective
 http://teamstepps.ahrq.gov/abouttoolsmaterials.htm
 Prerequisite “Coursework”
 Pre-training recorded webinar
 Readiness Assessment
 Implementation Planning
 Participant on-boarding live webinar



Mod 1 05.2 Page 24
Orientate and prepare participants for training
Meet training representative from Center staff
Initiate implementation planning
TEAMSTEPPS 05.2
TeamSTEPPS
Post-Training Support
 www.teamsteppsportal.org
 National Conference
 Help line/email
 http://teamstepps.ahrq.gov/
Mod 1 05.2 Page 25
TEAMSTEPPS 05.2
TeamSTEPPS
AHRQ Website
 AHRQ website (http://teamstepps.ahrq.gov/)
 Program overview
 Training curricula (Essentials course;
Fundamentals course; measures; new modules)
 Materials to download and/or order
 TeamSTEPPS Implementation Guide
 Measurement tools
Mod 1 05.2 Page 26
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Portal
 A centralized resource for everything
TeamSTEPPS
 Key features
 Webinars
 Tools and resources for use
 Implementation stories
 ListServ/Discussion forum
Mod 1 05.2 Page 27
TEAMSTEPPS 05.2
TeamSTEPPS
Upcoming Webinars
 Monthly scheduled webinars planned for 2013
Educational to support TeamSTEPPS users
 Invited speakers from around the field
 Special topics
 Program updates
 Portal updates
 Training updates
 Webinars are the second Wednesday of each month
 July 12: TeamSTEPPS and Simulation
 August 14: System-wide Implementation of TeamSTEPPS

Mod 1 05.2 Page 28
TEAMSTEPPS 05.2
TeamSTEPPS
Tools and Resources
 Ready-made implementation support tools
 Updated evidence base
 Scenarios
 Shared tools from users
Mod 1 05.2 Page 29
TEAMSTEPPS 05.2
TeamSTEPPS
Shared Tools
 Resource for posting and sharing new
TeamSTEPPS tools
 TeamSTEPPS is customizable
 No sense in reinventing the wheel
 Others have dealt with similar problems and
developed innovative solutions
 Contact [email protected]
 www.health.mil/dodpatientsafety/ProductsandSer
vices/Toolkits.aspx
Mod 1 05.2 Page 30
TEAMSTEPPS 05.2
TeamSTEPPS
Implementation Stories
 Cases studies of successful and unsuccessful
TeamSTEPPS implementations
 Learn from these critical incidents
 HRET team will interview, summarize, and post
the story
 Please follow the Survey Monkey link under
“Case Studies” on the portal to share your
experience
Mod 1 05.2 Page 31
TEAMSTEPPS 05.2
TeamSTEPPS
Discussion Forum
 Training-specific forums (for 2013 sessions)
Reconnect with classmates
 Directly interact with faculty
 Share tools
 ListServ for the entire TeamSTEPPS community

Mod 1 05.2 Page 32
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS 2.0
David P. Baker, PhD
IMPAQ International
Mod 1 05.2 Page 33
TEAMSTEPPS 05.2
TeamSTEPPS
Patient Safety Movement
“To Err
is Human”
IOM Report
1999
2001
TeamSTEPPS®
Institute for
Healthcare
Improvement
100K lives
Campaign
Executive
Memo from
President
DoD
MedTeams®
ED Study
1995
JCAHO National
Patient Safety
Goals
TeamSTEPPS
Released to the
Public
2003
2004
Patient Safety
and Quality
Improvement
Act of 2005
2005
2006 2007
Medical Team Training
Mod 1 05.2 Page 34
TEAMSTEPPS 05.2
TeamSTEPPS
National
Implementation
Program Began
Centers for
Medicare and
Medicaid
Partnership for
Patients Campaign
National
Implementation
of CUSP
2008
2011
TeamSTEPPS
What is TeamSTEPPS 2.0?
Part of effort to continually evolve
TeamSTEPPS
Provides an opportunity to….
 Leverage what has been learned so far:




Mod 1 05.2 Page 35
Lessons learned
Feedback from users
New and emerging evidence
Consider meaningful ways to integrate current
and future TeamSTEPPS efforts
TEAMSTEPPS 05.2
TeamSTEPPS
Environmental Scan
 Review of prior work efforts related to a next
iteration of TeamSTEPPS
 Usability reviews of existing curriculum and
materials
 Interviews with AHRQ and DoD stakeholders
 Focus groups with TeamSTEPPS experts




Mod 1 05.2 Page 36
Participants referred by AHRQ and/or DoD
Included TeamSTEPPS users, trainers, and those involved
in its development
5 virtual focus groups conducted
Represented over 80 years combined experience with
teaching and/or implementing TeamSTEPPS!
TEAMSTEPPS 05.2
TeamSTEPPS
Results
 Qualitative data analysis resulted in 189
aggregated recommendations
 Recommendations were clustered into 6
categories:






