© 2009 On the CUSP: STOP BSI Building a Team

© 2009 Learning Objectives To understand the central importance of your ICU quality improvement team To develop a strategy for building a successful team

© 2009 The Quality Improvement Team The core team working on the CUSP/ CLABSI project The small group that spreads the intervention to the rest of the ICU

© 2009 Importance of the Quality Improvement Team Why do you think the team would matter to outcomes? – “Absolute Power” over local implementation What do you think makes a good team? – The Who – The How

© 2009 Team Performance Outputs Performance Attitudes Behaviors Inputs Environment Hospital & Unit Context Team Composition Task Design Processes Inside Team Outside Team Team Traits

© 2009 Team Composition Size (not too small, not too large) Multidisciplinary representation – ICU Nurses – ICU Physicians – Infection Control – ICU Medical Director – Nurse Educator – ICU Nurse Manager – Executive Partner (VP or above) – Pharmacist – Hospital Patient Safety Officer or Chief Quality Officer – Staff from Safety, Quality or Risk Mgmt Office – Respiratory Therapist

© 2009 Team Composition A team leader Champions (nurse and physician) Local “opinion leaders” People with diverse opinions

© 2009 Team Composition Someone gregarious Someone who sees the big picture Someone detail-oriented Everyone dedicated

© 2009 Successful teams have… Reliable Processes – Education and engagement activities – Communication – Leadership support/buy-in – Conflict (and conflict resolution)

© 2009 Successful teams have …(cont.) Norms – Valuing individual contributions – Cohesion (team unity) – Goal agreement – Self-assessment of knowledge /skills – Participation of team members Role clarity

© 2009 Action Items Form your team with an appreciation of the importance of WHO is on the team Carefully plan HOW you will act as a unified group Do a “pre-mortem” assessment—if this project were to fail, why would it? What could the QI team have done to prevent failure?

© 2009 Reference List Marsteller, Jill A., Stephen Shortell, Michael Lin, Elizabeth Dell, Stephanie Wang, et al. “How Do Teams in Quality Improvement Collaboratives Interact?” Joint Commission Journal of Quality and Patient Safety, 2007 May; 33(5): Shortell, Stephen, Jill A. Marsteller, Michael Lin, Marjorie Pearson, Shinyi Wu, Peter Mendel, Shan Cretin, and Mayde Rosen. “The Role of Team Effectiveness in Improving Chronic Illness Care,” Medical Care, November 2004.