What's Next? Leveraging Current Tools to Support Implementation: Slide Presentation
TeamSTEPPS®: National Implementation
Slide 1
TeamSTEPPS Simulations: A Practical Manual
James Battles, PhD
Heidi King, MS, FACHE
Stephen Hines, PhD
Barb Edson, RN, MBA, MHA
David Baker, PhD
Slide 2
What's Next? Leveraging Current Tools to Support Implementation
Images: Three photographs show medical personnel at work in a hospital setting.
Slide 3
Presenters
- James Battles, PhD, Social Science Analyst for Patient Safety, AHRQ.
- Heidi King, MS, FACHE, Acting Director Department of Defense Patient Safety Program.
- Stephen Hines, PhD, Chief Research Officer, HRET.
- Barb Edson, RN, MBA, MHA, VP of Clinical Quality, HRET.
- David Baker, PhD, Senior Vice President, Health Division, IMPAQ International.
Images: Each of the above presenters' names is shown with a photograph.
Slide 4
Objectives
- Consider how TeamSTEPPS work influences other patient safety initiatives.
- Discuss new TeamSTEPPS variations.
- Lay out current and future plans for TeamSTEPPS national implementation.
Slide 5
Where Have We Been and Where Do We Go From Here?
James Battles, PhD
AHRQ
Slide 6
What TeamSTEPPS® Does
Image: A cross with its four branches captioned Leadership, Communication, Situation Monitoring, and Mutual Support is enclosed within a circle captioned Patient Care Team; this entire figured is captioned TeamSTEPPS. An arrow points from the TeamSTEPPS figure to a second figure, a circle formed by four arrows pointing counterclockwise. The center of the circle is filled with purple dots forming a spiral. In the spaces between the arrows is the text Higher Patient Satisfaction, Reduce Medical Errors, Improve Moral, and Patient Safety Culture.
Slide 7
Combat Tested
- Been to war in Iraq and Afghanistan.
Image: A photograph shows a military medical team bringing in a severely wounded soldier on a two-wheeled cart.
Slide 8
Hurricane Tested
- Played a critical role in Hurricane Sandy & other emergencies.
Image: A photograph shows New York City from across the Hudson River; a bridge and part of the waterfront are under water during Hurricane Sandy.
Slide 9
TeamSTEPPS® goes International
Image: A map of the world shows countries where TeamSTEPPS has been implemented: Canada, the United States (all 50 states), Peru, Brazil, Great Britain, the Netherlands, Germany, Switzerland, Italy, Singapore, China, Korea, Japan, Taiwan, and Australia. Photograph insets in the map show Macchu Picchu, an Alpine city, a pagoda, and people encountering kangaroos in the Outback.
Slide 10
Integrating TeamSTEPPS®
- CUSP for CLASBI.
- CUSP for CAUTI in hospitals and long term care.
- CUSP for VAP\VAC.
- Safe Surgery in Hospitals and Ambulatory Surgery Centers.
- Perinatal Safety Improvement Program.
- Medical Liability projects.
Slide 11
Where to From Here?
- Discussions with WHO about a region-by-region implementation of TeamSTEPPS®.
- Need to create new modules dealing with virtual teams and coordination of care between units within healthcare facilities and across care settings.
Image: A photograph of a wooden sign post has three signs pointing in different directions labelled Future, Present, and Past.
Slide 12
Where to From Here?
- Meeting growing demand for TeamSTEPPS ® training and implementation strategies in primary care.
- New on-line Master Team Training to be developed.
Image: A photograph shows a member of a medical team seated at his desk and filling out a checklist.
Slide 13
TeamSTEPPS New Tools and Resources from the Department of Defense
Heidi King, MS, FACHE
Department of Defense Patient Safety Program
Slide 14
DoD TeamSTEPPS: Where Have We Been?
- Utilizing over 5000 (and climbing) Master Instructors.
- Training and implementation in 90% of Military Treatment Facilities:
- Over 70,000 continuing education credits awarded.
- Using simulation and coaching as adjunct to training.
- Spread throughout medical/trauma teams in Theatre of Operations: Iraq and Afghanistan.
- Partnering with various federal agencies to leverage TeamSTEPPS integration.
Foundational to achieving culture change
Images: Photographs show an army nurse working with an infant in an incubator, a medical team carrying a patient on a stretcher away from a helicopter, a physician examining a small child, and a member of an army medical team attending a patient on a stretcher wearing a respirator.
Slide 15
DoD TeamSTEPPS: Where Are We Heading?
