Transcript TeamSTEPPS: The Present and the Future

TeamSTEPPS: The Present
and the Future
TeamSTEPPS Plans for the Future (2.0)
and the Present User Support Network
TeamSTEPPS National Conference
June 22, 2012
TeamSTEPPS
Session Moderator
 Andrea Amodeo, MS, IMPAQ International
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TEAMSTEPPS 05.2
TeamSTEPPS
Purpose
 To Provide Updates on the National Implementation
of TeamSTEPPS Program in terms of:
 Support
 Training
 Future directions
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TeamSTEPPS
Agenda
 Introduction
 User Support Network & Resources
 TeamSTEPPS “2.0”
 TeamSTEPPS Training & National Meeting
 Panel Q&A
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TeamSTEPPS
Panel Introductions
 Kathryn Schulke, Booz Allen Hamilton
 David P. Baker, PhD, IMPAQ International
 Stephen Hines, PhD, Health Research &
Educational Trust
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TEAMSTEPPS 05.2
TeamSTEPPS
User Support Network and
Resources
Kathryn Schulke
Booz Allen Hamilton
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TEAMSTEPPS 05.2
TeamSTEPPS
OVERVIEW OF TeamSTEPPS
USER SUPPORT NETWORK AND
RESOURCES
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TeamSTEPPS
Overview of TeamSTEPPS User Support
Network
User Support Portal
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AHRQ TeamSTEPPS Website
General Information
TeamSTEPPS Assessment Tools
Training Calendar
TeamSTEPPS Tools & Materials
Announcements
Event Calendar
Resource Center
Archives
Discussion Forum
Technical Assistance
TeamSTEPPS User Support
Portal
AHRQ TeamSTEPPS Website
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TeamSTEPPS
AHRQ TeamSTEPPS Website Resources
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TeamSTEPPS
AHRQ TeamSTEPPS Website Resources
 http://teamstepps.ahrq.gov/
 General Information
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Overview of TeamSTEPPS
National Implementation Plan Description
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Regional Training Centers
How to contact the TeamSTEPPS Implementation Team
Leadership Briefing Slides
 Assessment Tools
 TeamSTEPPS Readiness Assessment
 TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ)
 TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ)
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TeamSTEPPS
AHRQ TeamSTEPPS Website Resources cont.
 Training Registration & Dates
 TeamSTEPPS Tools and Materials
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TeamSTEPPS Rapid Response System training module
Using Simulation in TeamSTEPPS training guide
How to Order TeamSTEPPS materials
 Implementation Stories
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TeamSTEPPS
TeamSTEPPS User Support Portal Overview
 http://teamsteppsportal.com/
 Announcements
 Calendar of Events
 Resource Center
 Discussion Forum
 Request Support
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TEAMSTEPPS 05.2
Opportunities to receive TA
from SMEs
TeamSTEPPS
Specific Resources Available for TeamSTEPPS
Users
 Potential Users
 Announcements
 Calendar of Events
 TeamSTEPPS Trainees
 Resource Center
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Pre-Training Material
Tools by Key Principle
 Existing Users
 Discussion Forum
 Request Support
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TEAMSTEPPS 05.2
TeamSTEPPS
Potential Users
TeamSTEPPS
Trainees
TeamSTEPPS
Existing
Users
TeamSTEPPS
Specific Resources Available for TeamSTEPPS
Users cont.
TeamSTEPPS
Potential
Users
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TeamSTEPPS
Specific Resources Available for TeamSTEPPS
Users cont.
TeamSTEPPS
Potential
Users
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TeamSTEPPS
Specific Resources Available for TeamSTEPPS
Users cont.
TeamSTEPPS
Trainees
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TEAMSTEPPS 05.2
TeamSTEPPS
Specific Resources Available for TeamSTEPPS
Users cont.
