Team STEPPS The Present and the Future Team

Team. STEPPS: The Present and the Future

Team. STEPPS Plans for the Future (2. 0) and the Present User Support Network Team. STEPPS National Conference June 22, 2012

Team. STEPPS Session Moderator n Andrea Amodeo, MS, IMPAQ International Mod 1 05. 2 Page 3 TEAMSTEPPS 05. 2

Team. STEPPS Purpose n To Provide Updates on the National Implementation of Team. STEPPS Program in terms of: n Support n Training n Future directions Mod 1 05. 2 Page 4 TEAMSTEPPS 05. 2

Team. STEPPS Agenda n Introduction n User Support Network & Resources n Team. STEPPS “ 2. 0” n Team. STEPPS Training & National Meeting n Panel Q&A Mod 1 05. 2 Page 5 TEAMSTEPPS 05. 2

Team. STEPPS Panel Introductions n Kathryn Schulke, Booz Allen Hamilton n David P. Baker, Ph. D, IMPAQ International n Stephen Hines, Ph. D, Health Research & Educational Trust Mod 1 05. 2 Page 6 TEAMSTEPPS 05. 2

Team. STEPPS User Support Network and Resources Kathryn Schulke Booz Allen Hamilton Mod 1 05. 2 Page 7 TEAMSTEPPS 05. 2

Team. STEPPS OVERVIEW OF Team. STEPPS USER SUPPORT NETWORK AND RESOURCES Mod 1 05. 2 Page 8 TEAMSTEPPS 05. 2

Team. STEPPS Overview of Team. STEPPS User Support Network User Support Portal • • • AHRQ Team. STEPPS Website General Information Team. STEPPS Assessment Tools Training Calendar Team. STEPPS Tools & Materials Announcements Event Calendar Resource Center Archives Discussion Forum Technical Assistance Team. STEPPS User Support Portal AHRQ Team. STEPPS Website Mod 1 05. 2 Page 9 TEAMSTEPPS 05. 2

Team. STEPPS AHRQ Team. STEPPS Website Resources Mod 1 05. 2 Page 10 TEAMSTEPPS 05. 2

Team. STEPPS AHRQ Team. STEPPS Website Resources n http: //teamstepps. ahrq. gov/ n General Information n n Overview of Team. STEPPS National Implementation Plan Description n n Regional Training Centers How to contact the Team. STEPPS Implementation Team Leadership Briefing Slides n Assessment Tools n Team. STEPPS Readiness Assessment n Team. STEPPS Teamwork Perception Questionnaire (T-TPQ) n Team. STEPPS Teamwork Attitudes Questionnaire (T-TAQ) n Mod 1 05. 2 Page 11 TEAMSTEPPS 05. 2

Team. STEPPS AHRQ Team. STEPPS Website Resources cont. n Training Registration & Dates n Team. STEPPS Tools and Materials n n n Team. STEPPS Rapid Response System training module Using Simulation in Team. STEPPS training guide How to Order Team. STEPPS materials n Implementation Stories Mod 1 05. 2 Page 12 TEAMSTEPPS 05. 2

Team. STEPPS User Support Portal Overview n http: //teamsteppsportal. com/ n Announcements n Calendar of Events n Resource Center n Discussion Forum n Request Support n Mod 1 05. 2 Page 13 TEAMSTEPPS 05. 2 Opportunities to receive TA from SMEs

Team. STEPPS Specific Resources Available for Team. STEPPS Users n Potential Users n Announcements n Calendar of Events n Team. STEPPS Trainees n Resource Center n n Pre-Training Material Tools by Key Principle n Existing Users n Discussion Forum n Request Support Mod 1 05. 2 Page 14 TEAMSTEPPS 05. 2 Team. STEPPS Potential Users Team. STEPPS Trainees Team. STEPPS Existing Users