We needed a new sustainable model!
A E I O U:
- Align with patient safety and quality improvement initiatives.
- Encourage Innovation.
- Involve, Integrate, Impact: patients, staff, programs, outcomes.
- Overcoming challenges.
- Utilizing coaching and simulation for experiential learning.
Images: Photographs show an army medical team gathered around a soldier on a stretcher in front of large background photographs that simulate a desert military camp, and a second an army medical team attending a wounded soldier lying on the ground.
Slide 16
TeamSTEPPS Resources: Integration!
| Patient Activation Resource Guide Image: Photo of a doctor explaining resources to patient. |
Coaching Image: The shift process in three phases. Arrows point to Phase 1: Assessment and Phase 3: Sustainment. |
SBAR Toolkit Image: A PowerPoint slide captioned Effective Communication Using SBAR Facilitation Guide. |
Simulation-based Training (Centers and In-situ) Image: A PowerPoint slide captioned Using Simulation in TeamSTEPPS Training. |
| Professional Conduct Toolkit Image: The 4 Modules of the Professional Conduct Toolkit. |
Briefs, Huddles, Debrief Toolkits Image: A PowerPoint slide captioned Briefs and Huddles Toolkit and a second slide shows the Team Debrief Process Model. |
TeamSTEPPS and Partnership for Patients Image: The Partnership for Patients logo. |
TeamSTEPPS Tip Sheets and Scenarios Image: A TeamSTEPPS Tip Sheet. |
| TEA Image: A cyclical flowchart describes the training and debriefing process. |
MTPAT Image: Photo of a doctor taking a patient's blood pressure and recording information on a data tablet. |
Learning Circles and Workshops Image: Photo of students in a workshop course. |
Team UP Image: Copies of the Team UP Patient Safety brochure. |
| DoD Web site Image: Screen shot of the DoD Patient Safety Program page. |
eBulletin and Learning Update Image: An issue of the Patent Safety Monthly eBulletin. |
Facebook Image: Screen shot of the DoD Patient Safety Program Facebook page. |
Patient Safety Learning Center (Protected) Image: The DoD Patient Safety Learning Center (PSLC) logo. |
http://www.health.mil/dodpatientsafety
Slide 17
TeamSTEPPS National Implementation Overview
Barb Edson, RN, MBA, MHA
HRET
Slide 18
Goals
- To provide TeamSTEPPS Master Training to health care organizations interested in improving teamwork to enhance performance and patient safety.
- To grow the national cadre of TeamSTEPPS Master Trainers.
- To support TeamSTEPPS users.
- To evolve and advance the TeamSTEPPS program.
Slide 19
TeamSTEPPS Master Training
- Two-day training course.
- Train-the-trainer approach.
- Prepares you to serve as a TeamSTEPPS Master Trainer by:
- Providing instruction on TeamSTEPPS tools and strategies.
- Providing an opportunity to develop and plan your TeamSTEPPS implementation.
- Prepares you to serve as a leader for implementing TeamSTEPPS within your organization.
Slide 20
Regional Training Centers
Image: A map of the United States shows the locations of Regional Training Centers (TRC): University of Washington TRC, Minnesota—TRC, UCLA TRC, North Shore Long Island TRC, Duke TRC, and Tulane University TRC.
Slide 21
Regional Training Centers
- North Shore Long Island Jewish Health System in New Hyde Park, New York (NSLIJ):
- Implemented TeamSTEPPS system-wide.
- Duke Medical Center, Durham, North Carolina (Duke):
- Includes patients as part of TeamSTEPPS Master Training.
- Tulane University, New Orleans, Louisiana (Tulane):
- Integrates simulation into TeamSTEPPS Master Training.
- University of Minnesota Fairview Medical Center, Minneapolis, Minnesota (UM):
- Integrates TeamSTEPPS into inter-professional education (IPE).
- University of Washington Medicine, Seattle, Washington (UW):
- Integrates simulation into TeamSTEPPS Master Training.
- University of California Los Angeles, Los Angeles, California (UCLA):
- New center launching in fall/winter of 2013.
Slide 22
2012 Accomplishments
- 766 people trained via:
- 15 basic trainings.
- 1 training each focusing on IPE and Patient Engagement.
- 4 trainings with a special focus on central line associated blood stream infections.
- 395 attendees at the National Conference where:
- 99 attendees took part in a 1-day blended online and in-person Master Training course.
- Conference topics spanned:
- System-wide implementation.
- Specific clinical usage.
