TeamSTEPPS 2.0: Module 8

Sizing Up the Iceberg Exercise Sheet

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.


As you answer the questions below, consider the state of your current organization and the current safety climate. In your group, answer the following questions assigned to you by the instructor.

1. Do you have a "Fred" in your organization? If so, how is this person treated?

Step 1: A Sense of Urgency

2. What information do you have that may indicate a need for change in your organization?

3. Where else might you look for "hidden" information?

4. In the story, Fred took to Alice to see and experience the potential dangers for herself. How would you do that in your organization?

5. Have you ever known a "Nono?" What impact has that person had on change in your organization?

6. How is the need for change communicated in your organization? What do you think is the most appropriate way to communicate the need for change?

7. What can you do to create a sense of urgency for change in the organization?

Step 2: The Guiding Team

8. What characteristics would you look for in a team to guide change in your organization?

9. What do you think is the most crucial thing to enable this guiding team to truly function as a team?

Step 3: A Change Vision and Strategy

10. How might you best determine what your change strategy needs to be?

Step 4: Understanding and Buy-In

11. How could you best ensure understanding and buy-in of needed changes in your organization?

12. Identify ways to communicate and reinforce change that you believe would be most effective in your organization.

Step 5: Fewer Obstacles, More Empowerment

13. Where might you anticipate and eliminate barriers to change in the organization?

14. What do you believe might be behind people's resistance to change?

15. What are the norms of your "colony" that may interfere with change?

Step 6: Short-term wins

16. Identify examples of successes relative to the changes needed in your organization that you have already seen.

17. What could you do to reinforce success? (Remember the festival at the school?)

Step 7: Not Letting Up

18. Describe what you think it will take to really keep change going in your organization.

19. What resources and/or support will people need to implement the needed change?

Step 8: A New Culture

20. Describe the new culture that you see for your organization. What will the benefits of such a culture be?

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Page last reviewed March 2014
Page originally created September 2012
Internet Citation: TeamSTEPPS 2.0: Module 8. Content last reviewed March 2014. Agency for Healthcare Research and Quality, Rockville, MD.