Team STEPPS for OfficeBased Care Measurement OfficeBased Care

Team. STEPPS for Office-Based Care Measurement

Office-Based Care ® Objectives n Describe the importance of measurement n Describe the Kirkpatrick model of training evaluation n Identify measures that can be used to assess the impact of Team. STEPPS for Office-Based Care n Describe the AHRQ Medical Office Survey on Patient Safety Culture n Prepare a plan for determining if Team. STEPPS worked Mod Page 1 205. 2 Page 2 TEAMSTEPPS 05. 2

Office-Based Care ® Team. STEPPS Phases Requires Measurement Mod Page 1 305. 2 Page 3 TEAMSTEPPS 05. 2

Office-Based Care ® How To Measure - Kirkpatrick Level IV – Results Level III – Behavior Level II – Learning Level I – Reactions Mod Page 1 405. 2 Page 4 M U L T I L E V E L A P P R O A C H TEAMSTEPPS 05. 2 (Organizational results) (Transfer to the job) (Think, Do, Feel) (Like it and useful)

Office-Based Care ® Available Measures n Reactions n Team. STEPPS for Office-Based Care Course Evaluation Form n Learning n Team. STEPPS Teamwork Attitudes Questionnaire (TTAQ) for Office-Based Care n Team. STEPPS for Office-Based Care Knowledge Test n Team Performance Observation Tool for Office. Based Care n Team. STEPPS Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care Mod Page 1 505. 2 Page 5 TEAMSTEPPS 05. 2 n Behavior n Team Performance Observation Tool for Office. Based Care n Team. STEPPS Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care n AHRQ Medical Office Survey on Patient Safety Culture n Results n Patient outcome and clinical process measures n AHRQ Medical Office Survey on Patient Safety Culture n Consumer Assessment of Healthcare Providers and Systems for Patient-Centered Medical Homes

Office-Based Care ® Team. STEPPS for Office-Based Care Course Evaluation Form n Level I - Reactions n Includes evaluation questions for all components of the Team. STEPPS for Office-Based Care course n Customizable n Provides information about what trainees thought about the training Mod Page 1 605. 2 Page 6 TEAMSTEPPS 05. 2

Office-Based Care ® Team. STEPPS Teamwork Attitudes Questionnaire (T-TAQ) for Office-Based Care n Level II - Learning n 30 -item self-report tool n Respondents rate their agreement with items on a 5 -point Likert scale n Measures attitudes toward: Mod Page 1 705. 2 Page 7 n Team Structure n Leadership n Situation Monitoring n Mutual Support n Communication TEAMSTEPPS 05. 2

Office-Based Care ® Team. STEPPS for Office-Based Care Knowledge Test n Level II - Learning n Multiple-choice test n Uses: n To assess knowledge of teamwork n To measure changes in knowledge n Caution n Mod Page 1 805. 2 Page 8 Items tend to be too easy TEAMSTEPPS 05. 2

Office-Based Care ® Team Performance Observation Tool for Office-Based Care n Level II - Learning and Level III - Behavior n Tool for observing team performance n Site assessment n Measure of training effectiveness n Observers should practice using the tool n Can be adapted to a particular practice type Mod Page 1 905. 2 Page 9 TEAMSTEPPS 05. 2

Office-Based Care ® Team. STEPPS Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care n Level II - Learning and Level III - Behavior n 35 -item self-report tool n Respondents rate their agreement with items on a 5 -point Likert scale n Measures staff perceptions of: Mod Page 1 10 05. 2 Page 10 n Team Structure n Leadership n Situation Monitoring n Mutual Support n Communication TEAMSTEPPS 05. 2

Office-Based Care ® Behavior n Measure whether the information learned during training is transferred to the job n Two important factors in transfer are: n Whethere is an opportunity to use the new Team. STEPPS tools or strategies on the job n Whether use of the Team. STEPPS tools and strategies is valued and reinforced Mod Page 1 11 05. 2 Page 11 TEAMSTEPPS 05. 2

Office-Based Care ® Behavior: An Example As part of a pediatric practice’s efforts to improve teamwork, all nurses are trained on the use of SBAR for presenting patient information to physicians. However, while the physicians attended training, it is obvious that they did not buy in to SBAR. Shortly after implementing the SBAR strategy, a nurse calls the on-call physician with concerns about a patient who needs to be seen and may need to be admitted to the hospital. The nurse begins to present the patient’s situation and background, but before she can complete her SBAR report, the physician jumps in and says, “Forget that SBAR stuff; just tell me what I need to know!” Mod Page 1 12 05. 2 Page 12 TEAMSTEPPS 05. 2

Office-Based Care ® Behavior: Measures n Team Performance Observation Tool for Office- Based Care n Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care n AHRQ Medical Office Survey on Patient Safety Culture Mod Page 1 13 05. 2 Page 13 TEAMSTEPPS 05. 2

Office-Based Care ® Results: Measures n Patient outcome measures n Examples: Complication rates, infection rates, measurable medication errors, patient experience measures n Clinical process measures n Mod Page 1 14 05. 2 Page 14 Examples: Length of patient wait time, number of required patient appointments made and completed, percentage of lab results communicated to patients, staff perceptions of safety TEAMSTEPPS 05. 2

Office-Based Care ® Medical Office Survey on Patient Safety Culture n Designed specifically for outpatient medical office providers and staff n Designed for medical offices with at least three providers n Not recommended for use in solo practitioner or twoprovider offices, to protect confidentiality n Can be used to facilitate dialogue about patient safety and quality in small offices n Online at http: //www. ahrq. gov/professionals/ quality-patient-safety/patientsafetyculture/ medical-office/index. html Mod Page 1 15 05. 2 Page 15 TEAMSTEPPS 05. 2

Office-Based Care ® Medical Office Survey on Patient Safety Culture Uses n Raise awareness about patient safety issues n Assess patient safety culture n Track changes in patient safety culture over time n Evaluate the impact of patient safety interventions (e. g. , Team. STEPPS) Mod Page 1 16 05. 2 Page 16 TEAMSTEPPS 05. 2

Office-Based Care ® Survey Measures: 12 Dimensions and 2 Overall Items Survey Dimensions • • • Communication about error Communication openness Information exchange with other settings Office processes and standardization Organizational learning Overall perceptions of patient safety and quality • • • Owner/managing partner/leadership support for patient safety Patient care tracking/followup Patient safety and quality issues Staff training Teamwork Work pressure and pace Overall Items • • Mod Page 1 17 05. 2 Page 17 How they would rate this medical office on five different areas of health care quality (i. e. , patient centered, effective, timely, efficient, and equitable) How they would rate this medical office on patient safety TEAMSTEPPS 05. 2

Office-Based Care ® What Support Is Available? n Survey Toolkit n n n Survey forms Survey items and dimensions Survey User’s Guide n Comparative Database and Reports n Data Entry and Analysis Tool n E-mail questions to: Safety. Culture. Surveys@westat. com or Databases. On. Safety. Culture@westat. com Mod Page 1 18 05. 2 Page 18 TEAMSTEPPS 05. 2

Office-Based Care ® Evaluating Team. STEPPS for Office-Based Care Exercise n Break into small groups and identify: 1. One or two measures you can use to assess whether briefings transfer to the office setting 2. One or two measures to determine if briefings affect the office’s patient safety outcomes Mod Page 1 19 05. 2 Page 19 TEAMSTEPPS 05. 2