- Different training and educational models.
- Networking opportunities mixed military and civilian champions of TeamSTEPPS.
Slide 23
How do we support our participants?
Slide 24
Pre-Training Support
- Leadership Brief:
- Provides a C-suite perspective.
- http://teamstepps.ahrq.gov/abouttoolsmaterials.htm.
- Prerequisite "Coursework":
- Pre-training recorded webinar.
- Readiness Assessment.
- Implementation Planning.
- Participant on-boarding live webinar:
- Orientate and prepare participants for training.
- Meet training representative from Center staff.
- Initiate implementation planning.
Slide 25
Post-Training Support
- www.teamsteppsportal.org.
- National Conference.
- Help line/email.
- http://teamstepps.ahrq.gov
Images: Screen shots of the TeamSTEPPS Portal and AHRQ TeamSTEPPS Web sites.
Slide 26
AHRQ Website
- AHRQ Web site (http://teamstepps.ahrq.gov):
- Program overview.
- Training curricula (Essentials course; Fundamentals course; measures; new modules).
- Materials to download and/or order.
- TeamSTEPPS Implementation Guide.
- Measurement tools.
Slide 27
TeamSTEPPS Portal
- A centralized resource for everything TeamSTEPPS.
- Key features:
- Webinars.
- Tools and resources for use.
- Implementation stories.
- ListServ/Discussion forum.
Slide 28
Upcoming Webinars
- Monthly scheduled webinars planned for 2013:
- Educational to support TeamSTEPPS users.
- Invited speakers from around the field.
- Special topics.
- Program updates:
- Portal updates.
- Training updates.
- Webinars are the second Wednesday of each month:
- July 12: TeamSTEPPS and Simulation.
- August 14: System-wide Implementation of TeamSTEPPS.
Slide 29
Tools and Resources
- Ready-made implementation support tools.
- Updated evidence base.
- Scenarios.
- Shared tools from users.
Slide 30
Shared Tools
- Resource for posting and sharing new TeamSTEPPS tools:
- TeamSTEPPS is customizable.
- No sense in reinventing the wheel.
- Others have dealt with similar problems and developed innovative solutions.
- Contact AHRQTeamSTEPPS@aha.org.
- www.health.mil/dodpatientsafety/ProductsandServices/Toolkits.aspx.
Slide 31
Implementation Stories
- Cases studies of successful and unsuccessful TeamSTEPPS implementations:
- Learn from these critical incidents.
- HRET team will interview, summarize, and post the story.
- Please follow the Survey Monkey link under "Case Studies" on the portal to share your experience.
Slide 32
Discussion Forum
- Training-specific forums (for 2013 sessions):
- Reconnect with classmates.
- Directly interact with faculty.
- Share tools.
- ListServ for the entire TeamSTEPPS community.
Slide 33
TeamSTEPPS 2.0
David P. Baker, PhD
IMPAQ International
Slide 34
Patient Safety Movement
Image: A timeline shows the following events:
- 1995: Department of Defence (DoD) MedTeam® ED Study.
- 1999: "To Err is Human" Institute of Medicine (IOM) Report.
- 2001: Executive Memo from President.
- 2003: Joint Commission on Accreditation of Healthcare Organizations (JCAHO) National Patient Safety Goals.
- 2004: Institute for Healthcare Improvement 100K lives Campaign.
- 2005: TeamSTEPPS.
- 2005: Patient Safety and Quality Improvement Act of 2005.
- 2006: TeamSTEPPS Released to the Public.
- 2007: TeamSTEPPS National Implementation Program began.
- 2008: National Implementation of CUSP.
- 2011: Centers for Medicare and Medicaid Partnership for Patients Campaign.
An arrow pointing from left to right beneath the timeline is captioned Medical Team Training.
Slide 35
What is TeamSTEPPS 2.0?
- Part of effort to continually evolve TeamSTEPPS.
- Provides an opportunity to….
- Leverage what has been learned so far:
- Lessons learned.
- Feedback from users.
- New and emerging evidence.
- Consider meaningful ways to integrate current and future TeamSTEPPS efforts.
- Leverage what has been learned so far:
Image: A cartoon penguin in a green shirt is dressed as a fairy godmother with wings, a wand, pointed hat, and catseye glasses.
Slide 36
Environmental Scan
- Review of prior work efforts related to a next iteration of TeamSTEPPS.
- Usability reviews of existing curriculum and materials.
- Interviews with AHRQ and DoD stakeholders.
