Strategies and Tools to Enhance Performance and Patient

Strategies and Tools to Enhance Performance and Patient Safety Adoption in Action AHRQ funded project UNCHCS/RTI partnership READY Training OR 6

Introduction Teamwork Is All Around Us Mod 1 06. 2 05. 2 Page 2 TEAMSTEPPS 05. 2 2

Introduction Objectives Mod 1 06. 2 05. 2 Page 3 n Describe effective team structure n Describe effective leadership and leadership skills n Describe the relationship between situation monitoring, shared mental models, and team effectiveness n Describe effective verbal and task related mutual support n Describe effective communication skills n Recognize barriers to effective teamwork TEAMSTEPPS 05. 2 3

Introduction Why Do Errors Occur—Some Obstacles n Workload fluctuations courtesy n Interruptions n Fatigue n Halo effect n Multi-tasking n Passenger syndrome n Failure to follow up n Hidden agenda n Poor handoffs n Complacency n Ineffective n High-risk phase communication n Strength of an idea n Not following protocol Mod 1 06. 2 05. 2 Page 4 n Excessive professional TEAMSTEPPS 05. 2 n Task (target) fixation 4

Introduction Multi-Team System for Patient Care Contingency Teams Patient Core Team Coordinating Team Ancillary Services Administration Mod 1 06. 2 05. 2 Page 5 TEAMSTEPPS 05. 2 5

Introduction Mod 1 06. 2 05. 2 Page 6 TEAMSTEPPS 05. 2 6

Introduction Required Skills for Team Performance n Leadership n Situation Awareness n Mutual Support n Communication Mod 1 06. 2 05. 2 Page 7 TEAMSTEPPS 05. 2 7

Introduction Effective Team Leaders n Organize the team n Articulate clear goals n Make decisions through collective input of members n Empower members to speak up and challenge, when appropriate n Actively promote and facilitate good teamwork n Skillful at conflict resolution Mod 1 06. 2 05. 2 Page 8 TEAMSTEPPS 05. 2 8

Introduction Team Events n Briefs – planning n Huddles – problem solving n Debriefs – process improvement Leaders are responsible to assemble the team and facilitate team events But remember… Anyone can request a brief, huddle, or debrief Mod 1 06. 2 05. 2 Page 9 TEAMSTEPPS 05. 2 9

Introduction Briefing/Time Out n Team membership and roles n Clinical status of the patient n Team goals and potential pitfalls n Resources Mod 1 06. 2 05. 2 Page 10 TEAMSTEPPS 05. 2 10

Introduction Mod 1 06. 2 05. 2 Page 11 TEAMSTEPPS 05. 2 11

Introduction Team Huddles Mod 1 06. 2 05. 2 Page 12 TEAMSTEPPS 05. 2 12

Introduction Debriefs should be conducted for the following reasons: Mod 1 06. 2 05. 2 Page 13 n So team members learn from actual situations n So learning takes place collectively n So team members can exchange information n So teams can improve performance TEAMSTEPPS 05. 2 13

Introduction Mod 1 06. 2 05. 2 Page 14 TEAMSTEPPS 05. 2 14

Introduction Delegation of Resources Delegation is a means of managing resources whereby information, equipment, and key staff are allocated to specific tasks. Delegation is a skill that anyone can learn. Mod 1 06. 2 05. 2 Page 15 TEAMSTEPPS 05. 2 15

Introduction Modeling Teamwork n Effective team leaders utilize the team skills in their daily practice and encourage team behaviors by: n n Mod 1 06. 2 05. 2 Page 16 Sharing information Displaying appropriate communication, monitoring, and support behaviors Helping team members achieve the effective team performance using the same behaviors Encouraging active participation by all team members TEAMSTEPPS 05. 2 16

Introduction Required Skills for Team Performance n Leadership n Situation Awareness n Mutual Support n Communication Mod 1 06. 2 05. 2 Page 17 TEAMSTEPPS 05. 2 17

Introduction A Continuous Process Situation Monitoring (Skill) Situation Awareness (Individual Outcome) Shared Mental Models (Team Outcome) Mod 1 06. 2 05. 2 Page 18 TEAMSTEPPS 05. 2 18

Introduction How can I contribute to a Shared Mental Model? n Routinely update others n Acknowledge deviations or changes in the situation n Alert team to actual or potential problems n Verbalize a course of action n Request needed information Mod 1 06. 2 05. 2 Page 19 TEAMSTEPPS 05. 2 19

Introduction When to Share? n Briefs n Huddles n Debriefs n Shift Changes n Handing off care to another Mod 1 06. 2 05. 2 Page 20 TEAMSTEPPS 05. 2 20

Introduction Required Skills for Team Performance n Leadership n Situation Awareness n Mutual Support n Communication Mod 1 06. 2 05. 2 Page 21 TEAMSTEPPS 05. 2 21

Introduction Mutual Support Mutual support is the essence of teamwork n Protects team members from work overload situations that may reduce effectiveness and increase the risk of error n Mutual support consists of helping your fellow teammates by offering assistance n Two kinds of mutual support Mod 1 06. 2 05. 2 Page 22 n Task related n Verbal TEAMSTEPPS 05. 2 22

Introduction I’M SAFE Checklist I = Illness M = Medication S = Stress A = Alcohol and Drugs F = Fatigue E = Eating, Elimination, and Emotions Mod 1 06. 2 05. 2 Page 23 TEAMSTEPPS 05. 2 23

Introduction Required Skills for Team Performance n Leadership n Situation Awareness n Mutual Support n Communication Mod 1 06. 2 05. 2 Page 24 TEAMSTEPPS 05. 2 24

Introduction Mod 1 06. 2 05. 2 Page 25 TEAMSTEPPS 05. 2 25

Introduction Please Use CUS Words but only when appropriate! Mod 1 06. 2 05. 2 Page 26 TEAMSTEPPS 05. 2 26

Introduction SBARq is a technique for communicating clearly and concisely. n Communicate the following information: n n n Mod 1 06. 2 05. 2 Page 27 Situation Background Assessment Recommendation Any Questions? TEAMSTEPPS 05. 2 27

Introduction Be Complete and Brief Mod 1 06. 2 05. 2 Page 28 TEAMSTEPPS 05. 2 28

Introduction Be Clear Mod 1 06. 2 05. 2 Page 29 TEAMSTEPPS 05. 2

Introduction Be Timely Mod 1 06. 2 05. 2 Page 30 TEAMSTEPPS 05. 2 30

Introduction Check Back Sender verifies that the message was received Receiver accepts the message and provides feedback confirmation Sender initiates the message Mod 1 06. 2 05. 2 Page 31 TEAMSTEPPS 05. 2 31

Introduction Callout n A strategy used to communicate important or critical information. n It informs all team members simultaneously during emergency situations n It helps team members anticipate next steps n On you unit, what information would you want called out? Mod 1 06. 2 05. 2 Page 32 TEAMSTEPPS 05. 2 32

Introduction Mod 1 06. 2 05. 2 Page 33 TEAMSTEPPS 05. 2 33

Introduction Next Stepps n Begin practicing the teamwork skills – plan to use at least one skill during your next work day n You will get coaching from unit based master trainers n Coach and give feedback to each other! Mod 1 06. 2 05. 2 Page 34 TEAMSTEPPS 05. 2 34