1. SSM Health Care’s Foundation of Safety and Care STEPPS: Producing Effective Medical Teams to Achieve Optimal Patient Outcomes AHRQ Annual Conference Sept. 10, 2008 Andy Kosseff, MD SSM Health Care Medical Director

2. Why is STEPPS So Important Now Fragmentation of care Multiple initiatives – are patients safer Electronic health records Care giving doctors and nurses are the heart of a safety culture

3. SSM’s Progress Started TeamSTEPPS training in Oct., 2007 Have trained 400 clinicians on 3 pilot units Established outcomes measurement plan for each unit trained Will train another 300 clinicians in 2008

4. STEPPS Outcome Measures Number of serious and sentinel events Adverse Outcome Index (OB) /Trigger tool AHRQ Patient Safety Culture Survey Patient, physician, and nurse satisfaction surveys Nurse turnover rate

5. Additional Aspects of STEPPS Training It is acceptable communication training It sets a standard for performance on clinical units – agreed upon by bedside clinicians

6. Operationalizing STEPPS Prework Introduction to Administrative Council Introduction to doctors and nurses on unit to be trained Measurement Start training Implementation Coaches to sustain implementation Monthly STEPPS Steering Team meeting Sequential tools and concepts implementation Outcome data feedback Train new doctors and nurses

7. SSM Customization Focus on core teams Use clinical cases from units being trained Make initial Fundamentals training 4 hours Use as a foundation of safety and care

8. What We Should Have Known Doctors and nurses on both sides of the podium Training is the easy part Not all STEPPS trainers are trainers Understand advocacy and assertion clearly Separate teamwork training from EHR implementation

9. SSM’s STEPPS Future Intensive support for all trained units Train our own trainers Simulation training Broad use of STEPPS on all clinical units

10. Please contact Andy Kosseff for further information or discussion Andy_Kosseff_MD@ssmhc.com 608-238-1337