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How do you spell better teamwork and
communication? TeamSTEPPS®!
November 30, 2017
Objectives of the call:
3
• Learn more about the experience of each organization on their TeamSTEPPS journey.
• Discover how each organization has been working to implement TeamSTEPPS.
• Learn how you can use TeamSTEPPS to improve teamwork, communication and patient safety in your practice and your organization.
Jennifer Braun Chris Hund
Guest Speakers from the American Hospital Association:
TeamSTEPPS® in the U.S.
AHA Team Training
Chris Hund, MFA and Jen Braun, MPH
6
WHAT IS TEAMSTEPPS?
Team Strategies and Tools to Enhance
Performance and Patient Safety
• An evidence-based teamwork system designed to improve: quality,
safety and efficiency of health care
• Practical and adaptable
• Provides ready-to-use materials for training and ongoing teamwork
7
GOAL
Produce highly effective teams who optimize the use of information,
people and resources to achieve the best outcomes.
WHY NOW?
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• Cause of death in the United States:
• Heart disease: 611,000
• Cancer: 585,000
• Medical error: 251,000
• COPD: 149,000
• Suicide: 41,000
• Firearms: 34,000
• Motor vehicle: 34,000
Makary, M., & Daniel, M. (2016). Medical Error – The Third Leading Cause of Death in the U.S. BMJ, 353.
HISTORY OF TEAMSTEPPS IN THE U.S.
Patient Safety
and Quality
Improvement
Act of 2005
Executive
Memo from
President
DoD
MedTeams®
ED Study
Institute for
Healthcare
Improvement
100K lives
Campaign
“To Err
is Human”
IOM Report
TeamSTEPPS®
1995 1999 2001 2003 2004 2005
JCAHO National
Patient Safety
Goals
2006
TeamSTEPPS
Released to the
Public
2007
TeamSTEPPS
National
Implementation
Program Began
2008
National
Implementation
of CUSP
Centers for
Medicare and
Medicaid Services
Partnership for
Patients Campaign
2011
Medical Team Training
TeamSTEPPS
2.0,
TeamSTEPPS
Online, and
TeamSTEPPS
for Office-Based
Care
2014
TeamSTEPPS
Advanced
Course
2016
TEAMSTEPPS ACROSS THE CARE CONTINUUM
10
• Versions: Core Curriculum, Office-Based Care, Long-Term Care,
Rapid Response, LEP
• All available for free at www.ahrq.gov/teamstepps
NATIONAL IMPLEMENTATION OF TEAMSTEPPS
11
• Courses
• In-person at our Regional Training Centers
• Online
• National conference
• Technical assistance
• Monthly webinars
• Hotline
• New content development
• Evaluation
SUCCESS OF NATIONAL IMPLEMENTATION
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42,688 participants
in the national program
6,419 participants at
Master Training Courses
32,976 individuals attended monthly webinars
3,293 attendees at six national conferences
REGIONAL TRAINING CENTERS
13
SUCCESS STORY: METROHEALTH
14
• Background
• Implemented TeamSTEPPS in 2013
• Became a RTC in 2014
• Successes
• Staff training
• Reduced C. difficile by 36%
• Reduced blood clots which resulted in cost savings of nearly $500,000
• OR and Central Sterilization increased the quality of their trays from 30% to almost 100%
WHAT NEXT? AHA’S TEAM TRAINING
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• Commitment to continuing to offer:
• Courses at Regional Training Centers across the United States
• An annual conference
• Free monthly webinars
• Growing the movement by:
• Fostering partnerships with a diverse group of individuals and
organizations
• Creating new, innovative material
• Working to support implementation at individual health systems
TEAM TRAINING NATIONAL CONFERENCE
16
Debbie Gillis Karen Chapman
Guest Speakers from Michael GarronHospital:
TeamSTEPPS Implementation at MGH
November 2017
Create Health. Build Community.
Goals
• Review current state of TeamSTEPPS
implementation at MGH.
• Share stories and lessons learned about
the implementation of TeamSTEPPS
Tools in the MGH ICU.