Team. STEPPS Specific Resources Available for Team. STEPPS Users cont. Team. STEPPS Potential Users Mod 1 05. 2 Page 15 TEAMSTEPPS 05. 2

Team. STEPPS Specific Resources Available for Team. STEPPS Users cont. Team. STEPPS Potential Users Mod 1 05. 2 Page 16 TEAMSTEPPS 05. 2

Team. STEPPS Specific Resources Available for Team. STEPPS Users cont. Team. STEPPS Trainees Mod 1 05. 2 Page 17 TEAMSTEPPS 05. 2

Team. STEPPS Specific Resources Available for Team. STEPPS Users cont. Team. STEPPS Existing Users Mod 1 05. 2 Page 18 TEAMSTEPPS 05. 2

Team. STEPPS OVERVIEW OF 2012 WEBINAR Mod 1 05. 2 Page 19 TEAMSTEPPS 05. 2

Team. STEPPS Pre-Training Webinar n Held May 18, 2012 with over 80 participants n Presenter: David Baker, Ph. D Vice President Research, IMPAQ n Webinar Objectives: n n n Mod 1 05. 2 Page 20 Describe the importance of Team. STEPPS and the Master Trainer Program Describe what participants should do prior to Team. STEPPS Master Training Describe what happens after Team. STEPPS Master Training TEAMSTEPPS 05. 2

Team. STEPPS Using Team. STEPPS to Prevent High Priority Harms n Held May 31, 2012 with over 300 participants n Presenter: Stephen Hines, Ph. D Vice-President, Health Research and Education Trust n Webinar Objectives: n n n Mod 1 05. 2 Page 21 Frame teamwork as part of an integrated quality improvement strategy Provide a short overview of Team. STEPPS and AHRQ’s national implementation strategy Discuss strategies to maximize the impact of Team. STEPPS in efforts to reduce all 9 HACs and readmissions TEAMSTEPPS 05. 2

Team. STEPPS FUTURE Team. STEPPS USER RESOURCES Mod 1 05. 2 Page 22 TEAMSTEPPS 05. 2

Team. STEPPS Future Team. STEPPS User Resources n Future Webinars n n Two additional webinars will be hosted this year Discussions during the national meeting will determine subject matter for the webinars n Special Topic Team. STEPPS Master Trainings n n Mod 1 05. 2 Page 23 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

Team. STEPPS Additional Resources n Department of Defense Patient Safety Program Website n http: //www. health. mil/dodpatientsafety. aspx n Order Team. STEPPS Materials n n Phone: 800 -358 -9295 E-mail: Civilian Orders: ahrqpubs@ahrq. hhs. gov; Do. D/TRICARE Orders: dodteamstepps@ahrq. hhs. gov n Contact National Implementation Team n n Mod 1 05. 2 Page 24 Phone: 312 -422 -2609 E-mail: AHRQTeam. STEPPS@aha. org TEAMSTEPPS 05. 2

Team. STEPPS User Support Network and Resources n Fosters collaboration n Prevents Team. STEPPS users from “reinventing the wheel” n Provide support to ease the implementation process n Create a support system for Team. STEPPS users You are not alone! Mod 1 05. 2 Page 25 TEAMSTEPPS 05. 2

Team. STEPPS In Conclusion Keep on STEPPIN’ The sky’s the limit! Mod 1 05. 2 Page 26 TEAMSTEPPS 05. 2

Team. STEPPS “ 2. 0” David P. Baker, Ph. D IMPAQ International Mod 1 05. 2 Page 27 TEAMSTEPPS 05. 2

Team. STEPPS History of “ 1. 0” n Team. STEPPS Curriculum n n n Developed by AHRQ and Do. D Development completed in 2005 Released to the public in 2006 n Team. STEPPS National Implementation n n Mod 1 05. 2 Page 28 2008 – 2009: Created a national infrastructure to support the adoption of Team. STEPPS 2009 – Present: Support the spread of Team. STEPPS nationally TEAMSTEPPS 05. 2

