Assemble Module Alternate Text

Slide Number and TitleSlide ContentContent for Alternative Text (Illustration)
Slide 1
Cover Slide
(CUSP Toolkit logo)The "Assemble the Team" module of the Comprehensive Unit-Based Safety Program (CUSP) Toolkit. The CUSP toolkit is a modular approach to patient safety, and modules presented in this toolkit are interconnected and are aimed at improving patient safety.
Slide 2
Learning Objectives
  1. Understand the importance of your CUSP team
  2. Develop a strategy to build a successful team
  3. Identify characteristics of successful teams and barriers to team performance
  4. Define roles and responsibilities of team members
 
Slide 3
The Unit-Based CUSP Team
  • Understands that patient safety culture is local
  • Composed of engaged frontline providers who take ownership of patient safety
  • Includes staff members who have different levels of experience
  • Tailored to include members based on clinical intervention
  • Meets regularly (weekly or at least monthly)
  • Has adequate resources
Team members standing together.
Slide 4
CUSP Team Members
  • Nurses (including Nurse educator, Nurse manager)*
  • Physicians*
  • Senior executives*
  • Infection preventionists
  • Medical directors
  • Pharmacists
  • Respiratory therapists
  • Patient safety officers
  • Chief quality officers
  • Ancillary staff

*Key team members

The categories of Nurses, Physicians, and Senior executives have a star next to them, indicating they are key team members.
Slide 5
Team Characteristics1

CUSP

  • Has diverse local "opinion leaders" and dissenters
  • Is willing to help to spread the intervention

(Both)

  • Has strong team leadership
  • Sets defined team roles and responsibilities
  • Maintains clear values and shared vision
  • Contains mechanisms for collaboration and feedback

TeamSTEPPS

  • Develops a strong sense of collaborative trust and confidence
  • Manages and optimizes performance outcomes
  • Develops a strong sense of collective trust, team identity, and confidence
Venn Diagram depicting the similarities and differences between CUSP and TeamSTEPPS. CUSP teams have diverse local "opinion leaders" and dissenters that are willing to help spread the intervention.

Both CUSP and TeamSTEPPS teams emphasize strong team leadership, set defined team roles and responsibilities, maintain clear values and shared vision, and contain mechanisms for collaboration and feedback.

TeamSTEPPS teams develop a strong sense of collaborative trust and confidence; manage and optimize performance outcomes; and develop a strong sense of collective trust, team identity, and confidence.

Slide 6
Team Member Characteristics1

CUSP

  • Maintain positive outlook
  • Emphasize dedication to project aims
  • Focus on a broader view
  • Practice attention to detail

Both

  • Understand roles and responsibilities

TeamSTEPPS

  • Provide quality information and feedback
  • Skillful conflict management
  • Stress reduction for the whole team through better performance
Venn Diagram depicting the similarities and differences between CUSP and TeamSTEPPS.

CUSP team members have a positive outlook, a dedication to project aims, and a focus on a broader view, and they are detail oriented.

Both CUSP and TeamSTEPPS team members understand their roles and responsibilities.

TeamSTEPPS team members provide quality information and feedback, skillful conflict management and stress reduction for the whole team through better performance.

Slide 7
Building Your CUSP Team
(vignette still)Video icon
Slide 8
CUSP Teams’ Group Processes

Effective Group Processes include

  • Role Clarity
  • Effective Team Communication
  • Conflict Resolution
  • Education and Engagement
  • Leadership Buy-in and Support
  • Norms
Effective group processes include role clarity, effective team communication, conflict resolution, education and engagement, and leadership buy-in and support and norms. 
Slide 9
Team Performance

Inputs

  • Environment
  • Hospital unit and context
  • Team composition
  • Task design

Processes

  • Inside team
  • Outside team
  • Team traits

Outputs
Change in:

  • Performance
  • Attitudes
  • Behaviors
Inputs into team performance are environment, hospital unit and context, team composition, and task design,

Processes that are developed as a result of the inputs affect events that take place within the team and outside the team and influence team traits.

Outputs from the inputs and processes produce a change in performance, attitudes, and behaviors that influence team performance.

Slide 10
Barriers to Team Performance1
  • Inconsistency in team membership
  • Lack of time
  • Lack of information sharing
  • Hierarchy
  • Varying communication styles
  • Presence of conflict
  • Lack of coordination and follow up
  • Misinterpretation of cues
  • Lack of role clarity
Team member standing before a brick wall.
Slide 11
Stages of Engagement
  • Engagement: "To involve one’s self or become occupied; to participate fully and deeply"
  • Active support of the project
    1. Engaged
    2. Apathy
    3. Aversion
    4. Uninvolved
An arrow sweeps upward and, starting from the bottom, contains the terms "uninvolved," "aversion," "apathy," and "engaged."
Slide 12
Engage Team Members Using the 4 E’s2
  • Engage (adaptive)
    • How does this make the world a better place?
  • Educate (technical)
    • What do we need to know?
  • Execute (adaptive)
    • What do we need to do? What can we do with our resources and culture?
  • Evaluate (technical)
    • How do we know we improved safety?
  • Senior leaders
  • Team leaders
  • Staff
The roles of staff, team leaders and senior leaders are interconnected when unit teams apply the 4 E’s. The 4 E’s require teams and their leaders to Engage, Educate, Execute, and Evaluate their involvement in the CUSP program.

