TeamSTEPPs National Implementation (Text Version)

Slide Presentation from the AHRQ 2008 Annual Conference

On September 10, 2008, Robert J. McQuillan, M.D., made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (2 MB; Plugin Software Help).

Slide 1

TeamSTEPPs^® National Implementation

Creighton as a Living Lab & Team Resource Center (TRC)

Slide 2

Creighton's Search for Team Training

• High Quality.
• Accessible.
• Cost effective.
• Private companies offer Team Training—Quality? Cost?
• TeamSTEPPs^®:
  • Met our needs.

Slide 3

Clear Organizational Roles and Actions

Screen shot of a flowchart with the following information:

• Sponsoring VP & Guiding Coalition:
  • Monitors and guides the initiative.
  • Includes objectives in Walking Rounds.
  • Unblocks organizational bottlenecks.
  • Integrate outcomes into Org Report Card.

(Slide shows feedback between elements above and below)

• In-unit Change team:
  • Formal and informal leaders
    • Plan & prepare.
    • Train & Instruct.
    • Coach.
    • Develop & work teamwork improvement plans.

(Slide shows that elements above affect Staff, below)

• Staff:
  • Train.
  • Create teams.
  • Develop & maintain team climate.
  • Engage behaviors.

Slide 4

Effective Teamwork Fundamentals

• Team structure.
• Leadership.
• Situation monitoring.
• Mutual support.
• Communication.
• Combine this with a "culture of safety."

Slide 5

Impact Evaluation

• In Fiscal Year 2008-09, TeamSTEPPs^® will:
  • Continue to collect quantitative data for Level 1 and Level 2 evaluation.
  • Develop and implement standardized Level 3 & 4 assessment tools.
  • Include sustainment as part of system-wide evaluation.

Below the text is a pyramid-structured set of levels with each level bigger than the next.

Kirkpatrick's Model:

• Level 5—Return on Investment.
  Was the training worth the cost?
• Level 4—Results.
  Did the change in behavior positively affect the organization?
• Level 3—Behavior/Training Transfer.
  Did the participants change their behavior on-the-job based on what they learned?
• Level 2—Learning
  What skills, knowledge, or attitudes changed after training?
  By how much?
• Level 1—Reaction
  Did the participants like the training?
  What do they plan to do with what they learned?

Slide 6

Creighton University Medical Center (CUMC) Surgical Scores Pre- and Post TeamSTEPPs^® Training

Bar graphs show scores Pre 6 month and Post 6 month (score numbers are approximate, judging from scale on left which rises in 10-point increments)

Slide 7

CUMC Surgical Scores Pre- and Post TeamSTEPPs^® Training (continued)

Bar graphs show scores Pre 6 month and Post 6 month (score numbers are approximate, judging from scale on left which rises in 10-point increments)

Slide 8

Employee Communication and Teamwork Engagement Ratings by Area

Bar graph compares scores in 2006 and 2007; numbers are approximate, judging from scale on left which rises in 10-point increments

Both OR scores showed significant change (p <0.05)

Slide 9

Safety Culture Survey: Overall Patient Safety Grade

Bar graph shows scores; numbers are approximate judging from scale on left which rises in 10-point increments

Slide 10

Safety Culture Survey: Handoffs

Things "fall between the cracks" when transferring patients

Bar graph shows change in those agreeing Pre (n=128) and Post (n=78); scores are approximate judging from scale on left which rises in 10-point increments

Slide 11

Outpatient Surgical Patient Satisfaction Scores

Bar graph compares those "Willing to Recommend" from 3Q 2006 to 4Q 2007:

• 3Q 2006: 84.
• 4Q 2006: 84.
• 1Q 2007: 77.
• 2Q 2007: 80.
• 3Q 2007: 85.
• 4Q 2007: 89.

Slide 12

Outpatient Surgical Patient Satisfaction Scores (continued)

Bar graph compares scores on "Nursing Communication" from 3Q 2006 to 4Q 2007:

• 3Q 2006: 85.
• 4Q 2006: 89.5.
• 1Q 2007: 84.
• 2Q 2007: 80.
• 3Q 2007: 90.7.
• 4Q 2007: 91.2.

Slide 13

Outpatient Surgical Patient Satisfaction Scores (continued)

Bar graph compares scores on "Staff Provided Safe Patient Care" from 3Q 2006 to 4Q 2007:

• 3Q 2006: 88.
• 4Q 2006: 90.
• 1Q 2007: 84.
• 2Q 2007: 86.5.
• 3Q 2007: 91.
• 4Q 2007: 95.

Slide 14

Outpatient Surgical Patient Satisfaction Scores (continued)

Bar graph compares scores on "Overall Outpatient Surgery Score" from 3Q 2006 to 4Q 2007:

• 3Q 2006: 78.
• 4Q 2006: 80.
• 1Q 2007: 78.
• 2Q 2007: 81.
• 3Q 2007: 83.5.
• 4Q 2007: 83.6.

Slide 15

Outpatient Surgical Patient Satisfaction Scores (continued)

Bar graph compares scores on "Pre-op Testing Staff Explanations Clear" from 3Q 2006 to 4Q 2007:

• 3Q 2006: 78.
• 4Q 2006: 78.
• 1Q 2007: 80.
• 2Q 2007: 77.
• 3Q 2007: 90.
• 4Q 2007: 91.

Slide 16

What is a culture?

"Shared values (what is important) and beliefs (how things work) that interact with an organization's structures and control systems to produce behavioral norms (the way we do things around here)."

Slide 17

National Implementation Project

Goals:

• Create a national infrastructure to support the adoption of TeamSTEPPs^®:
  • Quality Improvement Organizations.
  • Patient Safety Improvement Corps.
• Make training available to early adopters!
  • Accelerating Change and Transformation in Organizations and Networks (ACTION) Partners.
  • Academic Medical Centers.
  • Others.
• Spread TeamSTEPPs^®.

Slide 18

National Implementation Team

Map of United States shows team members

• California—Lumetra.
• Minnesota—TRC.
• Nebraska—Creighton TRC.
• Maryland—Delmarva.
• District of Columbia region—AIR.
• District of Columbia region—Booz Allen Hamilton.
• Virginia—Carilion TRC.
• North Carolina—Duke TRC.

Slide 19

Program Progress

Slide 20

Creighton's Role as a TRC

• Provide a Team Resource Center where training can be conducted.
• Serve as a living lab where training is given.
• Trainees can take from the lessons learned at Creighton because of our rollout.
• After training our staff serves as expert resources for all those trained in this program.
• 79 Master Trainers trained at Creighton thus far.

Slide 21

Feedback on Our Work

Participant Feedback—Scores from 1 (Low) to 5 (High) on Eight Evaluation Criteria

• Well Organized: 4.43.
• Appropriate Confent: 4.41.
• Ability to Train Others: 4.
• Belief in TeamSTEPPs^®: 4.20.
• Ease to Transfer: 4.28.
• Ability to Work in Teams: 4.07.
• Likelihood to Apply: 4.28.
• Recommend: 4.33.