2Learning ObjectivesDefine your SUSP team composition and roles and responsibilities of team membersDiscuss the role of the executive partner on your SUSP teamPlan for initial SUSP team meetingsDefine the project ‘pre-mortem’ process and how to use it.
3The Peri-operative SUSP Team Understands that patient safety culture is localIs composed of engaged frontline providers from pre, intra-, and post-operative care areas who take ownership of patient safetyIncludes staff members who have different levels of experience and perspectivesMeets regularly (weekly or at least monthly)Has adequate resources including protected time2 to 4 hours per week for a team leader, surgeon, anesthesia, nurse, and infection preventionistNOTE: Will make sure this is consistent with other descriptions (this was pulled from FLEXTRA)
4SUSP Team Members Essential Team Members Surgeons Anesthesiologists CRNAsCirculating nursesScrub nurses / OR techsPerioperative nursesExecutive partnerNurse leadersEnhancing Team MembersPhysician assistantsNurse educatorsAnesthesia assistantsInfection preventionistsOR directorsPatient safety officersChief quality officersAncillary staff
5Summary of points to consider in team formation Team composition: Are we set up for success?Group sizeSkill mix (technical expertise, interpersonal skills)Team processes: Do we interact effectively?CommunicationLeadershipEducationConflict managementTeam norms: What are our values?Mutual trust and respectInclusivityTransparency
6Getting team composition right: SUSP Team Membership Form Poll Question:Have you identified all your core team members?YesNo
7Establishing clear roles & responsibilities: SUSP Team Formation Worksheet Armstrong Institute, 2012
8Engaging Executive Partners Identify an appropriate executive partnerContact hospital management to determine which senior executive will best fit the unit and the following criteria:Director level or aboveAvailable to round for at least one hour per monthApproachable and comfortable with sensitive topicsSplit slide into two
9Engaging Executive Partners Meet with the senior executive to secure his/her commitmentSenior executive participates in the Science of Safety TrainingSchedule a Kick-off MeetingSchedule the senior executive for 1.5 hours to ensure he/she has plenty of time to spend with the teamAlign priorities and gain buy-inAttend monthly SUSP meetingsOne-hour meeting, on the unit, half of time spent meeting, half of the time interacting with caregivers on the unitSplit slide into two
10Executive Leader’s SUSP Team Role Checklist EducationEnsure science of safety training for all current and new employeesFoster organizational learning: disseminate learning from defect lessons with expectations for local adaptation
11Executive Leader’s SUSP Team Role Checklist (cont’d) Policies and ProceduresCreate a policy for unit level accountability: document learning from at least one defect per quarterAssess and improve usefulness of briefing and debriefingQuality of implementationSurfacing and resolving defects
12Executive Leader’s SUSP Team Role Checklist (cont’d) Acknowledge work of teamsCelebrate success through stories in hospital newsletterOpportunities for teams to share with management and other teams
13Sample Agenda Items for Your Initial SUSP Team Meetings Clarify goals and vision for the team and projectIs it clear and compelling to everyone?Define roles and responsibilitiesDoes the team have all essential team members?Complete the SUSP Team Formation WorksheetDiscuss a communication and engagement strategyHow will you communicate your vision and engage others to participate?Icon that there is a tool for this.
14Sample Agenda Items for Your Initial SUSP Team Meetings (cont’d) Plan your strategy for educating staff on the science of safetyHow will you ensure everyone can have access to the training?Plan your strategy to administer your staff safety assessmentShould be done after the Science of Safety with clearly defined timeline.Staff safety assessment can be administered right after the Science of Safety training.First give team Vision then VoiceDevelop a plan for SUSP team interactionsWhat will your meeting schedule look like? How will you communicate in between meetings?Discuss safety culture assessmentHas one been conducted in the previous 12 months?HSOPS Aug 21st and 23rd are the planning your safety assessment calls.
15Sample Agenda Items for Your Initial SUSP Team Meetings (cont’d) Conduct a project ‘pre-mortem’What are the major obstacles to success and how can you proactively overcome them?HSOPS Aug 21st and 23rd are the planning your safety assessment calls.
16The Project Pre-Mortem In a postmortem, an autopsy is performed to learn why a patient died.While it may be helpful to those who perform it and hear about the results, it does not help the central figure in the medical drama—the patient.The PreMortem Exercise is used to identify potential barriers and vulnerabilities to project success before they occur.It builds intuition and sensitivity to future problems.
17Pre-mortem: Step 1Imagine that we are 1 year into the future and, despite all of the team’s efforts, the project has failed—catastrophically. Things have gone completely wrong on a number of fronts.Now, ask:What does the worst case scenario look like?
18Generate the reasons for failure. Pre-mortem: Step 2Generate the reasons for failure.Spend the next 10 minutes writing down all the reasons you believe this failure occurred.Now, ask:What could have caused our project to fail
19Prioritize your list of potential reasons for failure. Pre-mortem: Step 3Prioritize your list of potential reasons for failure.Address the top 2 or 3 items from your list that are of greatest concern.Now, ask:What specific actions can you take to avoid or manage these issues?
20Pre-mortem: Step 4Throughout your project, periodically review the potential problem list to remind yourself and the other team members of problems that may be emerging.
21Pre-mortem SummaryStep 1: Two years out, what does the worst case scenario look like?Step 2: What could have caused your project to fail?Step 3: What specific actions can you take to avoid or manage these issues?Step 4: Review and resensitize yourself to potential problems throughout the project.Need the pre-mortem tool.
22Action Items Actively engage your executive partner Schedule and hold your first SUSP team meeting (if you haven’t already). Make sure to address:Project vision, goals, and expectationsTeam composition and roles and responsibilitiesConduct a project pre-mortem (second meeting)