• How you can do it too!
TeamSTEPPS Implementation Journey at MGH
2014
Development of competency
framework. Sets groundwork for need
for enabling behaviours.
2015
Roll-out of selected communication tools to
RNs, RPNs, PCAs. Embedded in orientation.
Master Trainer certified in ICU.
2016Roll-out of
communication tools to IPP staff. ICU pilot.
Chief of StaffQuality and Safety Team
2017Development of a Quality Plan
Integration of TeamSTEPPS
tools in competency renewal
and resuscitation programs
2015 Initial Training:
Communication Tools
• Feedback
• CUS
Lessons Learned
• Giving feedback – challenging skill
• Constant reinforcement
• Leadership engagement
Implementation of TeamSTEPPS Tools
In the MGH ICU
November 2016
TeamSTEPPs Tools Implemented
in MGH ICU
Team Briefing
CUS
SBAR
Bedside Safety Check List
Closed Loop Feedback (“Call-Back”)
Team Huddle
Critical Event Debriefing
Quality and Safety Planning
• Engagement-all stakeholders
• Review of present state, including
incident reports, patient safety survey,
work being done
• Our Goal: Thoughtfulness not to create
new work and to increase our
coordinated efforts for alignment across
the organization
You can do it too!
• Start Simple
• Repetition/embed it
• Make it Stick
Start Simple and Make it Easy
• Leadership involvement
• Briefing - template
• CUS
• SBAR
• Closed Loop Communication
• Huddles
• Debriefing - template
Repetition
• Reintroduce/ remind
• Reinforce
• Integrate into other programs or training
• Include in debriefings
• Accountability feedback – annual reviews
• Embed into organizational standards
• Physician and leadership engagement
Make it Stick
Our Priorities
High Performing Teams
Speak Up for Safety
Early Warning Systems
System
Team
Individual
Guiding Principles and Alignment
with Corporate Priorities and
Opportunities
• Optimizes the use of information, people
and resources
• Increases team awareness and clarify
team roles and responsibilities
= alignment with strategic directions of the
organization
Next Steps:
• Confirm roles and responsibilities to coordinate
our focus
• Align with our QIP process including metrics
• Monitor and early planning for sustainability
• Develop corporate implementation plan
including evaluation strategy Build capacity for
future roll-out by training additional master
trainers
Create Health. Build Community.
825 Coxwell Avenue
Toronto, Ontario M4C 3E7
T: 416.461.8272
F: 416.469.6106
www.tegh.on.ca
Questions?
Tricia Swartz
Guest Speakers from the Canadian Patient Safety Institute:
Patient safety movement
1999
“To Err
Is Human”
IOM
Report
2001 2002
Halifax
Symposia on
Medical
Error
CPSI
established
(SHN in 2005)
2003
“Build a
Safer
System”
report
2004
Canadian
Adverse
Events
Study
2017201620112006
DoD
MedTeams®
ED Study
1995
PFPSC
groundwork
&
established
1.36
2015Three ground breaking
reports released which
necessitated a change
in thinking
• Cancer 75,112
• Heart Disease 49,891
• Patient Safety Incidents – 28,000
• Cerebrovascular Disease – 13,400
• Chronic Lower Respitory Disease – 11,976
• Accidents – 11,425
• Diabetes Mellitus 7,045
Why now?
Statistics Canada (Table 102-0561) 2013; RiskAnalytica
• Risk Analytica diagram
Cost to our system
• Patient safety incidents resulted in 28,000 death across Canada in acute and homecare (2013)
Over the next 30 years• 400,000 pt. safety incidents (PSI) within home care
and acute care• This equates to an additional 2.75 billion in healthcare
costs• The Patient Safety Incidents and costs incurred as
considered preventable
Patient safety today and future
• TeamSTEPPS Canada Master Trainer Education CentresPilot project to launch January 2018 in partnership with Health Quality Council of Alberta
• TeamSTEPPS Canada call series and community buildingdetails to be announced soon
• TeamSTEPPS Master Trainer education through CPSI
What’s Next?
Questions