- Focus groups with TeamSTEPPS experts:
- Participants referred by AHRQ and/or DoD.
- Included TeamSTEPPS users, trainers, and those involved in its development.
- 5 virtual focus groups conducted.
- Represented over 80 years combined experience with teaching and/or implementing TeamSTEPPS.
Slide 37
Results
- Qualitative data analysis resulted in 189 aggregated recommendations.
- Recommendations were clustered into 6 categories:
- Pre-training.
- Training materials.
- Training delivery.
- Implementation and sustainment.
- Evaluation.
- Integrating new modules.
Slide 38
TeamSTEPPS 2.0: Work in Progress
- Focuses on revisions, updates, and expansions to materials that support the Master Training course:
- Improvements for TeamSTEPPS users:
- Updated and expanded content.
- Reduced size of hard copy materials.
- Better preparation for implementation planning.
- Improvements for Master Trainers:
- Improved and enhanced Instructor Guides.
- Page numbers.
- Advance organizer for each instructional module.
- New discussion questions and exercises.
- Improvements for TeamSTEPPS users:
Slide 39
TeamSTEPPS 2.0: Work in Progress (Cont’d)
- Some highlights:
- Updating the evidence base.
- Reorganizing the order of training to emphasize the importance of communication.
- Providing information and guidance on engaging patients.
- Emphasizing the importance of implementation planning pre-training and throughout the course.
- Providing more detailed information on implementation and sustainment activities (e.g., Coaching, Measurement).
Slide 40
Next Steps
- Drafts of 2.0 materials are near completion.
- Review and testing with stakeholders—June 2013.
- Delivery for final AHRQ review—September 2013.
Slide 41
TeamSTEPPS New Tools and Resources
James Battles, PhD
AHRQ
Barb Edson, RN, MBA, MHA
HRET
Slide 42
New Tools
- TeamSTEPPS® Primary Care Version:
- Adapts core concepts of TeamSTEPPS® to reflect the environment of primary care office-based teams.
- Team STEPPS® Long-Term Care Version:
- Adapted to the environment of nursing homes and other long-term care settings such as assisted living & continuing care retirement communities.
- TeamSTEPPS® Limited English Proficiency (LEP) Module:
- A module to help develop a customized plan to train staff in teamwork skills as applied to work with patients who have difficulty communicating in English.
Image: Icon of a toolbox and tools.
Slide 43
TeamSTEPPS for Primary Care Medical Offices
- Builds on "TeamSTEPPS for Primary Care Teams."
- Works as a Master Trainer course with material on:
- How to be a practice facilitator of TeamSTEPPS.
- How to coach TeamSTEPPS using a variety of methods.
- How to implement, spread, and sustain TeamSTEPPS.
- And how to measure and evaluate TeamSTEPPS.
Slide 44
New Setting of Care, New Challenges, New Solutions
- Smaller teams with less ability to travel.
- Varied background in team-training and quality improvement initiatives.
- Available in a in-person training and online format:
- Online trainings will include virtual, game-based learning.
Slide 45
Interested?
- Please contact us at AHRQTeamSTEPPS@aha.org if you are interested.
- Pilot testing begins late summer/early fall 2013.
- National Implementation begins late winter/early spring 2014.
Slide 46
The Future of Teaching and Learning TeamSTEPPS
Steve Hines, PhD
HRET
Slide 47
Thoughts on the Future
- Teaching and learning TeamSTEPPS will change considerably:
- Sometimes out of necessity.
- Other times because of the opportunities presented by new technology.
- Great challenges exist.
- And there are approaches to address these challenges.
Slide 48
Current Challenges to TeamSTEPPS Training
- Limited resources for meetings and trainings:
- Funds are tight at healthcare organizations.
- Time is valuable.
- There are restrictions on meetings funded by the federal government.
- Radical increase in number of ongoing QI activities.
- Coordinating with other disciplines and settings of care:
- Need to accommodate a broader range of trainees.
- Work to understand how to best to connect and grow a community of users.
Slide 49
How Can We Approach these Challenges?
- Expand our training center capacity.
- Produce resources for a broader range of disciplines and settings of care.
- Create user-friendly resources for those who are not at trainings:
- Materials for the end user on the front lines to practice using the TeamSTEPPS tools.
- Resources to help make the case for implementation from a financial, quality, and safety standpoint.
- Alternative training modalities for self-teaching.
- Expanded use of observation and mentoring.
Slide 50
Time for Questions
Thank you for spending time with us this week in Dallas!
