Leadership Briefing What Is Team STEPPS n An
Leadership Briefing
What Is Team. STEPPS®? n An evidence-based teamwork system n Designed to improve: n Quality n Safety n Efficiency of health care n Practical and adaptable n Provides ready-to-use materials for training and ongoing teamwork Mod 1 2. 0 Page 2 TEAMSTEPPS 05. 2
Why Use Team. STEPPS? n Goal: Produce highly effective medical teams who optimize the use of information, people, and resources to achieve the best clinical outcomes n Teams of individuals who communicate effectively and back each other up dramatically reduce the consequences of human error n Team skills are not innate; they must be trained Mod 1 2. 0 Page 3 TEAMSTEPPS 05. 2
Why Invest in Team. STEPPS? n Cost of Team. STEPPS is minimal compared with savings n Annual cost is approximately 98, 000 lives and $17 -29 billion n Errors can be reduced by changes to the health care system, specifically by providing interdisciplinary team training Mod 1 2. 0 Page 4 TEAMSTEPPS 05. 2
What Can Team. STEPPS Do for Us? Emergency Department 1 n After implementation of multiple medical team training programs: n n After implementation of SBAR Improved observed team behaviors n Enhanced staff attitudes toward teamwork n Reduced observed clinical errors Mod 1 2. 0 Page 5 Clinical Units in a Medical Center 2 TEAMSTEPPS 05. 2 to improve communication among clinical caregivers: n Reduced rate of adverse drug events (from 30 to 18 per 1, 000 patient days) n Improved medication reconciliation at patient admission from 72% to 88% and at discharge from 53% to 89%
What Can Team. STEPPS Do for Us? Labor and Delivery Units 1 Intensive Care Units 2 n After implementation of multiple n After implementation of a teamwork strategies and tools: n n Mod 1 2. 0 Page 6 A 50% reduction in the Weighted Adverse Outcome Score, which 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 TEAMSTEPPS 05. 2 “Patient Daily Goals” form to facilitate staff communication: n A 50% decrease in mean ICU length of stay from 2. 2 days to 1. 1 days
What Can Team. STEPPS Do For Us? Interprofessional Training/Education 1 n After participating in an interprofessional Team. STEPPS training during neonatal resuscitation in a simulated environment: Mod 1 2. 0 Page 7 n Nurses who challenged a scripted medication order error increased from 38% before the training to 77% after training n The team’s ability to detect and correct inadequate chest compressions increased from 61. 5% to 84. 6% after the training TEAMSTEPPS 05. 2
What Can Team. STEPPS Do for Us? Operating Rooms n After implementation of a “pre-op” brief: n n n Mod 1 2. 0 Page 8 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 Better 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 TEAMSTEPPS 05. 2
What Makes Team. STEPPS Different? n Evidence based and field tested n Comprehensive n Customizable n Easy to use n Publicly available Mod 1 2. 0 Page 9 TEAMSTEPPS 05. 2
What Will Our Teams Learn? Mod 1 2. 0 Page 10 TEAMSTEPPS 05. 2
How Does Team. STEPPS Work? n I. Assessment Clearly define the need n II. Planning, Training, and Implementation n Plan to sustain the effort n Train individuals n Implement and test the strategies n III. Sustainment n Integrate into daily practice n Monitor and measure programs n Mod 1 2. 0 Page 11 TEAMSTEPPS 05. 2
What Do We Need To Make This Work? n Clearly define the need n Focus on enhancing teamwork and establishing a n n Mod 1 2. 0 Page 12 teamwork and safety culture Get support from senior leadership Allocate sufficient resources n Personnel n Time n Resources Measure success Reward and reinforce teamwork TEAMSTEPPS 05. 2
What Does Training Cost? Key to Table Figures n $A = Trainer preparation costs: Trainers’ time x trainers’ hourly rate n $B = Travel costs related to any of the trainer sessions n $C = Trainer costs to conduct training: Trainers’ time x trainer hourly rate n $D = Trainee costs: Number of staff to be trained x (number of training hours) x staff hourly rate n $E = Other training expenses: Food, senior leadership time for kickoff, etc. n $F = Trainer costs for ongoing support: Number of “areas” participating x (hours of support) x trainer/coach hourly rate n $G = Optional cost for staff time discussions: As normal course of business n $H = Other ongoing support costs n $I, $J, $K = Total: Estimated costs at bottom of each column Mod 1 2. 0 Page 13 TEAMSTEPPS 05. 2
What Does Training Cost? Trainer Mod 1 2. 0 Page 14 Staff Other Costs Preparing Trainers $A Conducting Training $C $D $E Providing 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 Team. STEPPS National Implementation Regional Training Centers Mod 1 2. 0 Page 15 TEAMSTEPPS 05. 2
Training for the Guiding Team n Training is available on a “first come – first served” basis n Visit AHRQ’s Team. STEPPS Web site for more information and available courses n Mod 1 2. 0 Page 16 https: //www. ahrq. gov/teamstepps/ TEAMSTEPPS 05. 2
Backup Slides n The following slides (18– 21) can support the briefing and may be integrated into slides 1– 14 as appropriate. Mod 1 2. 0 Page 17 TEAMSTEPPS 05. 2
National Teamwork Initiatives n The Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges include aspects of communication, coordination, and collaboration in physician competencies n The National Quality Forum included teamwork training, skill building, and teamwork interventions in Safe Practices for Better Health Care: A Consensus Report (2006 update) n The Joint Commission has increasingly included elements of teamwork in their National Patient Safety Goals and accreditation standards n The Centers for Medicare & Medicaid Services included Team. STEPPS in the 9 th Scope of Work Mod 1 2. 0 Page 18 TEAMSTEPPS 05. 2
Importance of Communication n Communication failure has been identified as the leading root cause of sentinel events over the past 10 years (Joint Commission) n Communication failure is a primary contributing factor in almost 80% of more than 6, 000 root cause analyses of adverse events and close calls (VA Center for Patient Safety) Mod 1 2. 0 Page 19 TEAMSTEPPS 05. 2
What Does it Cost? n Costs can be modified by obtaining materials and having trainers teach themselves n Based on the National Implementation of Team. STEPPS Project, we estimate that a Change Team member will spend 10% FTE (200 hours) on this effort Mod 1 2. 0 Page 20 TEAMSTEPPS 05. 2
Resources Available n Team. STEPPS resources include: n Three teamwork training curricula n Course Management Guide n Multimedia course materials n Team. STEPPS Implementation Guide n Measurement tools n Web site for updated resources and information: n Mod 1 2. 0 Page 21 https: //www. ahrq. gov/teamstepps/ TEAMSTEPPS 05. 2
- Slides: 21