1. Strategies and Tools to Enhance Performance and Patient Safety Adoption in Action AHRQ funded project UNCHCS/RTI partnership READY Training OR 6

2. T EAM STEPPS 05.2 Mod 1 05.2 Page 2 Introduction Mod 1 06.2 Page 2 2 Teamwork Is All Around Us

3. T EAM STEPPS 05.2 Mod 1 05.2 Page 3 Introduction Mod 1 06.2 Page 3 3 Objectives Describe effective team structure Describe effective leadership and leadership skills Describe the relationship between situation monitoring, shared mental models, and team effectiveness Describe effective verbal and task related mutual support Describe effective communication skills Recognize barriers to effective teamwork

4. T EAM STEPPS 05.2 Mod 1 05.2 Page 4 Introduction Mod 1 06.2 Page 4 4 Why Do Errors Occur—Some Obstacles Workload fluctuations Interruptions Fatigue Multi-tasking Failure to follow up Poor handoffs Ineffective communication Not following protocol Excessive professional courtesy Halo effect Passenger syndrome Hidden agenda Complacency High-risk phase Strength of an idea Task (target) fixation

5. T EAM STEPPS 05.2 Mod 1 05.2 Page 5 Introduction Mod 1 06.2 Page 5 5 Multi-Team System for Patient Care Patient Core Team Coordinating Ancillary Team Services Administration Contingency Teams

6. T EAM STEPPS 05.2 Mod 1 05.2 Page 6 Introduction Mod 1 06.2 Page 6 6

7. T EAM STEPPS 05.2 Mod 1 05.2 Page 7 Introduction Mod 1 06.2 Page 7 7 Required Skills for Team Performance Leadership Situation Awareness Mutual Support Communication

8. T EAM STEPPS 05.2 Mod 1 05.2 Page 8 Introduction Mod 1 06.2 Page 8 8 Effective Team Leaders Organize the team Articulate clear goals Make decisions through collective input of members Empower members to speak up and challenge, when appropriate Actively promote and facilitate good teamwork Skillful at conflict resolution

9. T EAM STEPPS 05.2 Mod 1 05.2 Page 9 Introduction Mod 1 06.2 Page 9 Team Events Briefs – planning Huddles – problem solving Debriefs – process improvement 9 Leaders are responsible to assemble the team and facilitate team events But remember… Anyone can request a brief, huddle, or debrief

10. T EAM STEPPS 05.2 Mod 1 05.2 Page 10 Introduction Mod 1 06.2 Page 10 10 Briefing/Time Out Team membership and roles Clinical status of the patient Team goals and potential pitfalls Resources

11. T EAM STEPPS 05.2 Mod 1 05.2 Page 11 Introduction Mod 1 06.2 Page 11 11

12. T EAM STEPPS 05.2 Mod 1 05.2 Page 12 Introduction Mod 1 06.2 Page 12 12 Team Huddles

13. T EAM STEPPS 05.2 Mod 1 05.2 Page 13 Introduction Mod 1 06.2 Page 13 13 Debriefs Debriefs should be conducted for the following reasons: So team members learn from actual situations So learning takes place collectively So team members can exchange information So teams can improve performance

14. T EAM STEPPS 05.2 Mod 1 05.2 Page 14 Introduction Mod 1 06.2 Page 14 14

15. T EAM STEPPS 05.2 Mod 1 05.2 Page 15 Introduction Mod 1 06.2 Page 15 15 Delegation of Resources Delegation is a means of managing resources whereby information, equipment, and key staff are allocated to specific tasks. Delegation is a skill that anyone can learn.

