1. The Power of Teams Across America: Lessons Learned from the National Implementation of TeamSTEPPS Project

2. T EAM STEPPS 05.2 Mod 1 05.2 Page 2 Page 2 Initial design for success About The National Implementation of TeamSTEPPS Project The journey – challenge and adaptation Lessons learned Overview

3. T EAM STEPPS 05.2 Mod 1 05.2 Page 3 Page 3 What is TeamSTEPPS? Evidence based teamwork system to improve communication and teamwork skills among health care professionals Reduce medical errors Improve patient safety

4. T EAM STEPPS 05.2 Mod 1 05.2 Page 4 Page 4 What is TeamSTEPPS? Based upon 4 key skills: 1. Leadership 2. Communication 3. Mutual Support 4. Situation Monitoring

5. T EAM STEPPS 05.2 Mod 1 05.2 Page 5 Page 5 Why the National Implementation of TeamSTEPPS Program Began AHRQ released TeamSTEPPS training materials in 2006 Need for implementation and training support soon apparent New approach for AHRQ – fund TeamSTEPPS training and user support program

6. T EAM STEPPS 05.2 Mod 1 05.2 Page 6 Page 6 Initial Design for Success Designed program on the “agricultural extension service” model Focus initial training recruitment on:  Traditional early adopters such as High Reliability Organizations  Established diverse geographical groups involved in health care safety and quality:  CMS Quality Improvement Organizations  AHRQ Patient Safety Improvement Corps

7. T EAM STEPPS 05.2 Mod 1 05.2 Page 7 Page 7 Build It and They Will Come…

8. T EAM STEPPS 05.2 Mod 1 05.2 Page 8 Page 8 What is the National Implementation of TeamSTEPPS Program? AHRQ contracted with American Institutes for Research in Washington DC to:  Set up a train the trainer model program at training centers in “early adopter” hospitals that already understood TeamSTEPPS  Recruit teams to attend training  Develop support system for TeamSTEPPS Master Trainers after training

9. T EAM STEPPS 05.2 Mod 1 05.2 Page 9 Page 9 More Components of the National Implementation of TeamSTEPPS Program Facilitate the integration of teamwork training into health professions education Development of additional measurement instruments and modules Conduct evaluation of project effectiveness

10. T EAM STEPPS 05.2 Mod 1 05.2 Page 10 Page 10 National Implementation of TeamSTEPPS Training We have conducted 58 training sessions We have trained > 1500 Master Trainers from: U.S. - every state and Puerto Rico Taiwan Australia Netherlands Japan

11. T EAM STEPPS 05.2 Mod 1 05.2 Page 11 Page 11 Spread of National Implementation in U.S. to Date

12. T EAM STEPPS 05.2 Mod 1 05.2 Page 12 Page 12 National Implementation of TeamSTEPPS Training Center Locations Carilion Clinic TRC Duke TRC Creighton Univ. TRC Univ. Minnesota TRC AIR - Lead Univ. Washington TRC

13. T EAM STEPPS 05.2 Mod 1 05.2 Page 13 Page 13 TeamSTEPPS Master Trainer Sessions Sessions are free – teams are responsible for travel costs Open to all health provider organizations & health profession educators CME and CEU - awarded upon completion Limited to approx. 30 seats Classes of diverse teams – greatest asset!

14. T EAM STEPPS 05.2 Mod 1 05.2 Page 14 Page 14 TeamSTEPPS Master Trainer Sessions 2 ½ day sessions: Day 1:  Fundamentals curriculum - DIDACTIC Day 2 :  Planning, includes change management, coaching, measurement, implementation planning – INTERACTIVE Day 3:  Teach back - PRACTICE

15. T EAM STEPPS 05.2 Mod 1 05.2 Page 15 Page 15 National Implementation of TeamSTEPPS User Support AIR’s User Support Network Center Director and Program Specialists Call center team Technical experts and administrative support Email listserv – peer to peer support http://Teamstepps.ahrq.gov Topical webinars (17 completed so far) Annual user group meeting/collaborative

16. T EAM STEPPS 05.2 Mod 1 05.2 Page 16 Page 16 The Journey – Change and Adaptation First major adaptation – Update to trainer/coach module slides  To adapt to the goals and challenges of trainee teams  Add special implementation slides for CMS QIOs

17. T EAM STEPPS 05.2 Mod 1 05.2 Page 17 Page 17 The Journey – Change and Adaptation Second major change – requirement of “statement of readiness”  Goals  Challenges  Leadership support  Who will you send and why?

18. T EAM STEPPS 05.2 Mod 1 05.2 Page 18 Page 18 The Journey – Change and Adaptation Third major change – required standardization of all training sessions across training centers  Equality across all centers  Required for consistent CME and CEU credits  Additional training segments allowed, with no credit

19. T EAM STEPPS 05.2 Mod 1 05.2 Page 19 Page 19 Lessons Learned Peer to peer support is priceless  Training sessions where teams from different types, sizes and locations are mixed together is a rich environment to learn Lesson – help them connect with others that have had similar problems

20. T EAM STEPPS 05.2 Mod 1 05.2 Page 20 Page 20 Lessons Learned Readiness statement is often a predictor to success for sustainment  Prepares teams in focusing on goals identified through RCA or HSOP survey findings  Gets teams thinking about change before training Lesson – read and evaluate each readiness statement – respond as necessary

21. T EAM STEPPS 05.2 Mod 1 05.2 Page 21 Page 21 Lessons Learned “Bottom or middle up” vs. “top down” driven initiatives are revealed as most sustained Organizations where the fiat “Thou shalt do TeamSTEPPS” has been issued often fail Lesson – help them “market” TeamSTEPPS to the front line, bring a front line unofficial leader to become Master Trainer

22. T EAM STEPPS 05.2 Mod 1 05.2 Page 22 Page 22 Lessons Learned Post training support is critical to success and sustainment  Implementation and sustainment are the hardest parts  Be ready to help them think out of the box  Utilize peer to peer support Lesson – be responsive and accessible

23. T EAM STEPPS 05.2 Mod 1 05.2 Page 23 Page 23 Lessons Learned Changing the SOP  Some special needs cases will arise  Still important to ask, is this fair to everyone else that is waiting for a seat? Lesson - be adaptable but still fair

24. T EAM STEPPS 05.2 Mod 1 05.2 Page 24 Page 24 Lessons Learned Teams implementing TeamSTEPPS and TRC instructors have good ideas  We take suggestions for improvement seriously  Often best ideas come from new teams Lesson - ask for feedback and suggestions for improvement – act on the good ones and give them credit

25. T EAM STEPPS 05.2 Mod 1 05.2 Page 25 Page 25 Have We Been Successful? Build it and they will come – they are still coming! What is the measure of success?  In numbers of people trained the program is successful Another measure of success will be adoption and sustainment of change – Project evaluation to come!

26. T EAM STEPPS 05.2 Mod 1 05.2 Page 26 Page 26 Questions? Thank you, and feel free to contact me: Deborah A. Milne dmilne@air.org (202) 403-5968