TeamSTEPPS
Existing
Users
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TeamSTEPPS
OVERVIEW OF 2012
WEBINAR
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TeamSTEPPS
TeamSTEPPS Pre-Training Webinar
 Held May 18, 2012 with over 80 participants
 Presenter: David Baker, PhD
Vice President Research, IMPAQ
 Webinar Objectives:
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Describe the importance of TeamSTEPPS and the Master
Trainer Program
Describe what participants should do prior to TeamSTEPPS
Master Training
Describe what happens after TeamSTEPPS Master Training
TEAMSTEPPS 05.2
TeamSTEPPS
Using TeamSTEPPS to Prevent High
Priority Harms
 Held May 31, 2012 with over 300 participants
 Presenter: Stephen Hines, PhD
Vice-President, Health Research and Education Trust
 Webinar Objectives:
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Frame teamwork as part of an integrated quality improvement
strategy
Provide a short overview of TeamSTEPPS and AHRQ’s
national implementation strategy
Discuss strategies to maximize the impact of TeamSTEPPS in
efforts to reduce all 9 HACs and readmissions
TEAMSTEPPS 05.2
TeamSTEPPS
FUTURE TeamSTEPPS USER
RESOURCES
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TEAMSTEPPS 05.2
TeamSTEPPS
Future TeamSTEPPS User Resources
 Future Webinars
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Two additional webinars will be hosted this year
Discussions during the national meeting will
determine subject matter for the webinars
 Special Topic TeamSTEPPS Master Trainings
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Inter-professional Education held at University of Minnesota
Fairview Medical Center, August 6-7, 2012
Patient Engagement held at Duke University,
August 30-31, 2012
TEAMSTEPPS 05.2
TeamSTEPPS
Additional Resources
 Department of Defense Patient Safety Program
Website
 http://www.health.mil/dodpatientsafety.aspx
 Order TeamSTEPPS Materials
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Phone: 800-358-9295
E-mail: Civilian Orders: [email protected];
DoD/TRICARE Orders: [email protected]
 Contact National Implementation Team
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Phone: 312-422-2609
E-mail: [email protected]
TEAMSTEPPS 05.2
TeamSTEPPS
User Support Network and Resources
 Fosters collaboration
 Prevents TeamSTEPPS users from “reinventing the
wheel”
 Provide support to ease the implementation process
 Create a support system for TeamSTEPPS users
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TEAMSTEPPS 05.2
TeamSTEPPS
In Conclusion
Keep on STEPPIN’
The sky’s the limit!
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TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS “2.0”
David P. Baker, PhD
IMPAQ International
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TeamSTEPPS
History of “1.0”
 TeamSTEPPS Curriculum
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Developed by AHRQ and DoD
Development completed in 2005
Released to the public in 2006
 TeamSTEPPS National Implementation
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2008 – 2009: Created a national infrastructure to
support the adoption of TeamSTEPPS
2009 – Present: Support the spread of
TeamSTEPPS nationally
TEAMSTEPPS 05.2
TeamSTEPPS
Patient Safety Movement Prior to 2006
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29
TeamSTEPPS
OR Teamwork Climate and Postoperative Sepsis Rates
Length of ICU Stay After Team Training
(per 1000 discharges)
18
2.4
Avg. Length of Stay (days)
16
2.2
14
50
2
1.8
%
Group Mean
12
Re
du
cti
on
AHRQ National Average
10
Low Teamwork
Climate
8
1.6
Mid Teamwork
Climate
6
1.4
4
High Teamwork
Climate
1.2
2
1
June
July
August
Sept
Oct
Nov
Dec
Jan
Feb
March
April
0
May
Teamwork Climate Based on Safety Attitudes Questionnaire
(Sexton, 2006)
Johns Hopkins
(Pronovost, 2003)
Johns Hopkins
Journal of Critical Care Medicine
Adverse Outcomes
Low

High
Indemnity Experience
Pre-Teamwork Training
Post-Teamwork Training
25
20
50%
Reduction
20
50%
Reduction
15
11
10
5
0
(Mann, 2006)
Beth Israel Deaconess Medical Center
Contemporary OB/GYN
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Malpractice Claims, Suits, and Observations
TEAMSTEPPS 05.2
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Medical Errors Still Claiming
Many Lives
TeamSTEPPS
By Elizabeth Weise, USA TODAY
05/18/2005
As many as 98,000 Americans still die each year because of medical errors despite an unprecedented focus on
patient safety over the last five years, according to a study released today. Significant improvements have
been made in some hospitals since the Institute of Medicine released a landmark report in 2000 that revealed
many thousands of Americans die each year because of medical mistakes.
But nationwide, the pace of change is painstakingly slow, and the death rate has not changed much, according
to the study in The Journal of the American Medical Association.
The researchers blame the complexity of health care systems, a lack of leadership, the reluctance of doctors to
admit errors and an insurance reimbursement system that rewards errors — hospitals can bill for additional
services needed when patients are injured by mistakes — but often will not pay for practices that reduce those
errors.
"The medical community now knows what it needs to do to deal with the problem. It just has to overcome the
barriers to doing it," says study co-author Lucian Leape of Harvard's School of Public Health.