16. T EAM STEPPS 05.2 Mod 1 05.2 Page 16 Introduction Mod 1 06.2 Page 16 16 Modeling Teamwork Effective team leaders utilize the team skills in their daily practice and encourage team behaviors by: Sharing information Displaying appropriate communication, monitoring, and support behaviors Helping team members achieve the effective team performance using the same behaviors Encouraging active participation by all team members

17. T EAM STEPPS 05.2 Mod 1 05.2 Page 17 Introduction Mod 1 06.2 Page 17 17 Required Skills for Team Performance Leadership Situation Awareness Mutual Support Communication

18. T EAM STEPPS 05.2 Mod 1 05.2 Page 18 Introduction Mod 1 06.2 Page 18 18 A Continuous Process Situation Awareness (Individual Outcome) Shared Mental Models (Team Outcome) Situation Monitoring (Skill)

19. T EAM STEPPS 05.2 Mod 1 05.2 Page 19 Introduction Mod 1 06.2 Page 19 19 How can I contribute to a Shared Mental Model? Routinely update others Acknowledge deviations or changes in the situation Alert team to actual or potential problems Verbalize a course of action Request needed information

20. T EAM STEPPS 05.2 Mod 1 05.2 Page 20 Introduction Mod 1 06.2 Page 20 20 When to Share? Briefs Huddles Debriefs Shift Changes Handing off care to another

21. T EAM STEPPS 05.2 Mod 1 05.2 Page 21 Introduction Mod 1 06.2 Page 21 21 Required Skills for Team Performance Leadership Situation Awareness Mutual Support Communication

22. T EAM STEPPS 05.2 Mod 1 05.2 Page 22 Introduction Mod 1 06.2 Page 22 22 Mutual Support Mutual support is the essence of teamwork Protects team members from work overload situations that may reduce effectiveness and increase the risk of error Mutual support consists of helping your fellow teammates by offering assistance Two kinds of mutual support Task related Verbal

23. T EAM STEPPS 05.2 Mod 1 05.2 Page 23 Introduction Mod 1 06.2 Page 23 23 I’M SAFE Checklist I=Illness M=Medication S=Stress A=Alcohol and Drugs F=Fatigue E=Eating, Elimination, and Emotions

24. T EAM STEPPS 05.2 Mod 1 05.2 Page 24 Introduction Mod 1 06.2 Page 24 24 Required Skills for Team Performance Leadership Situation Awareness Mutual Support Communication

25. T EAM STEPPS 05.2 Mod 1 05.2 Page 25 Introduction Mod 1 06.2 Page 25 25

26. T EAM STEPPS 05.2 Mod 1 05.2 Page 26 Introduction Mod 1 06.2 Page 26 26 Please Use CUS Words but only when appropriate!

27. T EAM STEPPS 05.2 Mod 1 05.2 Page 27 Introduction Mod 1 06.2 Page 27 27 SBARq SBARq is a technique for communicating clearly and concisely. Communicate the following information: Situation Background Assessment Recommendation Any Questions?

28. T EAM STEPPS 05.2 Mod 1 05.2 Page 28 Introduction Mod 1 06.2 Page 28 28 Be Complete and Brief

29. T EAM STEPPS 05.2 Mod 1 05.2 Page 29 Introduction Mod 1 06.2 Page 29 Be Clear

30. T EAM STEPPS 05.2 Mod 1 05.2 Page 30 Introduction Mod 1 06.2 Page 30 30 Be Timely

31. T EAM STEPPS 05.2 Mod 1 05.2 Page 31 Introduction Mod 1 06.2 Page 31 31 Check Back Receiver accepts the message and provides feedback confirmation Sender initiates the message Sender verifies that the message was received

32. T EAM STEPPS 05.2 Mod 1 05.2 Page 32 Introduction Mod 1 06.2 Page 32 32 Callout A strategy used to communicate important or critical information. It informs all team members simultaneously during emergency situations It helps team members anticipate next steps On you unit, what information would you want called out?

33. T EAM STEPPS 05.2 Mod 1 05.2 Page 33 Introduction Mod 1 06.2 Page 33 33

34. T EAM STEPPS 05.2 Mod 1 05.2 Page 34 Introduction Mod 1 06.2 Page 34 34 Next Stepps Begin practicing the teamwork skills – plan to use at least one skill during your next work day You will get coaching from unit based master trainers Coach and give feedback to each other!