TeamSTEPPS Fundamentals Course: Module 6. Mutual Support
Slide 1: Mutual Support
Slide 2: Objectives
Slide 3: Mutual Support
Slide 4: Mutual Support
Slide 5: Task Assistance
Slide 6: Task Assistance Example
Slide 7: What Is Feedback?
Slide 8: Types of Feedback
Slide 9: Characteristics of Effective Feedback
Slide 10: Providing Effective Feedback Video
Slide 11: Feedback Exercise
Slide 12: Advocacy and Assertion
Slide 13: The Assertive Statement
Slide 14: Two-Challenge Rule
Slide 15: Two-Challenge Rule
Slide 16: Two-Challenge Rule, cont.
Slide 17: Please Use CUS Words but only when appropriate!
Slide 18: Advocacy and Assertion Scenario
Slide 19: Conflict in Teams
Slide 20: Conflict Resolution: DESC Script
Slide 21: DESC-It
Slide 22: A DESC Scenario
Slide 23: Tools & Strategies Summary
Slide 24: Applying TeamSTEPPS Exercise
- Describe how mutual support affects team processes and outcomes.
- Discuss specific strategies to foster mutual support (e.g., task assistance, feedback).
- Identify specific tools to facilitate mutual support.
- Describe conflict resolution strategies.
- Dependent upon information gathered through situation monitoring.
- Moderated by the communication of information.
- Enhanced by leaders who encourage and role model mutual support behaviors.
Mutual support involves members:
- Assisting each other.
- Providing and receiving feedback.
- Exerting assertive and advocacy behaviors when patient safety is threatened.
Team members foster a climate in which it is expected that assistance will be actively sought and offered as a method for reducing the occurrence of error.
Two members of the GI Laboratory are assessing an elderly patient who has just had conscious sedation for a colonoscopy. The monitor shows SVT at a rate of 150 and a BP of 76/48. The nurse calls out the vital signs while the physician continues to monitor the rhythm. A nurse passing by the room hears the call-out.
Feedback is information provided for the purpose of improving team performance.
- Retrospective and typically scheduled in advance.
- Has an evaluative quality.
- Examples: Collaborative discussions, case conferences, individual performance reviews.
- Typically in real time.
- Provided on an ongoing basis.
- Focuses on knowledge and practical skills development.
- Examples: Huddles, debriefs.
Effective Feedback is—
- Directed toward improvement:
- Helps prevent the same problem from occurring in the future.
Select the link below to access the video.
Feedback (Flash video, 29 sec.)
An attending watches an intern start to place a chest tube in an obese patient in an incorrect location.
How would you provide effective feedback?
- Advocate for the patient:
- Invoked when team members' viewpoints don't coincide with that of a decisionmaker.
- Assert a corrective action in a firm and respectful manner.
- Respectful and supportive of authority.
- Clearly asserts concerns and suggestions.
- Is nonthreatening and ensures that critical information is addressed.
- Five-Step Process:
- Open the discussion.
- State the concern.
- State the problem—real or perceived.
- Offer a solution.
- Obtain an agreement.
Invoked when an initial assertion is ignored...
- It is your responsibility to assertively voice your concern at least two times to ensure that it has been heard.
- The member being challenged must acknowledge.
- If the outcome is still not acceptable:
- Take a stronger course of action.
- Use supervisor or chain of command.
- Empower any member of the team to "stop the line" if he or she senses or discovers an essential safety breach.
- This is an action never to be taken lightly, but it requires immediate cessation of the process and resolution of the safety issue.
Select the link below to access the video.
CUS (Flash video, 10 sec.)
A medical floor nurse is assigned to a patient following a myocardial infarction. The attending physician provides the final treatment, reviews the clinical situation, and determines that the patient is well enough to be discharged.
Before the patient is discharged, the nurse checks the patient's vitals one last time. The nurse finds it unusual that the blood pressure and heart rate are substantially elevated.
(We have different information!) → Two-Challenge Rule or DESC Script
(Hostile and harassing behavior) → DESC Script
A constructive approach for managing and resolving conflict
D—Describe the specific situation.
E—Express your concerns about the action.
S—Suggest other alternatives.
C—Consequences should be stated.
- Have timely discussion.
- Work on win-win.
- Frame problem in terms of your own experience.
- Choose a private location.
- Use "I" statements; avoid blaming statements.
- Critique is not criticism.
- Focus on what is right, not who is right.
A nurse feels that a patient has abdominal distension and pain secondary to a distended bladder and needs a Foley catheter. The nurse receives the order from the resident on call. When the attending later realizes that the order was given without his consent, he raises his voice to the resident in front of staff and the patient.
|Barriers||Tools and Strategies||Outcomes|
- Is your teamwork issue related to mutual support?
- If yes, what is the mutual support issue?
- Which mutual support tools or strategies might you consider implementing to address the issue?