Gears symbolizing the roles of staff, unit team leaders, and senior leadership depict the interconnected and dependent relationship that exists between each aspect of the unit team.

Slide 13
Using the 4 E’s
(vignette still)
Click to play
Video icon
Slide 14
The CUSP  Project Leader’s Role
  • Encourages unit staff involvement
  • Obtains staff feedback
  • Manages documentation of CUSP activities
  • Educates staff about CUSP
  • Is a frontline provider, nurse educator, physician, or other staff member
A female project leader figure positioned in front of other team members.   
Slide 15
Engage Physicians on the CUSP Team
  • Identify physician leaders
  • Create an understanding of this role
  • Listen to physician concerns
  • Develop plans to address concerns
  • Reward physician leaders
  • Create a vehicle for communication
  • Develop a plan for communications
The steps to engage physicians are listed in rectangles in two rows. The top row contains four rectangles: Identify physician leaders, Create an understanding of this role, Listen to physician concerns, and Develop plans to address concerns. The bottom row contains three rectangles: Reward physician leaders, Create a vehicle for communication, and Develop a plan for communications.
Slide 16
The Physician Champion’s Role
  • Serves as role model for CUSP activities
  • Meets with CUSP team at least monthly
  • Participates in monthly senior executive partnership meetings
  • Communicates with physician group as needed
  • Assists with implementation of interventions
A male physician figure positioned in front of other team members.   
Slide 17
Physician Engagement
(vignette still) – In correctVideo icon
Slide 18
Engage Other CUSP Team Members
  • Nurses
  • Executive partners
  • Infection preventionists
  • Patient safety officers
Team members standing together.
Slide 19
The Senior Executive’s Role
  • Facilitates improvement efforts
  • Helps the team navigate organizational bureaucracy
  • Ensures the CUSP team has resources to fix problems
  • Makes rounds and meets monthly with members of health care team on the unit
A female executive positioned in front of the other team members.   
Slide 20
The Nurse Manager’s Role
  • Supports CUSP activities
  • Ensures safety assessment results are shared with staff
  • Assigns project leaders to interventions
  • Assists with scheduling executive partnership
  • Manages local resources
A male nurse manager positioned in front of the other team members.
Slide 21
The Patient Safety Coordinator/ Patient Safety Officer’s Role
  • Serves as a senior executive partner in some institutions
  • Coordinates executive orientation
  • Verifies that surveys are analyzed and results are reviewed in a timely manner
  • Monitors progress of the intervention
  • Disseminates results and shares stories
A male patient safety coordinator positioned in front of other team members.
Slide 22
Psychological Safety3

Psychological safety is the degree to which team members feel that their environment supports the interpersonal risk involved in asking for help or learning from mistakes.

Team members who promote psychological safety will:

  • Invite input from all team members
  • Encourage team members to contribute
  • Promote active listening and learning from each other
  • Ensure all team members are accessible
  • Acknowledge the limits of current knowledge
 
Slide 23
Psychological Safety
(vignette still)Video icon
Slide 24
Exercise
  • Create your team with attention to who is on the team.
  • Carefully plan how you will act as a unified group.
  • Do a "pre-mortem" assessment. If this project were to fail, why would it? What could the team have done to prevent failure?
Exercise icon
Slide 25
Assemble the Team: What the
Team Needs To Do
  • Recruit a team lead, nurse manager, physician, and executive partner along with any other team members
  • Meet with hospital departments (risk management, quality improvement, infection prevention) to ensure that CUSP efforts are integrated into overall hospital quality improvement and patient safety efforts
  • List team member names and contact information on the Background Quality Improvement Team Information Form and post the form in a central location 
  • Use the 4 Es to ensure team engagement:
    1. Engage them in the process
    2. Educate them about their roles
    3. Execute the processes
    4. Evaluate what you did
 
Slide 26
Summary
  • The CUSP team will include health care providers, support and leadership staff.
  • The "4 E’s" is a highly effective tool for recruiting team members
  • Team members work together to identify barriers and address them as a group
  • For teams to be successful, the roles and responsibilities of team members need to be clearly defined
 
Slide 27
TeamSTEPPS Tools1
  • Briefing Checklist
  • Debrief Checklist

*Please refer to the Implement Teamwork and Communication module for more information.*

Tools icon

TeamSTEPPS logo and penguin

Slide 28
CUSP Tools
  • Background Quality Improvement Team Information Form
  • Culture Check-up Tool
Tools icon
Slide 29
References
  • Agency for Healthcare Research and Quality, Department of Defense. TeamSTEPPS.  www.ahrq.gov/teamsteppstools/instructor/index.html
  • Pronovost PJ, Berenholtz SM, Goeschel CA, et al. Creating high reliability in health care organizations Health Serv Res 2006;41(4, pt 2):1599–1617.
  • Edmondson, AC. Managing the Risk of Learning: Psychological Safety in Work Teams. In West M, ed. International Handbook of Organizational Teamwork. London: Blackwell; 2003.
 
Current as of March 2013
Internet Citation: Assemble Module Alternate Text. March 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/modules/assemble/assemblealttext.html