Implementation of TeamSTEPPS

This scholarly project focused on implementing Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) in an emergency room (ER). The aim of TeamSTEPPS is to improve patient outcomes by educating healthcare professionals on communication and teamwork skills. TeamSTEPPS teaches healthcare professionals leadership skills, shared mental models, mutual trust, and closed loop communication. The purpose of the scholarly project was to improve teamwork and communication. The study method was descriptive analysis of 51 pre and posttest questionnaires, specifically looking for increased knowledge of TeamSTEPPS tools. The participants included: ER physicians, ER nurses, ER certified nursing assistants/health unit coordinators, a pharmacy technician, public safety officers, and patient revenue management organization (PRMO). Further research is needed to evaluate how to significantly increase staff knowledge on TeamSTEPPS tools in a class setting

Building a collaborative culture in cardiothoracic operating rooms: Pre and postintervention study protocol for evaluation of the implementation of teamSTEPPS training and the impact on perceived psychological safety

IntroductionThe importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment.Methods and analysisThis study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA. All team members participating in cardiac and thoracic OR cases during this 17-month study period will be identified by the primary surgical staff attending on the OR schedule.TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) training course will be taught to all CT OR staff. Before TeamSTEPPS training, staff will respond to a 39-item questionnaire that includes constructs from the Agency for Healthcare Research and Quality Hospital Survey on Patient Safety Culture, Edmondson’s ‘Measure of psychological safety’ questionnaire, and questionnaires on turnover intentions, job satisfaction and ‘burnout’. The questionnaires will be readministered at 6 and 12 months.The primary outcomes to be assessed include the perceived psychological safety of CT OR team members, the overall effect of TeamSTEPPS on burnout and job satisfaction, and observed turnover rate among the OR nurses. As secondary outcomes, we will be assessing self-reported rates of medical error and near misses in the ORs with a questionnaire at the end of each case.Ethics and disseminationEthics approval is not indicated as this project does not meet the federal definitions of research requiring the oversight of the Institutional Review Board (IRB). Patient health information (PHI) will not be generated during the implementation of this project. Results of the trial will be made accessible to the public when published in a peer-reviewed journal following the completion of the study.</jats:sec

Integrating Research and Quality Improvement Using TeamSTEPPS: A Health Team Communication Project to Improve Hospital Discharge

Purpose/Objectives: The purpose of this article is to describe an innovative approach to the integration of quality improvement and research processes. A project with the objective of improving health team communication about hospital discharge provides an exemplar case. Description of the Project/Program: The TeamSTEPPS 10-step action planning guide provided the structure for planning, developing, and evaluating a redesign of interprofessional health team communication to improve hospital discharge led by 2 clinical nurse specialists. The redesign involved development of processes for team bedside rounding, registered nurse bedside shift reports, and briefing tools to support the rounding processes. Outcome: Using the TeamSTEPPS process, a 4-phase combined quality improvement and research project was designed and implemented. Implementation is ongoing, supported by process evaluation for continuing process improvement. Longitudinal analysis of research outcomes will follow in the future. Conclusions: Led by unit-based clinical nurse specialists, use of an integrated process of quality improvement and research creates evidence-based innovation to solve interprofessional practice problems. Incorporating research within the project design allows for data-based decisions to inform the clinical process improvement, as well as documentation of both the processes and outcomes of the local improvements that can inform replications in other sites

Implementation & Evaluation of an Interprofessional TeamSTEPPS Simulation Program

Joint Commission 2015 sentinel event data identified communication as the third leading cause of all medical errors in the United States. The complex delivery of health care requires teamwork; however, members of the health care team are rarely trained together and often come from different educational and cultural backgrounds. To improve communication, an interprofessional high fidelity simulation-based program that uses the Agency for Healthcare Research and Quality TeamSTEPPS® 2.0 Framework and associated communication tools was implemented and evaluated in a medium sized acute care community hospital. This quantitative descriptive correlational study addresses two research questions: (1) how does the implementation of a TeamSTEPPS® Simulation Program impact the communication between members of the interprofessional team? (2) How does the implementation of a TeamSTEPPS® Simulation Program impact individual’s attitudes, knowledge, and skills towards teamwork

Access Update, August 2010

Monthly newsletter for the Iowa Department of Public Healt

Redesigning Instruction for Inter-Professional Education

Purpose: A pilot project created a curriculum model infusing Interprofessional Education (IPE) in Mercy College’s School of Health and Natural Sciences (SHNS), allowing students and faculty to integrate IPE within programmatic courses. Background: As institutions focus on patient safety, quality and cost effective care, the call for interprofessional collaboration among providers continues to rise (Chen, Delnat & Gardner, 2015). This program included innovative teaching strategies and curriculum development in the health care programs within the SHNS. Description of Program: Pilot projects focused on history taking and IPE patient case scenarios, allowing students to experience interactive hands on learning of IPE concepts and competencies. Two workshops were held to educate the faculty in developing IPE cases and debriefing strategies. The first program used real patients with chronic conditions allowing students to gain confidence in interviewing while understanding the commonalities between disciplines. This project included students from communication disorders, nursing, occupational therapy, physical therapy and physician assistant programs. Participants completed an adapted version of the Attitudes Towards Health Care Teams Scale (ATHCTS) (Kim & Ko, 2014) before and after each pilot program, and a one minute reflection after each program. Findings identified significant changes in five variables on the adapted ATHCTS. The qualitative one minute reflection identified themes of commonalities between disciplines. All students identified a need to provide more IPE education among all of the disciplines. This project demonstrated a new way to use strategies to engage patients as partners in developing new models of IPE and care. This project also addressed approaches to prepare and engage both students and faculty in the IPE process. IPE activities will be broadened in the upcoming years and continue to include patients in the IPE education process. Learning Objectives: By the end of this presentation participants will be able to - Identify new modalities of creating IPE initiatives for implementation across disciplines that incorporate patients into the IPE process. - Identify methods of training faculty in creating IPE strategies and debriefing. Reference: Kim, K & Ko, J. (2014). Attitudes toward interprofessional health care teams scale: a confirmatory factor analysis. Journal of Interprofessional Care, 2014; 28(2): 149–154

