Appendix C: Team Performance Observation Tool

TeamSTEPPS Course Management Guide

TeamSTEPPS is a teamwork system developed jointly by the Department of Defense (DoD)and the Agency for Healthcare Research and Quality (AHRQ) to improve institutional collaboration and communication relating to patient safety.

Team Performance Observation Tool

Date: _________________________
Unit: _________________________
Team: _________________________
Shift: _________________________

Rating Scale (circle 1)
Please comment if 1 or 2

1 = Very Poor
2 = Poor
3 = Acceptable
4 = Good
5 = Excellent

1. Team StructureRating
a.  Assembles a team. 
b.  Establishes a leader. 
c.  Identifies team goals and vision. 
d.  Assigns roles and responsibilities. 
e.  Holds team members accountable. 
f.  Actively shares information among team members. 

Comments:

Overall Rating - Team Structure

 
2. LeadershipRating
a.  Utilizes resources efficiently to maximize team performance. 
b.  Balances workload within the team. 
c.  Delegates tasks or assignments, as appropriate. 
d.  Conducts briefs, huddles, and debriefs. 
e.  Empowers team members to speak freely and ask questions. 

Comments:

Overall Rating - Leadership

 
3. Situation MonitoringRating
a.  Includes patient/family in communication. 
b.  Cross monitors fellow team members. 
c.  Applies the STEP process when monitoring the situation. 
d.  Fosters communication to ensure team members have a shared mental model. 

Comments:

Overall Rating - Situation Monitoring

 
4. Mutual SupportRating
a.  Provides task-related support. 
b.  Provides timely and constructive feedback to team members. 
c.  Effectively advocates for the patient. 
d. Uses the Two-Challenge rule, CUS, and DESC script to resolve conflict. 
e. Collaborates with team members. 

Comments:

Overall Rating - Mutual Support

 
5. CommunicationRating
a.  Coaching feedback routinely provided to team members, when appropriate. 
b.  Provides brief, clear, specific and timely information to team members. 
c.  Seeks information from all available sources. 
d.  Verifies information that is communicated. 
e.  Uses SBAR, call-outs, check-backs and handoff techniques to communicate effectively with team members. 

Comments:

Overall Rating - Communication

 
TEAM PERFORMANCE RATING 

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Current as of November 2008
Internet Citation: Appendix C: Team Performance Observation Tool: TeamSTEPPS Course Management Guide . November 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/coursemgmtappc.html