Mod 1 05.2 Page 37
Pre-training
Training materials
Training delivery
Implementation and sustainment
Evaluation
Integrating new modules
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS 2.0: Work in Progress
 Focuses on revisions, updates, and expansions to
materials that support the Master Training course

Improvements for TeamSTEPPS users




Improvements for Master Trainers




Mod 1 05.2 Page 38
Updated and expanded content
Reduced size of hard copy materials!
Better preparation for implementation planning
Improved and enhanced Instructor Guides
Page numbers!
Advance organizer for each instructional module
New discussion questions and exercises
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS 2.0: Work in Progress
(Cont’d)
 Some highlights:
 Updating the evidence base
 Reorganizing the order of training to emphasize the
importance of communication
 Providing information and guidance on engaging
patients
 Emphasizing the importance of implementation
planning pre-training and throughout the course
 Providing more detailed information on implementation
and sustainment activities (e.g., Coaching,
Measurement)
Mod 1 05.2 Page 39
TEAMSTEPPS 05.2
TeamSTEPPS
Next Steps
 Drafts of 2.0 materials are near completion!
 Review and testing with stakeholders – June 2013
 Delivery for final AHRQ review – September 2013
Mod 1 05.2 Page 40
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS New Tools and
Resources
James Battles, PhD
AHRQ
Barb Edson, RN, MBA, MHA
HRET
Mod 1 05.2 Page 41
TEAMSTEPPS 05.2
TeamSTEPPS
New Tools
 TeamSTEPPS® Primary Care Version

Adapts core concepts of TeamSTEPPS® to reflect the
environment of primary care office-based teams
 Team STEPPS® Long-Term Care Version

Adapted to the environment of nursing homes and other
long-term care settings such as assisted living & continuing
care retirement communities
 TeamSTEPPS® Limited English Proficiency (LEP)
Module

A module to help develop a customized plan to train staff in
teamwork skills as applied to work with patients who have
difficulty communicating in English
http://teamstepps.ahrq.gov
Mod 1 05.2 Page 42
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS for Primary Care
Medical Offices
 Builds on “TeamSTEPPS for Primary Care
Teams”
 Works as a Master Trainer course with material
on
 How to be a practice facilitator of TeamSTEPPS
 How to coach TeamSTEPPS using a variety of
methods
 How to implement, spread, and sustain
TeamSTEPPS
 And how to measure and evaluate TeamSTEPPS
Mod 1 05.2 Page 43
TEAMSTEPPS 05.2
TeamSTEPPS
New Setting of Care, New
Challenges, New Solutions
 Smaller teams with less ability to travel
 Varied background in team-training and quality
improvement initiatives
 Available in a in-person training and online
format
 Online trainings will include virtual, game-based
learning
Mod 1 05.2 Page 44
TEAMSTEPPS 05.2
TeamSTEPPS
Interested?
 Please contact us at
[email protected] if you are
interested
 Pilot testing begins late summer/early fall 2013
 National Implementation begins late winter/early
spring 2014
Mod 1 05.2 Page 45
TEAMSTEPPS 05.2
TeamSTEPPS
The Future of Teaching and
Learning TeamSTEPPS
Steve Hines, PhD
HRET
Mod 1 05.2 Page 46
TEAMSTEPPS 05.2
TeamSTEPPS
Thoughts on the Future
 Teaching and learning TeamSTEPPS will change
considerably
 Sometimes out of necessity
 Other times because of the opportunities
presented by new technology
 Great challenges exist
 And there are approaches to address these
challenges
Mod 1 05.2 Page 47
TEAMSTEPPS 05.2
TeamSTEPPS
Current Challenges to
TeamSTEPPS Training
 Limited resources for meetings and trainings
Funds are tight at healthcare organizations
 Time is valuable
 There are restrictions on meetings funded by the
federal government
 Radical increase in number of ongoing QI
activities
 Coordinating with other disciplines and settings
of care
 Need to accommodate a broader range of trainees
 Work to understand how to best to connect and
grow a community of users

Mod 1 05.2 Page 48
TEAMSTEPPS 05.2
TeamSTEPPS
How Can We Approach these Challenges?
 Expand our training center capacity
 Produce resources for a broader range of
disciplines and settings of care
 Create user-friendly resources for those who are
not at trainings
 Materials for the end user on the front lines to
practice using the TeamSTEPPS tools
 Resources to help make the case for
implementation from a financial, quality, and
safety standpoint
 Alternative training modalities for self-teaching
 Expanded use of observation and mentoring
Mod 1 05.2 Page 49
TEAMSTEPPS 05.2
TeamSTEPPS
Time for Questions
Thank you for spending time
with us this week in Dallas!
Mod 1 05.2 Page 50
TEAMSTEPPS 05.2