TeamSTEPPS 2.0: Module 9

Coaching Scenarios

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

Coaching Scenario 1
Coaching Scenario 2
Coaching Scenario 3
Coaching Scenario 4
Coaching Scenario 5
Coaching Scenario 6
Coaching Scenario 7
Coaching Scenario 8
Coaching Scenario 9


Coaching Scenario 1

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 1

You are assigned to coach day shift staff in the Emergency Department (ED) on teamwork skills. When you arrive at 0900, the department is very busy and there is no evidence that teams have been formed. You locate the coordinating team nurse in the department for an update, and she tells you, "We're not doing teamwork today, the ED is just too busy. I have made the assignments, and we are going to manage things "the good old fashioned way today."

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Coaching Scenario 2

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 2

A staff member comes to you complaining of being put on a team in the Surgery Clinic with a "slacker." She says, "Joan makes herself scarce and almost never offers to help her teammates, even when she has down time. I've had it!"

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Coaching Scenario 3

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 3

The on-call third-year internal medicine resident was sitting in the break room talking with the chief resident when an Intensive Care Unit (ICU) code was announced over the intercom. The two residents ran to the ICU. The chief resident arrived first and was receiving information about the patient while examining the patient, when the on-call resident reached the room and began calling out orders to the nurses without assessing the patient or learning the history. By this time, both residents were giving orders, and the Emergency Room staff became confused as to whom they should listen to. The residents then began to argue with each other because each felt his or her plan of action was right. As a result, there were orders that were not carried out because no one knew whom to listen to or who was in charge. Ultimately, the on-call staff internist arrived and took over the code, but the patient did not survive.

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Coaching Scenario 4

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 4

The department has been busy all evening. Both teams are experiencing a consistently moderate to high workload. You observe a member of the Green Team who appears to be overwhelmed by the task requirements of two demanding patients. None of the team member's teammates have come to offer him assistance, so you assume that they are equally busy with their own patients. He appears to "suck it up" and do the best he can.

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Coaching Scenario 5

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 5

The Operating Room (OR) is very quiet with the exception of one patient who needs an urgent procedure performed. The attending surgeon is running a little late, so the resident assumes situational leadership and begins to organize the team and get things started. Everything is proceeding without incident until the attending surgeon abruptly charges into the room and starts shouting out orders and criticizing the team. The procedure goes smoothly, but the team is not happy. The OR nurse approaches the resident to discuss what happened.

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Coaching Scenario 6

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 6

A 77-year-old female has been admitted for pneumonia. She has developed a mucous plug and has been transferred to the telemetry unit. The telemetry technician reports to the nurse that the telemetry is not working correctly and that several patients have had inadequate cardiac monitoring. From 1200 to 1330, the patient's cardiac strips are intermittent, a few beats then static. This is assumed to be technical malfunction rather than actual severe bradycardia. At 1331, the patient is discovered unresponsive, and a code is called. Pacing is successful and she was transferred to the Intensive Care Unit. The patient becomes minimally responsive, and life support is terminated.

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Coaching Scenario 7

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 7

You observe a confrontation at the desk area, where a physician has just reprimanded an Intensive Care Unit nurse for moving his patient to the ward without notifying him. The nurse is upset and embarrassed but later states that she has experienced this side of Dr. Pool before. She decides it is not worth discussing with him because he never listens anyway.

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Coaching Scenario 8

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 8

You observe a nurse apply the Two-Challenge rule with the team anesthesiologist during a complex procedure. The anesthesiologist continues the procedure without responding to the nurse's expressed concerns. The procedure is successfully completed. When you interview the anesthesiologist, he tells you that he has performed this procedure many times before without incident and feels he had been needlessly challenged.

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Coaching Scenario 9

Instructions:

Read the scenario below and, among your group:

  • As the coach, provide constructive and purposeful feedback to the team member about the issues.
  • As a team member, assume an interactive role by questioning and sharing information.
  • As the observer, watch the interaction between the coach and the team member. Mark your observations on the coaching feedback form.

Scenario 9

A 43-year-old male with a history of chronic back pain and past suicidal gestures has been transferred to a facility and admitted to the Inpatient Psych Unit. An orthopedic surgeon at the receiving facility examines the patient and determines that back surgery is not warranted. The patient then becomes angry and is transferred to a room across from the nurses station. The patient verbally expresses hostility toward the surgeon and about his room assignment; however, he expresses no suicidal ideation. The psychiatrist orders Q15 minute patient checks. The registered nurse (RN) acknowledges the order in the computer and passes it on to the technician, who does not acknowledge that order. At a later date, the patient refuses to attend the community meeting, complaining of back pain, which he has frequently done in the past. After the meeting, the patient is discovered hanging from the ceiling by a cord. Resuscitative measures fail. The team is devastated.

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Current as of March 2014
Internet Citation: TeamSTEPPS 2.0: Module 9: Coaching Scenarios. March 2014. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module9/coachscenarios.html