Improvements
Hospitals have taken steps
to reduce medical errors and
injuries.
Examples:
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Computerized
prescriptions: 81%
decrease in errors.
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Including pharmacist in
medical team: 78%
decrease in preventable
drug reactions.
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Team training in delivery
of babies: 50% decrease
in harmful outcomes —
such as brain damage —
in premature deliveries.
The institute, a public policy organization, pushed key health care organizations to focus on patient safety, the
new report says. As a result, reductions as much as 93% have been made in certain kinds of error-related
illnesses and deaths.
Computerized prescriptions, adding a pharmacist to medical teams and team training in the delivery of babies
are among the improvements medical centers are making, the study finds.
But "we have to turn the heat up on the hospitals," Leape says.
For example, 5% to 8% of intensive-care patients on ventilators develop pneumonia, the study says. But by
strictly following a simple protocol of bed elevation, drugs and periodic breathing breaks, those outbreaks can
be reduced to almost zero. "A little hospital in DeSoto, Miss., called Baptist Memorial did it, so it doesn't take a
big academic medical center," Leape says.
Source: Journal of the American
Medical Association
Hospitals that eliminate infections should receive bonuses, Leape says. "If insurance companies paid 20%
more for patients in (intensive-care units) where there were no infections, they'd cut costs substantially.
"We really need to rethink how we pay for health care. What we do now is pay for services, but what we should
do is pay for care and outcomes."
…little progress towards the goal
Leape and Berwick,
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JAMA May 2005
31
TeamSTEPPS
JCAHO Sentinel Events
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TeamSTEPPS
Since 2005
 The science of patient safety and quality has grown
and is now established
 Michigan Keystone
 CUSP CLABSI
 PfP
 Importance of teamwork and team training is well
accepted in healthcare
 There has been tremendous research on the topic
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TEAMSTEPPS 05.2
TeamSTEPPS
What is “2.0?”
 Part of Effort to Continually Evolve TeamSTEPPS
 Provides an Opportunity to:
 Leverage what has been learned so far
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Lessons learned through National Implementation
Feedback from users
New and emerging evidence
Consider meaningful ways to integrate current and
future TeamSTEPPS efforts
 Should be Considered a Work in Progress….
 Scope of revisions/additions has not yet been
determined
 Recommendations due to AHRQ in Aug 2012
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TEAMSTEPPS 05.2
TeamSTEPPS
Gathering Input for “2.0”
 Meetings with AHRQ and DoD
 Focus Groups with Experienced TeamSTEPPS
Users and Trainers
 Participants referred by AHRQ and/or DoD
 5 virtual focus groups conducted
 DoD, RTRC, others
 Over 80 years combined experience with
teaching and/or implementing TeamSTEPPS!
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TeamSTEPPS
What We’ve Been Hearing…
 The Following Slides Provide a High-Level
Summary of What We Have Heard
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Topics include: TeamSTEPPS pre-training, materials,
delivery, and implementation/sustainment
Not comprehensive; intended to provide an overview
Still defining what 2.0 will be
 We Want to Hear YOUR Thoughts and Ideas!
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TEAMSTEPPS 05.2
TeamSTEPPS
What We’ve Been Hearing…
 Pre-Training
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Provide overview of Master Training course and role of
a Master Trainer (it’s more than attending training…)
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Provide guidance on who to send to training
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Update/augment resources for obtaining buy-in
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Emphasize the need to develop a plan!
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What are the goals for implementation?
In which unit/areas of the organization will you begin?
How will implementation be measured or monitored?
