TeamSTEPPS 2.0: Module 11. Implementation

Classroom Slides

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.

Contents

Slide 1: Implementation Planning
Slide 2: Objectives
Slide 3: Shift Toward A Culture Of Safety
Slide 4: Key Principles of Implementation
Slide 5: 10 Steps of Implementation Planning
Slide 6: Describe the Targeted Unit/Work Area
Slide 7: Step 1: Create a Change Team
Slide 8: Step 2: Define the Problem or Opportunity for Improvement
Slide 9: Example: Problem Definition
Slide 10: Step 3: Define the Aims of TeamSTEPPS Intervention
Slide 11: Step 4: Design a TeamSTEPPS Intervention
Slide 12: Step 5: Develop a Plan for Testing Your TeamSTEPPS Interventions
Slide 13: Step 6. Develop an Implementation Plan
Slide 14: Determine How Coaches May Be Used
Slide 15: Step 7: Develop a Sustainment Plan:
Slide 16: Step 8: Develop a Communications Plan
Slide 17: Step 9. Develop an Implementation Plan Timeline
Slide 18: Change Team Meetings
Slide 19: Step 10: Review Your Plan with Key Stakeholders
Slide 20: TeamSTEPPS Implementation Planning Exercise
 


Slide 1: Implementation Planning

Implementation Planning

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Slide 2: Objectives

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  • Describe the steps involved in implementing TeamSTEPPS.
  • Develop a TeamSTEPPS Implementation Plan.

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Slide 3: Shift Toward A Culture Of Safety

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Image: The shift process has three phases.

Phase 1: Assessment. Pretraining assessment includes site assessment, culture survey and data/measures. Are these ready? If no, pass through climate improvement and return to pretraining assessment. If yes proceed to action plan and then move on to Phase 2.

Phase 2: Planning, training and implementation. Training leads to intervention. Intervention includes testing and leads to Phase 3.

Phase 3: Sustainment. This phase includes culture change: coach and integrate, monitor the plan, and continuous improvement. Continuous improvement includes going back to training to lead to more culture change.

In short: Set the stage, decide what to do, make it happen and make it stick.

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Slide 4: Key Principles of Implementation

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  • The Implementation Guide is based on the principle of improving patient safety and quality of care by improving health care team processes. Key activities include:
    • Identifying a recurring problem or opportunity for improvement.
    • Developing a flowchart or map of the process.
    • Studying the process to identify risk points.
    • Implementing interventions aimed at eliminating the risk points.
    • Testing the intervention.
    • Sustaining positive changes.

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Slide 5: 10 Steps of Implementation Planning

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  1. Create a Change Team.
  2. Define the Problem, Challenge, or Opportunity for Improvement.
  3. Define the Aim(s) of your TeamSTEPPS Intervention.
  4. Design a TeamSTEPPS Intervention.
  5. Develop a Plan for Testing the Effectiveness of Your TeamSTEPPS Intervention.
  6. Develop an Implementation Plan.
  7. Develop a Plan for Sustained Continuous Improvement.
  8. Develop a Communications Plan.
  9. Develop a TeamSTEPPS Implementation Plan timeline.
  10. Review your TeamSTEPPS Implementation Plan With Key Stakeholders and Modify According to Input.

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Slide 6: Describe the Targeted Unit/Work Area

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Key Actions:

  • Describe the targeted unit or work area:
    • Unit/Work area name.
    • Size in terms of number of beds or admissions.
    • Number of staff by profession.

Name of targeted unit/work area:

Size of unit/work area:

Number of staff within unit/work area:

  • Physicians:
  • Nurses:
  • Other:

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Slide 7: Step 1: Create a Change Team

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Key Actions:

  • Select a multidisciplinary Change Team.
  • Ensure representation from different leadership levels.
  • Ensure at least one member has completed TeamSTEPPS Master Training.
  • Ensure one member has experience in performance improvement.

Team Member Role TeamSTEPPS Trained?
     
     
     
     
     
     

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Slide 8: Step 2: Define the Problem or Opportunity for Improvement

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Key Actions:

  • Review unit performance and safety data:
    • Incident reports.
    • AHRQ patient safety survey.
    • Clinical process and outcome measures.
  • Review RCAs and/or FMEAs.
  • Ask frontline staff.
  • Conduct the Magic Wand exercise.
  • Refer to the teamwork issue you identified on the TeamSTEPPS Implementation Worksheet as a starting point, if applicable.

What existing information will you review?

What new information will you collect?

What are the main problems and opportunities?

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Slide 9: Example: Problem Definition

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Problem:

Suboptimal communication among surgical team members.

Team Process:

  • What: Communication of critical information about the patient and surgical procedure.
  • Who: Surgeons, anesthesiologists, operating room nurses, and scrub technicians in the General Surgery Service.
  • When: Just prior to first incision.
  • Where: In the operating room.

