Team Check-up Tool

CUSP Toolkit

Purpose of the tool: This tool helps assess unit strengths and opportunities for improving unit processes and upgrading unit safety culture.

Who should use this tool? Health care providers.

Directions: Your team should collectively complete one Team Check-up Tool every month and submit it to the project lead. The information collected will be used for individual coaching assistance and reported in aggregate with other units' Team Check-up Tool results.

State:

Hospital Name:

Date:

 

  Knowledge/Skills Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
1 Five randomly selected staff members (e.g., nurses, physicians) from our unit can list at least three interventions that are part of the CUSP project.          
2 Unit staff are confused about how to proceed with project activities to improve safety.          
3 All staff can communicate the project's goals.          
4 All team members can list the number of days between incidents on the unit.          
5 There are good systems in our unit to ensure we meet the goal of <Insert a safety measure here>.          
6 There is a lack of quality improvement skills on our team.          
7 We perform a unit analysis for each incident using the Learning from Defects Tool.          
  Attitudes/Beliefs Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
1 We have had ownership from staff members in this unit.          
2 We have had good ownership from physician staff in this unit.          
3 We have had good ownership from nursing staff in this unit.          
4 Staff in this unit do not believe that <incident> is an issue for this unit.          
5 A junior staff member feels comfortable questioning a more senior staff member who is not following the <Insert a safety measure here>.          
6 Our senior executive can state three safety concerns the staff have identified.          
  Resources Strongly Disagree Disagree Neither Agree nor Disagree Agree Strongly Agree
1 Our team meets at least once a month.          
2 There is not enough time to get our team's work done.          
3 Unit leadership (managers, physicians, opinion leaders) is stable (i.e., low turnover).          
4 Data collection has not been a burden.          
5 Staff do not have time to collect maintenance data.          
Page last reviewed December 2012
Internet Citation: Team Check-up Tool. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/cusptoolkit/toolkit/teamcheckup.html