Appendix A. Team Roster

AHRQ Safety Program for Long-Term Care: HAIs/CAUTI

This template provides suggestions about roles, characteristics, and responsibilities for members of your improvement team. Develop your team and document influential and respected leaders, clinicians, frontline staff, and residents and families who will provide primary and backup support for each core team member's role.

Create a Team
Objective: To assemble a core team of influential leaders and staff members necessary to drive successful implementation of the AHRQ Safety Program for Long-Term Care: Preventing Catheter-Associated Urinary Tract Infections (CAUTI) and other healthcare-associated infections (HAIs) at your facility.
Instructions: Review key characteristics of each core team member role and suggested responsibilities to determine who should be on the team. We recommend that you include backup (alternate or deputy) team members to support each suggested core team member's role and responsibilities. On the next page, use the matrix to build consensus and determine each role's responsibilities.

 

Name(s) Team Member Role Key Characteristics Suggested Responsibilities
1.

2.

Team Leader Ability to engage staff through persistence, commitment, continuity, style, and collaboration
Energized; positive attitude
Data driven
  • Understand and clearly articulate program goals.
  • Recruit, guide, and manage the team.
  • Establish systems for implementation, delegate tasks, and hold others accountable.
  • Ensure all staff, on all shifts, are educated about CAUTI and/or other HAI interventions.
  • Track and facilitate a review of data/progress.
1.

2.

Administrative Champion Senior policy and delivery support
Energized; positive attitude
  • Align project goals with organizational goals.
  • Sponsor and visibly support the team to make the work a priority.
  • Commit time and resources to achieve objectives.
  • Meet regularly with the team to review data/progress.
  • Facilitate the removal of barriers.
  • Share progress with senior leadership and board of directors.
1.

2.

Infection Preventionist Data driven
Collaborative
Problem solver
Advocate
  • Ensure data collection/entry is up to date.
  • Meet regularly with the team to review data/progress.
  • Assist in developing, implementing, and/or monitoring infection control strategies.
  • Serve as the infection control expert/consultant.
  • Communicate goals and progress in meetings and other settings within the facility.
1.

2.

Physician Champion Resourceful
Problem solver
Influencer
Data driven
  • Educate peers about HAIs/CAUTI prevention best practices.
  • Actively work with the team to develop and implement strategies to remove barriers physicians and others may have.
1.

2.

Nurse Champion Energized; positive attitude
Collaborative
Influencer
Advocate
  • Educate peers about HAIs/CAUTI prevention best practices.
  • Actively work with the team to develop and implement strategies to prevent HAIs/CAUTI and to improve teamwork and patient safety.
  • Empower nurses and other staff to stop procedures if protocols are not being followed.
  • Identify practical ways to assist in standardizing indwelling urinary catheter insertion and maintenance.
  • Achieve daily assessment for device necessity.
1.

2.

Frontline Champion Resourceful
Problem solver
  • Inspire others to commit to goals and interventions.
  • Educate peers formally and by modeling.
  • Identify practical ways to assist in standardizing indwelling urinary catheter maintenance and care.
  • Identify practical ways to assist in standardizing infection prevention practices.

Bibliography
1. Action Planning Worksheets. TeamSTEPPS Implementation Guide. Rockville, MD: Agency for Healthcare Research and Quality; October 2014.
2. Appendix A. Checklists for Assessing Executive and Physician Champion Potential. Toolkit for Reducing Catheter-Associated Urinary Tract Infections in Hospital Units: Implementation Guide. Rockville, MD: Agency for Healthcare Research and Quality; October 2015.

Instructions: Review the suggested responsibilities for each core team member role listed on the team roster and use this matrix to build consensus among staff and determine each role's responsibilities. Alternatively, you can use this tool to begin planning suggested responsibilities of each role to discuss with the team. Check each box when responsibilities are agreed upon for each role.

Team Responsibilities Team Leader Administrative Champion Physician Champion Nurse Champion Frontline Champion Infection Preventionist
Advocate for project goals with peers            
Represent team to leadership and committees            
Prioritize safety defects            
Meet regularly to review progress            
Educate peers about HAIs/CAUTI and infection prevention practices            
Identify and implement strategies to overcome barriers            
Empower nurses and other staff to stop procedures if protocols are not followed            
Collect and review data            
Support implementation of recommendations            
Page last reviewed March 2017
Page originally created March 2017
Internet Citation: Appendix A. Team Roster. Content last reviewed March 2017. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/implement/team-roster.html