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Slide 10: Step 3: Define the Aims of TeamSTEPPS Intervention

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Key Actions:

  • Develop one to three measurable aims:
    • What do you hope to achieve?
    • Who will be involved?
    • When and where will the improvements occur?
  • Consider including team process, team outcome, and clinical outcome aims.

Team Process Aim(s)

Team Outcome Aim(s)

Clinical Outcome Aim(s)

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Slide 11: Step 4: Design a TeamSTEPPS Intervention

 

Key Actions:

  • Flowchart or map the process during which the target problem/challenge/opportunity occurs.
  • Identify risk points.
  • Determine which TeamSTEPPS tools or strategies would work best to eliminate the process risk points.
  • State what tools and strategies will be implemented; who will use them, when and where (Refer to your responses on the TeamSTEPPS Implementation Worksheet, if applicable).
  • Evaluate your TeamSTEPPS intervention for potential benefits and negative effects.

List the risk points you intend to address

List the TeamSTEPPS tools and strategies that will be implemented

List the order in which the tools and strategies will be implemented

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Slide 12: Step 5: Develop a Plan for Testing Your TeamSTEPPS Interventions

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Key Actions:

  • Identify who on your Change Team will be responsible for data collection, analysis, and presentation (generation of graphs and charts).
  • Identify a measure and define target ranges for that measure.
  • Measure before and after you implement TeamSTEPPS.
  • Consider Kirkpatrick's taxonomy when selecting measures.

Who is responsible?

At what level will you measure and what measures will you use?

  1. Level I Reactions.

 

  1. Level II Learning.

 

  1. Level III Behavior.

 

  1. Level IV Results.

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Slide 13: Step 6. Develop an Implementation Plan

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Key Actions:

  • Determine who needs to be trained on what TeamSTEPPS skills and by when.
  • Develop a training plan for each audience.
  • Determine if refresher training is required.
  • Create training timelines.

Who will attend the training sessions?

 

What skills will you train?

 

When will the training sessions occur and for how long?

 

Where will the sessions occur?

 

How will you train (method of presentation, tools, supplies)?

 

What are the logistics to consider?

 

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Slide 14: Determine How Coaches May Be Used

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Key Actions:

  • Determine whether coaches will be used to facilitate sustainment.
  • If coaches will be used, determine:
    • How many are needed.
    • When and how they will be trained.
    • How they will be used.
    • Expectations for the role of coaches.

Will coaches be used?

 

If Yes:

 

Number required:

 

When will coaches be trained?

 

How will coaches be trained?

 

How will coaches be used?

 

What are the expectations for the role of coaches?

 

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Slide 15: Step 7: Develop a Sustainment Plan

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Key Actions:

  • For your monitoring plan, determine:
    • Measures and target outcomes.
    • Data source (e.g., existing QI database).
    • Resources required (money, time, equipment, personnel, expertise).
    • Person(s) responsible for implementation and oversight.
  • Determine how data from your monitoring plan will be used to continually improve processes and performance.

Identify Components of a Monitoring Plan:

  1. Measures and Targeted Outcomes.

 

  1. Data Sources.

 

  1. Resource Requirements.

 

  1. Individual Responsible.

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Slide 16: Step 8: Develop a Communications Plan

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Key Actions:

Develop a communication plan:

  • Identify goals for communication with this group. What do you want to achieve?
  • Who will receive the information?
  • What information will you communicate?
  • When and how often will you communicate?
  • How will you communicate (e.g., reports, presentations, Emails)?

Who are the stakeholders?

What do you want to achieve?

What information will you communicate?

When will you communicate?

How will you communicate?

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Slide 17: Step 9. Develop an Implementation Plan Timeline

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Step Lead Completion Date Resources Required
1. Identify the Change Team      
2. Define the Main Problems      
3. Define TeamSTEPPS Aims      
4. Describe the Intervention      
5. Develop a Test Plan      
6. Develop an Implementation Plan      
7. Develop a Monitoring Plan      
8. Develop a Communication Plan      

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Slide 18: Change Team Meetings

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Purpose Lead Meeting Date
     
     
     
     
     
     
     
     

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Slide 19: Step 10: Review Your Plan with Key Stakeholders

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Key Actions:

  • Identify stakeholders who could contribute significantly to the Implementation Plan.
  • Ask key stakeholders to review your Action Plan and to provide input.
  • Modify your Action Plan based on their input, if needed.

Who are the key stakeholders that need to review the plan?

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Slide 20: TeamSTEPPS Implementation Planning Exercise

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  • Break into working groups by unit or by best alignment of common issues.
  • Develop your Action Plan based on the 10-step process.
  • Be ready to present and discuss your Action Plan with the larger group.

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Page last reviewed March 2014
Internet Citation: TeamSTEPPS 2.0: Module 11. Implementation: Classroom Slides. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module11/slimplement.html