1. National Implementation of TeamSTEPPS TM David P. Baker, PhD American Institutes for Research James Battles Agency for Healthcare Research and Quality Heidi King Department of Defense

2. T EAM STEPPS 05.2 Mod 1 05.2 Page 2DRAFT 1.1 Page 2 AcademyHealth Project Purposes To transition evidence-based best practices into tools and strategies that maximize team performance in the delivery of healthcare To disseminate these tools and strategies throughout healthcare

3. T EAM STEPPS 05.2 Mod 1 05.2 Page 3DRAFT 1.1 Page 3 AcademyHealth Purpose 1 To transition evidence-based best practices into tools and strategies that maximize team performance in the delivery of healthcare Making Research Relevant!

4. T EAM STEPPS 05.2 Mod 1 05.2 Page 4DRAFT 1.1 Page 4 AcademyHealth Project Drivers To Err is Human NDAA 2001 National Patient Safety Goals IHI NQF All cite the need for team training in healthcare

5. T EAM STEPPS 05.2 Mod 1 05.2 Page 5DRAFT 1.1 Page 5 AcademyHealth AHRQ/DoD Initiatives Activities began in 2002 AHRQ issued PSO Task Order Contract to American Institutes of Research (AIR) Expert Panel Comprehensive Literature Review Case Study Analysis Journals/Articles Presentations Clinical Measures of Teamness (RAND evaluation contract Mod) Medical Team Training Curriculum TeamSTEPPS Edited Handbook Evidence- Based Methods Tools for Training and Measurement Principles and Guidelines

6. T EAM STEPPS 05.2 Mod 1 05.2 Page 6DRAFT 1.1 Page 6 AcademyHealth Collaboration Products Teamwork in Professional Education Relevant Evidence Teamwork in Healthcare Teamwork & Simulation

7. T EAM STEPPS 05.2 Mod 1 05.2 Page 7DRAFT 1.1 Page 7 AcademyHealth Results Need for Public Domain Curriculum and Support Materials Dueling Team Training in DoD elsewhere in Healthcare Training materials not readily available Need to get evidence base into practice Need to focus on actual training not development of materials

8. T EAM STEPPS 05.2 Mod 1 05.2 Page 8DRAFT 1.1 Page 8 AcademyHealth TeamSTEPPS TM AHRQ and DoD public domain curriculum for teaching teamwork to healthcare professionals Developed in the DoD Released in Fall 2006 National standard for team training in healthcare Initiative based on evidence Designed to be customizable to the institution

9. T EAM STEPPS 05.2 Mod 1 05.2 Page 9DRAFT 1.1 Page 9 AcademyHealth TeamSTEPPS Framework

10. T EAM STEPPS 05.2 Mod 1 05.2 Page 10DRAFT 1.1 Page 10 AcademyHealth Curriculum Content TOOLS and STRATEGIES Brief Huddle Debrief STEP Cross Monitoring Feedback Advocacy and Assertion Two-Challenge Rule CUS DESC Script Collaboration SBAR Call-Out Check-Back Handoff OUTCOMES Shared Mental Model Adaptability Team Orientation Mutual Trust Team Performance Patient Safety!! BARRIERS Inconsistency in Team Membership Lack of Time Lack of Information Sharing Hierarchy Defensiveness Conventional Thinking Complacency Varying Communication Styles Conflict Lack of Coordination and Follow-Up with Co-Workers Distractions Fatigue Workload Misinterpretation of Cues Lack of Role Clarity

11. T EAM STEPPS 05.2 Mod 1 05.2 Page 11DRAFT 1.1 Page 11 AcademyHealth Purpose 2 To disseminate these tools and strategies throughout healthcare Making Research Accessible!

12. T EAM STEPPS 05.2 Mod 1 05.2 Page 12DRAFT 1.1 Page 12 AcademyHealth National Implementation of TeamSTEPPS TM Federally funded project (AHRQ and DoD) Objectives: Create a national infrastructure to support the dissemination and implementation of TeamSTEPPS TM Develop new tools, techniques, and measures to advance and sustain TeamSTEPPS TM principles Support and sustain TeamSTEPPS TM Evaluate program impact – locally and nationally

13. T EAM STEPPS 05.2 Mod 1 05.2 Page 13DRAFT 1.1 Page 13 AcademyHealth Team Resource Centers and the National Implementation Team Carilion TRC Duke TRC Creighton TRC Minnesota -TRC AIR Lumetra Delmarva Booz | Allen | Hamilton

14. T EAM STEPPS 05.2 Mod 1 05.2 Page 14DRAFT 1.1 Page 14 AcademyHealth Team Resource Centers Train 1200 Master Trainers/Change Agents CMS Quality Improvement Organizations (QIOs) AHRQ High Reliability Organizations (HROs) AHRQ ACTION Partners (120 institutions) AHRQ Patient Safety Improvement Corps (PSIC) Implement and demonstrate TeamSTEPPS TM Tools and Strategies SBAR Standardized handoffs Conduct research on the link between effective teamwork and clinical outcomes

15. T EAM STEPPS 05.2 Mod 1 05.2 Page 15DRAFT 1.1 Page 15 AcademyHealth Progress Training began end of January 2008 425 participants had registered for training as of June 1 Training Statistics Total trained to date – 271 Number of institutions they represented – 59 Number of individuals from QIOs – 122 Number of QIOs represented – 29

16. T EAM STEPPS 05.2 Mod 1 05.2 Page 16DRAFT 1.1 Page 16 AcademyHealth Technical Assistance 1-800- XXX-XXXX

17. T EAM STEPPS 05.2 Mod 1 05.2 Page 17DRAFT 1.1 Page 17 AcademyHealth User Support Meetings and Conferences Quarterly teleconferences Topically driven webinars TeamSTEPPS Collaborative 2007 AIR 2008 Duke 2009 Creighton June National meeting of program participants

18. T EAM STEPPS 05.2 Mod 1 05.2 Page 18DRAFT 1.1 Page 18 AcademyHealth Information Dissemination www.ahrq.gov/teamstepps About TeamSTEPPS Readiness Assessment Tools and Materials Spotlight More to come!

19. T EAM STEPPS 05.2 Mod 1 05.2 Page 19DRAFT 1.1 Page 19 AcademyHealth Summary Large-scale effort to transition the best evidence available into practical, user friendly tools. National training initiative to push this into the health system More information: www.ahrq.gov/teamstepps teamsteppscontact@air.org