Team. STEPPS Patient Safety Movement Prior to 2006 Mod 1 05. 2 Page 29 TEAMSTEPPS 05. 2 29

Team. STEPPS (Pronovost, 2003) Johns Hopkins Journal of Critical Care Medicine (Sexton, 2006) Johns Hopkins (Mann, 2006) Beth Israel Deaconess Medical Center Contemporary OB/GYN Mod 1 05. 2 Page 30 TEAMSTEPPS 05. 2 30

Medical Errors Still Claiming Many Lives Team. STEPPS 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: n Computerized prescriptions: 81% decrease in errors. n Including pharmacist in medical team: 78% decrease in preventable drug reactions. n 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 De. Soto, 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, Mod 1 05. 2 Page 31 TEAMSTEPPS 05. 2 JAMA May 2005 31

Team. STEPPS JCAHO Sentinel Events Mod 1 05. 2 Page 32 TEAMSTEPPS 05. 2 32

Team. STEPPS Since 2005 n The science of patient safety and quality has grown and is now established n Michigan Keystone n CUSP CLABSI n Pf. P n Importance of teamwork and team training is well accepted in healthcare n There has been tremendous research on the topic Mod 1 05. 2 Page 33 TEAMSTEPPS 05. 2

Team. STEPPS What is “ 2. 0? ” n Part of Effort to Continually Evolve Team. STEPPS n Provides an Opportunity to: n Leverage what has been learned so far n n Lessons learned through National Implementation Feedback from users New and emerging evidence Consider meaningful ways to integrate current and future Team. STEPPS efforts n Should be Considered a Work in Progress…. n Scope of revisions/additions has not yet been determined n Recommendations due to AHRQ in Aug 2012 Mod 1 05. 2 Page 34 TEAMSTEPPS 05. 2

Team. STEPPS Gathering Input for “ 2. 0” n Meetings with AHRQ and Do. D n Focus Groups with Experienced Team. STEPPS Users and Trainers n Participants referred by AHRQ and/or Do. D n 5 virtual focus groups conducted n Do. D, RTRC, others n Over 80 years combined experience with teaching and/or implementing Team. STEPPS! Mod 1 05. 2 Page 35 TEAMSTEPPS 05. 2

Team. STEPPS What We’ve Been Hearing… n The Following Slides Provide a High-Level Summary of What We Have Heard n n n Topics include: Team. STEPPS pre-training, materials, delivery, and implementation/sustainment Not comprehensive; intended to provide an overview Still defining what 2. 0 will be n We Want to Hear YOUR Thoughts and Ideas! Mod 1 05. 2 Page 36 TEAMSTEPPS 05. 2

Team. STEPPS What We’ve Been Hearing… n Pre-Training n Provide overview of Master Training course and role of a Master Trainer (it’s more than attending training…) n Provide guidance on who to send to training n Update/augment resources for obtaining buy-in n Emphasize the need to develop a plan! n n n Mod 1 05. 2 Page 37 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

Team. STEPPS What We’ve Been Hearing… n Materials n CD/DVD n n Pocket Guide n n n Continues to be useful Many users customizing and printing Guide to Action n Mod 1 05. 2 Page 38 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

Team. STEPPS What We’ve Been Hearing… n Materials (Cont’d) n Instructor Guide n n n n Mod 1 05. 2 Page 39 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

Team. STEPPS What We’ve Been Hearing… n Materials (Cont’d) n Other suggested improvements n n n Mod 1 05. 2 Page 40 Improve information about coaching (e. g. , why important and how it fits in implementing Team. STEPPS) Consider the variety of audiences (new vs. experienced users; Master trainers vs. staff; unit vs. institutional change agents) Link Team. STEPPS to other change models Include more resources for obtaining buy-in and gaining physician engagement Integrate work on patient engagement TEAMSTEPPS 05. 2