Effects of SBAR Utilization by Healthcare Providers on Patient Outcomes: A Systematic Review of the Literature

Problem: Communication failures have been identified as a leading cause of sentinel events. Communication failures have been shown to lead to patient management errors which include falls risk, medication administration mis-management or error, and delay in patient treatment. Studies show that SBAR (Situation-Background-Assessment-Recommendation), a structured communication tool, helps guide communication among healthcare professionals and when used, can reduce the incidence of sentinel events and improve patient health outcomes. Purpose: The purpose of this systematic review was to assess the literature evaluating the effectiveness of SBAR utilization by healthcare providers on patient health outcomes. Search Strategy: The Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library Databases, PubMed, and non-indexed journals were searched for studies published from 2008 to 2019. Articles in English, with keywords SBAR, communication, patient/health outcomes, nurse, physician/doctor, interprofessional healthcare team or patient safety were eligible for inclusion. Studies conducted outside of inpatient settings or in simulated settings, and studies that did not measure patient outcomes were excluded. Results of Literature Search: Out of 570 articles identified, eight articles met the inclusion criteria. Synthesis of Evidence: Outcomes measured described in the articles include collaboration and perception of communication (n=7), incident reports related to poor communication (n=3), unplanned intensive care unit (ICU) admissions (n=1), decrease in unexpected deaths (n=1), and Foley removal compliance (n=1). Two overarching themes were noted: perception of collaboration and patient outcomes. There were significant improvements in perception of collaboration and communication, patient safety, number of incident reports, unexpected deaths, readmission rates, and Foley catheter removal compliance. Although one study noted a decrease in near-miss reporting and in the number of major falls, there was an overall increase in falls. Implications for Practice: SBAR utilization among healthcare providers was found to have positive patient health outcomes as a result of clear, concise communication. Being at the forefront of patient care, registered nurses need to be educated in and encouraged to implement SBAR as a structured communication tool when speaking with healthcare professionals.No embargoAcademic Major: Nursin

TeamSTEPPS Pilot Course

A new and exciting course on TeamSTEPPS was introduced at Jefferson last Spring. JCIPE has embraced the concept of TeamSTEPPS, a program developed by the Department of Defense and now sponsored by AHRQ to train healthcare professionals to work together effectively as a team to ensure patient safety. The following team skills are emphasized: leadership, situational awareness, team support and communication skills. To introduce this to the campus JCIPE sponsored a pilot project in May, 2013 to train a cadre of students in the techniques of TeamSTEPPS

Effects of Implementing a Health Team Communication Redesign on Hospital Readmissions Within 30 Days

Background and Rationale Poor communication between health team members can interfere with timely, coordinated preparation for hospital discharge. Research on daily bedside interprofessional health team rounds and nursing bedside shift handoff reports provides evidence that these strategies can improve communication. Aims To improve health team communication and collaboration about hospital discharge; improve patient experience of discharge measured by patient‐reported quality of discharge teaching, readiness for discharge, and postdischarge coping difficulty; and reduce readmissions and emergency department (ED) visits postdischarge. Methods A two‐sample pre‐ and postintervention design provided baseline data for redesign of health team communication processes and comparison data for evaluation of the new process’ impact. Health team members (n = 105 [pre], n = 95 [post]) from two surgical units of an academic medical center in the midwestern United States provided data on discharge‐related communication and collaboration. Patients (n = 413 [pre], n = 191 [post]) provided data on their discharge experience (quality of discharge teaching, readiness for discharge, postdischarge coping difficulty) and outcomes (readmissions, ED visits). Chi‐square and t tests were used for unadjusted pre‐ and postintervention comparisons. Logistic regression of readmissions with a matched pre‐ and postintervention sample included adjustments for patient characteristics and hospitalization factors. Results Readmissions decreased from 18% to 12% (p \u3c .001); ED visits decreased from 4.4% to 1.5% (p \u3c .001). Changes in health team communication and collaboration and patients’ experience of discharge were minimal. Discussion The targeted outcomes of readmission and ED visits improved after the health team communication process redesign. The process indicators did not improve; potential explanations include unmeasured hospital and unit discharge, and other care process changes during the study timeframe. Linking Evidence to Practice Evidence from daily interprofessional team bedside rounding and bedside shift report studies was translated into a redesign of health team communication for discharge. These strategies support readmission reduction efforts