TEAMSTEPPS 05.2
TeamSTEPPS
What We’ve Been Hearing…
 Materials
 CD/DVD
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Pocket Guide
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Continues to be useful
Many users customizing and printing
Guide to Action
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Provide all materials and files on a single disk
Update contents
Improve labeling and reorganize
Many agreed useful as an electronic resource
TEAMSTEPPS 05.2
TeamSTEPPS
What We’ve Been Hearing…
 Materials (Cont’d)
 Instructor Guide
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Variable feedback on hard copy vs. electronic materials
Improve labeling of modules and contents
Improve ease of updating materials
Eliminate redundancies
Update slides, introductory information, and references
that support evidence base
Consistent agreement on usefulness of Instructor Notes
Add new scenarios that address more clinical areas
TEAMSTEPPS 05.2
TeamSTEPPS
What We’ve Been Hearing…
 Materials (Cont’d)
 Other suggested improvements
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Improve information about coaching (e.g., why important
and how it fits in implementing TeamSTEPPS)
Consider the variety of audiences (new vs. experienced
users; Master trainers vs. staff; unit vs. institutional
change agents)
Link TeamSTEPPS to other change models
Include more resources for obtaining buy-in and gaining
physician engagement
Integrate work on patient engagement
TEAMSTEPPS 05.2
TeamSTEPPS
What We’ve Been Hearing…
 Delivery
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Variable feedback on 2-day vs. 2.5-day course
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Variable feedback on use of teach-backs
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Importance of simulation
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Some users eliminate this exercise
Other users emphasize its importance in ensuring the
trainees understand the material and feel comfortable
teaching it
Demonstrates how trainers can integrate tools and
strategies into simulation at any level of fidelity
Provides another way for trainees to relate to materials
(i.e., tells a story)
TEAMSTEPPS 05.2
TeamSTEPPS
What We’ve Been Hearing…
 Implementation & Sustainment
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Provide more specific guidance and examples related
to coaching, implementation, and measurement
Emphasize importance of post-training follow-up
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Ensure accountability for following the plan
Provide guidance on anticipated barriers
Integrate TeamSTEPPS into new employee
orientation, annual competency training, and
performance appraisals
Strengthen evaluation information and resources
Provide information and emphasize integration of
TeamSTEPPS into other patient safety and quality
initiatives
TEAMSTEPPS 05.2
TeamSTEPPS
The Components of a
Patient Safety Program
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TeamSTEPPS
Next Steps
 Analyze and summarize the focus group results
 Make recommendations to AHRQ/DoD
 Implement recommendations – FY13
 Important considerations
 Demand for TeamSTEPPS Master Training
 The available resources
 Demand for 2.0
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TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Training and the
2013 National Conference
Steve Hines, PhD
Health Research & Educational Trust
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TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Trainings
 Changes We’ve Made
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Expanded number of centers to reach broader
audience
Increased number of seats available in trainings
Fostering cross-pollination across Centers
Designing advance topic trainings:
 Use of simulation
 TS in professional education
 Making patients a part of the team
Encouraging innovation in the trainings
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Training
Advanced topics: IPE, Patient Engagement, and Simulation
States with RTRCs:
 WA (Seattle):
University of
Washington
CO (Denver):
Presbyterian / St. Luke’s
MN (Minneapolis):
University of Minnesota
LA (New Orleans):
Tulane University
NC(Durham):
Duke University
NY (New Hyde Park):
North Shore LIJ
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TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Trainings
 How we’re doing:
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Enrollment:
 Every training has been full
 Waiting list of 600+ persons
Satisfaction:
 Evaluations from all trainings positive &
insightful
Impact:
 Ultimate standard, but hardest to assess
 Plans to follow-up with participants to monitor
their progress
 Goal: Continuous improvement
TEAMSTEPPS 05.2
TeamSTEPPS
TeamSTEPPS Trainings
 What we’re learning
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Mod 1 05.2 Page 49
About excellence in training teams
 Clinical backgrounds
 Diversity
 Adult education
 Experience
 Behavioral feedback
About maximizing success rates
 Improving “prequipping” via homework and
readiness assessment
 Linking TS training to other support activities
TEAMSTEPPS 05.2
TeamSTEPPS
2013 National Conference
 2012 Conference
150+ more attendees than last year
 More & more diverse presentations
 2013 Conference (pending contract extension)
 Parameters
 Location: San Antonio
 Time: mid- to late-June
 Size: larger venue to accommodate demand
 Changes
 Poster sessions to facilitate sharing

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TEAMSTEPPS 05.2
TeamSTEPPS
2013 National Conference
 2013 Conference (pending contract extension)

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Changes
 Theme: soliciting ideas
 Poster sessions to facilitate sharing
 Call for papers & panels
 Increased number of concurrent sessions
 Recruitment of conference sponsors
 Networking forums
 Other changes based on feedback from this
year
TEAMSTEPPS 05.2
TeamSTEPPS
Questions and Answers
 We’d like to hear your questions and feedback about:
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The User Support Network
Plans for “2.0”
Upcoming national meeting
TeamSTEPPS national trainings
Resources that prospective and current users of
TeamSTEPPS would like to see available
TEAMSTEPPS 05.2
TeamSTEPPS
Thank You!
For more information, please contact our team at:
[email protected]
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TEAMSTEPPS 05.2