A TeamSTEPPS Initiative occurs in three continuous phases: Phase I—Assessment; Phase II—Planning, Training, & Implementation; and Phase III—Sustainment. A health care organization or work unit can shift toward a culture of safety using team tools and strategies by progressing through each of the three phases and completing the key actions within each phase. The TeamSTEPPS Initiative provides guidelines, tools, and resources for completing each phase and for gathering data necessary for progression to the next phase. Keys to success at each phase include involvement of the right people, use of information-driven decisionmaking, and careful planning before acting. The following paragraphs provide an overview of each of the phases, including goals and objectives, key actions, and recommended tools and resources.
Implementation At-A-Glance Figure
Phase I: Assessment
The goal of Phase I is for an organization (or work unit) to determine if it is ready to undertake a TeamSTEPPS Initiative. An organization is ready if it has (a) a climate conducive to change and (b) objective information to support the need for a TeamSTEPPS Intervention. A climate conducive to change is characterized by leadership and key staff members who are committed to making a change and who are willing and able to dedicate the necessary time, resources, and personnel.
During Phase I, an initial Change Team (the group of individuals who will drive the TeamSTEPPS Initiative) is formed of leaders and key staff members, who determine organizational readiness for undertaking the TeamSTEPPS Initiative by conducting a Site Assessment and reviewing available organizational data.
At the completion of Phase I, an organization decides that it is or is not ready for a TeamSTEPPS Initiative. If the Change Team determines that the organization is not ready but believes that a TeamSTEPPS Initiative would likely benefit safety and quality of care, they should make efforts to move the organizational climate toward readiness and to collect objective data that would support the need for the initiative. If the Change Team determines that the organization IS ready for a TeamSTEPPS Initiative, they will proceed through the three phases.
Phase II: Planning (Action Plan), Training, and Implementation
The goal of Phase II is for the Change Team to develop a detailed Action Plan for their entire TeamSTEPPS Initiative and then to follow that Plan to conduct medical team training and to implement the TeamSTEPPS Intervention. Three key actions occur during Phase II—writing a TeamSTEPPS Action Plan, conducting medical team training, and implementing (and testing) the TeamSTEPPS Intervention.
Phase III: Sustainment—Monitor, Coach, and Integrate
The goal of Phase III is to sustain and spread improvements in teamwork behavior and in associated clinical processes and outcomes resulting from the TeamSTEPPS Initiative. Specific objectives are to integrate key elements of the TeamSTEPPS Initiative into normal daily routines, to monitor the ongoing effectiveness of medical team training and the TeamSTEPPS Intervention, to identify opportunities for continued improvement, and to spread positive changes throughout the organization.
Tools & Resources:
- Measurement Tools: AHRQ Patient Safety Culture Survey, Patient and Staff Satisfaction Surveys, Team Assessment Questionnaire, Team Performance Observation Tool, Learning Benchmarks, and site specific process and outcome measures.
- TeamSTEPPS Training Techniques, Sample Course Evaluation
- Guide to Developing a TeamSTEPPS Action Plan
- Massoud MR et al. A Framework for Spread: From Local Improvements to System-wide Change. IHI Innovation Series white paper. Cambridge, MA: Institute for Healthcare Improvement; 2006. (Available on http://www.ihi.org/resources/Pages/IHIWhitePapers/AFrameworkforSpreadWhitePaper.aspx)
- How-to Guide: Running a Successful Campaign in Your Hospital. Institute for Healthcare Improvement 100,000 Lives Campaign; 2006. (Available on http://www.ihi.org/resources/Pages/Tools/HowtoGuideRunningSuccessfulCampaign.aspx)
- How-to Guide: Sustainability and Spread. Institute for Healthcare Improvement 100,000 Lives Campaign; 2006. (Available on http://www.ihi.org/resources/Pages/Tools/HowtoGuideSustainabilitySpread.aspx)