Team Performance Observation Tool

TeamSTEPPS Long-Term Care Instructor Guide

The Long-Term Care version of TeamSTEPPS adapts the core concepts of the TeamSTEPPS program to reflect the environment of nursing homes and other other long-term care settings such as assisted living and continuing care retirement communities. The examples, discussions, and exercises below are tailored to the long-term care environment.

Date:  _________________________________

Unit:  _________________________________

Team:  _________________________________

Shift:  ________________________________

Rating Scale (circle one) 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 resident/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 resident 
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. Routinely provides coaching feedback 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

 

Return to Contents

Current as of October 2008
Internet Citation: Team Performance Observation Tool: TeamSTEPPS Long-Term Care Instructor Guide. October 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/longtermcare/sitetools/tmpot.html