TeamSTEPPS® for Diagnosis Improvement

TeamSTEPPS® is an evidence-based program built on a framework composed of four teachable, learnable skills—communication, leadership, situation monitoring, and mutual support. The TeamSTEPPS® for Diagnosis Improvement Course applies the TeamSTEPPS® framework to the specific problem of diagnostic error.

When implementing TeamSTEPPS® for Diagnosis Improvement, teams will learn about the four skills and how improved communication among all members of the care team can help lead to safer, more accurate, and more timely diagnosis in all healthcare settings.

About the Course

Diagnostic harm is an emerging area of concern in healthcare quality and patient safety. A growing body of patient safety and risk management literature as well as care delivery research shows that diagnostic harm is both widespread and costly and that diagnostic excellence is rare. Organizations and providers need resources to mitigate diagnostic harm and few tools are available to guide such efforts.

TeamSTEPPS for Diagnosis Improvement aims to raise diagnostic safety awareness, introduce the concept of a broad multidisciplinary diagnostic team that includes nonclinicians and patients and their families, and provide assessment and training tools to support local efforts to reduce diagnostic harm. The course consists of seven PowerPoint® training modules customizable to the needs of the local team and course facilitator.

The course can be delivered virtually, in a classroom setting, or as individual self-paced learning modules. Supplemental resources for trainees include the Team Assessment Tool for Improving Diagnosis, the case study of the Diagnostic Journey of Mr. Kane, the Reflective Practice Tool, and the Postcourse Knowledge Assessment.

The Facilitator’s Guide is designed to help the course facilitator develop and deploy a customized plan to train staff in teamwork and communication skills to improve their diagnostic processes. The Participant Workbook supports trainees with course activities such as exercises, case-based scenarios, and reflective practices.

Ready To Start?

Course Facilitators: The Facilitator’s Implementation Roadmap (PDF, 355 KB) is the facilitator’s starting point for TeamSTEPPS training and provides step-by-step instructions for planning and implementing the course with a team.

Individual Self-Paced Learners: Individuals who plan to take the course but will not complete it as part of a team should follow the Self-Paced Learner’s Roadmap (PDF, 574.3 KB). This document provides step-by-step instructions to maximize the value of time spent on the course and ways to leverage core principles and tools.

Step 1: Prepare Yourself and Your Organization

• Facilitator’s Guide (PDF, 5.3 MB) is designed to help the course facilitator plan and implement a customized plan to train staff in teamwork and communication skills and improve the diagnostic process.
• Course Infographic (PDF, 716.2 KB) provides information about diagnostic errors that can be used to engage leaders and raise awareness of the problem.
• Module 1: Introduction (PowerPoint, 10.8 MB) provides an overview of the evidence on diagnostic errors and how TeamSTEPPS principles can support achieving a safe, accurate, and timely diagnosis.

Step 2: Make a Plan

• Team Assessment Tool for Improving Diagnosis (PDF, 407.5 KB) should be completed by course participants after Module 1. The results of this assessment can be used to organize training, identify modules on which to focus, and highlight communication areas to prioritize. Individuals completing the course as self-paced learners are encouraged to complete the assessment and can use their results to identify modules to prioritize and to track their perceptions over time.
• Implementation Tip Sheet (PDF, 246.2 KB) provides resources that can be used during training.
• Participant Workbook (PDF, 5.3 MB) supports trainees with course activities such as exercises, case-based scenarios, and reflective practices.

Step 3: Train Your Team or Yourself

• Core Learning Modules:
  • Module 1: Introduction (PowerPoint, 10.8 MB; Facilitator's Notes, PDF, 1.9 KB). Estimated time for completion: 60 min.
  • Module 2: Diagnostic Team Structure (PowerPoint, 2.7 MB; Facilitator's Notes, PDF, 1.4 MB). Estimated time for completion: 45 min.
  • Module 3: Communication (PowerPoint, 2.6 MB; Facilitator's Notes, PDF, 1.7 MB). Estimated time for completion: 30 min.
  • Module 4: Leadership (PowerPoint, 1.7 MB; Facilitator's Notes, PDF, 1.3 MB). Estimated time for completion: 30 min.
  • Module 5: Situation Monitoring (PowerPoint, 2 MB; Facilitator's Notes, PDF, 960 KB). Estimated time for completion: 30 min.
  • Module 6: Mutual Support (PowerPoint, 2 MB; Facilitator's Notes, PDF, 1.3 MB). Estimated time for completion: 30 min.
  • Module 7: Putting It All Together (PowerPoint, 10.9 MB; Facilitator's Notes, PDF, 2 MB). Estimated time for completion: 45 min.
• Supplementary Materials:
  • The Diagnostic Journey of Mr. Kane (PowerPoint, 22 MB; Facilitator's Notes, PDF, 1.8 MB) is a reality-based case referenced throughout the learning modules to stimulate group discussion and to reinforce key concepts.
  • Reflective Practice Tool (PDF, 423.3 KB) is a handout with the three-word prompt, “Ask, Listen, and Act” that can serve as a reminder of the reflective process.

Step 4: Evaluate

• The Team Assessment Tool for Improving Diagnosis (PDF, 407.5 KB) can be used to evaluate a team’s or individual’s progress against the key TeamSTEPPS® domains over time.
• The TeamSTEPPS for Diagnosis Improvement Knowledge Assessment (PDF, 275.7 KB) provides 20 questions and a response key in the Facilitator’s Guide to assess understanding of the content covered.

Acknowledgments

Project Team

This project was led by the MedStar Health Institute for Quality and Safety under the direction of:

• Chris Goeschel Sc.D., RN.
• Katie Carlin, M.B.A.
• Melissa Eckroade, M.H.A.
• Bryan O. Buckley, Dr.P.H., M.P.H.
• Kisha Ali, M.S.
• Mary Hill, B.S.
• Kelly Smith, Ph.D.
• Kelley Baker, M.A.

Development Partners

Partners for this work included the following subject matter experts:

• Dana Siegal, RN, CRICO Strategies.
• Michael Rosen, Ph.D., Johns Hopkins University School of Medicine.
• Heidi King, M.S., Department of Defense (DoD) Patient Safety Program.
• Gwen Sherwood, Ph.D., RN, University of North Carolina at Chapel Hill, School of Nursing.
• Helen Haskell, M.A., Mothers Against Medical Error.
• Bonnie DiPietro, M.S., RN, Maryland Patient Safety Center.
• Matthew P. Schreiber, M.D., M.H.S., MedStar Washington Hospital Center.
• Mark L. Graber, M.D., Society to Improve Diagnosis in Medicine.

Organizational partners included the MedStar Health Research Institute, Baylor College of Medicine, Clinical Directors Network, and National Nurse-Led Care Consortium.