The Power of Teams Across America: Lessons Learned from The National Implementation of TeamSTEPPS Project (Text Version)

On September 27, 2010, Deborah A. Milne, made this presentation at the 2010 Annual Conference. Select to access the PowerPoint® presentation (900 KB).  

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Slide 1

The Power of Teams Across America: Lessons Learned from The National Implementation of TeamSTEPPS® Project

AHRQ 2010 Annual Conference
September 27, 2010

Deborah A. Milne, RN, MPA
American Institutes for Research

Slide 2

Overview

• Initial design for success.
• About The National Implementation of TeamSTEPPS Project.
• The journey—challenge and adaptation.
• Lessons learned.

Slide 3

What is TeamSTEPPS?

• Evidence based teamwork system to improve communication and teamwork skills among health care professionals
  • Reduce medical errors.
  • Improve patient safety.

Slide 4

What is TeamSTEPPS?

Image: The TeamSTEPPS triangle logo is a visual model that represents some basic but critical concepts related to teamwork training.

TeamSTEPPS is based upon 4 key skills:

1. Leadership.
2. Communication.
3. Mutual Support.
4. Situation Monitoring.

These skills are listed at the center of the triangle logo.

If a team has tools and strategies it can leverage to build a fundamental level of competency in each of those skills, research has shown that the team can enhance three types of teamwork outcomes:

1. Performance.
2. Knowledge.
3. Attitudes.

These outcomes appear at the three points of the triangle logo.

Slide 5

Why the National Implementation of TeamSTEPPS Program Began

• AHRQ released TeamSTEPPS training materials in 2006.
• Need for implementation and training support soon apparent.
• New approach for AHRQ—fund TeamSTEPPS training and user support program.

Slide 6

Initial Design for Success

• Designed program on the "agricultural extension service" model.
• Focus initial training recruitment on:
  • Traditional early adopters such as High Reliability Organizations.
  • Established diverse geographical groups involved in health care safety and quality:
    • CMS Quality Improvement Organizations.
    • AHRQ Patient Safety Improvement Corps.

Slide 7

Build it and they will come...

Image: A field filled with rows of empty chairs is shown.

Slide 8

What is the National Implementation of TeamSTEPPS Program?

• AHRQ contracted with American Institutes for Research in Washington DC to:
  • Set up a train the trainer model program at training centers in "early adopter" hospitals that already understood TeamSTEPPS.
  • Recruit teams to attend training.
  • Develop support system for TeamSTEPPS Master Trainers after training.

Slide 9

More Components of the National Implementation of TeamSTEPPS Program

• Facilitate the integration of teamwork training into health professions education.
• Development of additional measurement instruments and modules.
• Conduct evaluation of project effectiveness.

Slide 10

National Implementation of TeamSTEPPS Training

• We have conducted 58 training sessions.
• We have trained > 1500 Master Trainers from:
• • U.S.—every state and Puerto Rico.
  • Taiwan.
  • Australia.
  • Netherlands.
  • Japan.

Slide 11

Spread of National Implementation in U.S. to Date

Image: A map of the USA is shown.

Slide 12

National Implementation of TeamSTEPPS Training Center Locations

Image: Map of the United States is shown with the training center locations pointed to.

Carilion Clinic TRC
Duke TRC
Creighton Univ. TRC
Univ. Minnesota TRC
AIR—Lead
Univ. Washington TRC

Slide 13

TeamSTEPPS Master Trainer Sessions

• Sessions are free—teams are responsible for travel costs.
• Open to all health provider organizations & health profession educators.
• CME and CEU—awarded upon completion.
• Limited to approx. 30 seats.
• Classes of diverse teams—greatest asset!

Slide 14

TeamSTEPPS Master Trainer Sessions

2 1/2 day sessions:

Day 1:

• Fundamentals curriculum—Didactic.

Day 2:

• Planning, includes change management, coaching, measurement, implementation planning—Interactive.

Day 3:

• Teach back—Practice.

Slide 15

 

National Implementation of TeamSTEPPS User Support

• AIR's User Support Network:
  • Center Director and Program Specialists.
  • Call center team.
  • Technical experts and administrative support.
  • E-mail listserv—peer to peer support.
  • http://teamstepps.ahrq.gov.
  • Topical webinars (17 completed so far).
  • Annual user group meeting/collaborative.

Slide 16

The Journey—Change and Adaptation

• First major adaptation—Update to trainer/coach module slides:
  • To adapt to the goals and challenges of trainee teams.
  • Add special implementation slides for CMS QIOs.

Slide 17

The Journey—Change and Adaptation

• Second major change—requirement of "statement of readiness"
  • Goals.
  • Challenges.
  • Leadership support.
  • Who will you send and why?

Slide 18

The Journey—Change and Adaptation

• Third major change—required standardization of all training sessions across training centers:
  • Equality across all centers.
  • Required for consistent CME and CEU credits.
  • Additional training segments allowed, with no credit.

Slide 19

Lessons Learned

• Peer to peer support is priceless:
  • Training sessions where teams from different types, sizes and locations are mixed together is a rich environment to learn.
• Lesson—help them connect with others that have had similar problems.

Slide 20

Lessons Learned

• Readiness statement is often a predictor to success for sustainment:
  • Prepares teams in focusing on goals identified through RCA or HSOP survey findings.
  • Gets teams thinking about change before training.
• Lesson—read and evaluate each readiness statement—respond as necessary.

Slide 21

Lessons Learned

• "Bottom or middle up" vs. "top down" driven initiatives are revealed as most sustained.
• Organizations where the fiat "Thou shalt do TeamSTEPPS" has been issued often fail.
• Lesson—help them "market" TeamSTEPPS to the front line, bring a front line unofficial leader to become Master Trainer.

Slide 22

Lessons Learned

• Post training support is critical to success and sustainment:
  • Implementation and sustainment are the hardest parts.
  • Be ready to help them think out of the box.
  • Utilize peer to peer support.
• Lesson—be responsive and accessible.

Slide 23

Lessons Learned

• Changing the SOP:
  • Some special needs cases will arise.
  • Still important to ask, is this fair to everyone else that is waiting for a seat?
• Lesson—be adaptable but still fair.

Slide 24

Lessons Learned

• Teams implementing TeamSTEPPS and TRC instructors have good ideas:
  • We take suggestions for improvement seriously.
  • Often best ideas come from new teams.
• Lesson—ask for feedback and suggestions for improvement—act on the good ones and give them credit.

Slide 25

Have We Been Successful?

• Build it and they will come—they are still coming!
• What is the measure of success?
  • In numbers of people trained the program is successful.
• Another measure of success will be adoption and sustainment of change—Project evaluation to come!

Slide 26

Questions?

• Thank you, and feel free to contact me:

  Deborah A. Milne
  dmilne@air.org
  (202) 403-5968