Team. STEPPS What We’ve Been Hearing… n Delivery n Variable feedback on 2 -day vs. 2. 5 -day course n Variable feedback on use of teach-backs n n n Importance of simulation n n Mod 1 05. 2 Page 41 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

Team. STEPPS What We’ve Been Hearing… n Implementation & Sustainment n Provide more specific guidance and examples related to coaching, implementation, and measurement n Emphasize importance of post-training follow-up n n n Mod 1 05. 2 Page 42 Ensure accountability for following the plan Provide guidance on anticipated barriers Integrate Team. STEPPS into new employee orientation, annual competency training, and performance appraisals Strengthen evaluation information and resources Provide information and emphasize integration of Team. STEPPS into other patient safety and quality initiatives TEAMSTEPPS 05. 2

Team. STEPPS The Components of a Patient Safety Program Mod 1 05. 2 Page 43 TEAMSTEPPS 05. 2 43

Team. STEPPS Next Steps n Analyze and summarize the focus group results n Make recommendations to AHRQ/Do. D n Implement recommendations – FY 13 n Important considerations n Demand for Team. STEPPS Master Training n The available resources n Demand for 2. 0 Mod 1 05. 2 Page 44 TEAMSTEPPS 05. 2

Team. STEPPS Training and the 2013 National Conference Steve Hines, Ph. D Health Research & Educational Trust Mod 1 05. 2 Page 45 TEAMSTEPPS 05. 2

Team. STEPPS Trainings n Changes We’ve Made n n n Mod 1 05. 2 Page 46 Expanded number of centers to reach broader audience Increased number of seats available in trainings Fostering cross-pollination across Centers Designing advance topic trainings: n Use of simulation n TS in professional education n Making patients a part of the team Encouraging innovation in the trainings TEAMSTEPPS 05. 2

Team. STEPPS 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 Mod 1 05. 2 Page 47 TEAMSTEPPS 05. 2

Team. STEPPS Trainings n How we’re doing: n n n Mod 1 05. 2 Page 48 Enrollment: n Every training has been full n Waiting list of 600+ persons Satisfaction: n Evaluations from all trainings positive & insightful Impact: n Ultimate standard, but hardest to assess n Plans to follow-up with participants to monitor their progress n Goal: Continuous improvement TEAMSTEPPS 05. 2

Team. STEPPS Trainings n What we’re learning n n Mod 1 05. 2 Page 49 About excellence in training teams n Clinical backgrounds n Diversity n Adult education n Experience n Behavioral feedback About maximizing success rates n Improving “prequipping” via homework and readiness assessment n Linking TS training to other support activities TEAMSTEPPS 05. 2

Team. STEPPS 2013 National Conference n 2012 Conference 150+ more attendees than last year n More & more diverse presentations n 2013 Conference (pending contract extension) n Parameters n Location: San Antonio n Time: mid- to late-June n Size: larger venue to accommodate demand n Changes n Poster sessions to facilitate sharing n Mod 1 05. 2 Page 50 TEAMSTEPPS 05. 2

Team. STEPPS 2013 National Conference n 2013 Conference (pending contract extension) n Mod 1 05. 2 Page 51 Changes n Theme: soliciting ideas n Poster sessions to facilitate sharing n Call for papers & panels n Increased number of concurrent sessions n Recruitment of conference sponsors n Networking forums n Other changes based on feedback from this year TEAMSTEPPS 05. 2

Team. STEPPS Questions and Answers n We’d like to hear your questions and feedback about: n n n Mod 1 05. 2 Page 52 The User Support Network Plans for “ 2. 0” Upcoming national meeting Team. STEPPS national trainings Resources that prospective and current users of Team. STEPPS would like to see available TEAMSTEPPS 05. 2

Team. STEPPS Thank You! For more information, please contact our team at: AHRQTeam. STEPPS@aha. org Mod 1 05. 2 Page 53 TEAMSTEPPS 05. 2