1. Building Your SUSP Team Part I Armstrong Institute for Patient Safety and Quality

2. Learning Objectives Describe the importance of your SUSP team Develop a strategy to build a successful team Define roles and responsibilities of team members Identify characteristics of successful teams and barriers to team performance 2

3. An overview of the SUSP team

4. The Armstrong Institute Model to Improve Care Surgical Unit based Safety Program (SUSP) 1.Educate staff on science of safety 2.Identify defects 3.Recruit executive to adopt unit 4.Learn from one defect per quarter 5.Implement teamwork tools Translating Evidence Into Practice (TRiP) 1.Summarize the evidence 2.Identify local barriers to implementation 3.Measure performance 4.Ensure all patients get the evidence Engage Educate Execute Evaluate Reducing Surgical Site Infections Emerging Evidence Local Opportunities to Improve Collaborative learning http://www.hopkinsmedicine.org/armstrong_institute Technical WorkAdaptive Work

5. The Peri-operative SUSP Team Understands that patient safety culture is local Composed of engaged frontline providers from pre-, intra-, and post-operative care areas who take ownership of patient safety Includes staff members who have different levels of experience and perspectives Meets regularly (weekly or at least monthly) Has adequate resources including protected time –2 to 4 hours per week for a team leader, surgeon, anesthesia, nurse, and infection preventionist

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

7. SUSP Team Members Surgeons Anesthesiologists CRNAs Circulating nurses Scrub nurses / OR techs Perioperative nurses Executive partner Nurse leaders Physician assistants Nurse educators Anesthesia assistants Infection preventionists OR directors Patient safety officers Chief quality officers Ancillary staff

8. Team Composition A team leader Champions (nurse and physician) Local “opinion leaders” People with diverse opinions 8

9. Team Composition Someone outgoing Someone who sees the big picture Someone detail-oriented Everyone dedicated 9

10. Successful teams have… Reliable Processes –Education and engagement activities –Communication –Leadership support/buy-in –Conflict (and conflict resolution) 10

11. Successful teams have … (cont.) Norms –Valuing individual contributions –Cohesion (team unity) –Goal agreement –Self-assessment of knowledge /skills –Participation of team members Role clarity 11

12. Forming your SUSP team

13. Engage Core SUSP Team Members Surgeons Anesthesiologists CRNAs Circulating nurses Scrub nurses / OR techs Perioperative nurses Executive partner Nurse leaders

14. Kevin Driscoll CRNA CRNA Lead Deb Hobson RN “Coach” Tracie Cometa RN Lead RN Mary Grace Hensel RN Manager OR Sean Berenholtz MD Anesthesia Lead Lucy Mitchell RN NSQIP SCR Elizabeth Wick MD Surgery Lead Renee Demski MBA Senior Director Quality Johns Hopkins Medicine Executive Coach NSQIP Outcomes Steph Mullens CST Lead Tech

15. Tips for Engaging Physicians on the SUSP Team 1.Identify physician leaders 2.Create a forum for this role 3.Listen to physician concerns 4.Develop plans to address concerns 5.Reward physician leaders 6.Create a vehicle for communication 7.Develop a plan for communications

16. Physician Engagement Strategies Create a Compact (an Agreement) with management –Clearly define what is expected of physicians –Review performance regularly 16

17. Example Physician Champion Compact Hospital will provide support for percent of physicians’ time In return, physician will do the following: –Monitor and improve quality Implement CUSP and SSI interventions Hold regular meetings with team Involve other members of Medical staff in quality Report SSI rates and learning from defects results to senior leaders and board 17

18. Example Physician Champion Compact Further, physician will do the following: –Work with hospital to clarify what will be measured, who will measure it, and who will produce reports Meet quarterly to discuss progress 18

19. Tips for Scheduling Your Meetings Incorporate SUSP meetings into ongoing educational activities to ease scheduling challenges –Regularly scheduled nurse training –Grand rounds for physicians –Invite RNs to joint grand rounds Create incentives for participating –Educational credit for participation

20. Establishing clear roles and responsibilities on your SUSP team 20 Armstrong Institute, 2012

21. Action Items Form your team with an appreciation of the importance of WHO is on the team Complete the SUSP Team Membership Form Plan to attend Part II of Building your SUSP Team