1. Improving Patient Safety Through Teamwork Goodall Hospital Muskie School of Public Service Improving Patient Safety Through Leadership and Teamwork and Teamwork Goodall Hospital Muskie School of Public Service

2. Background Goodall Hospital Strategic Plan, Quality Plan Hospital Survey on Patient Safety Culture Donaghue Foundation RFP Topic Selection Proposal process Funded projects

3. Grant Specifics Leadership involvement Project goals Academic partner Teamwork training Formative evaluation Dissemination

5. Teamwork Training MedTeams Crew Resource Management Project structure – Train the Trainer – Emergency Department training – Inclusion of Sanford Fire Dept. paramedics – Engagement of management

6. Project Specifics How we did the training Who we trained and why Where we plan to train next

8. Some examples of MedTeams® Concepts Shared mental model Call outs Check back Cross-monitoring DESC Huddles Debriefs

9. Project evaluation components Qualitative interviews with staff Patient Satisfaction surveys Quality of Care surveys AHRQ Culture of Safety survey Process evaluation Lessons learned, dissemination

10. Challenges (so far) Roll-out issues Choice of trainers Sustainability for training (staff Turnover) $$ Physician role in training, uptake Leadership turnover

11. Challenges (so far) Financial pressures Lay-offs Economic downturn has led to increase in ER utilization and unreimbursed care Convincing staff that this is not a fad Setting clear expectations

13. Opportunities (so far) Leadership support Tie-in with patient safety culture improvement goals Skill building – Increased communication at both management and unit level about teamwork behaviors – Common language Engagement with paramedics

14. Opportunities Starting to hard-wire teamwork behavior through hospital policies and procedures – Code of conduct – Job descriptions – HR performance evaluations (peer and supervisor) – meeting agenda items – root cause analysis – Skills fair

15. Opportunities Patient satisfaction Formative evaluation - make course corrections along the way, project direction shared with Muskie

17. Next Steps Spread within hospital to other units Evaluation continues Retraining More trainers Dissemination activities Results

18. Questions? Contact info: Mary Finnegan mfinnegan@goodallhospital.org Cheryl Ciechomski cciechomski@goodallhospital.org Judy Tupper jtupper@usm.maine.edu