Evaluating Efforts to Optimize TeamSTEPPS Implementation in Surgical and Pediatric Intensive Care Units

Mayer, Celeste; Cluff, Laurie; Lin, Wei; Willis, Tina Schade; Stafford, Renae E.; Williams, Christa; Saunders, Roger; Short, Kathy A.; Lenfestey, Nancy; Kane, Heather; Amoozegar, Jacqueline

doi:10.1016/s1553-7250(11)37047-x

Cited by 114 publications

(98 citation statements)

References 9 publications

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“…The meta-analysis conducted by Salas et al supports team training as an appropriate intervention for influencing team processes and performance 27. Our findings are similar to recent reports of the impact of team training using TeamSTEPPS/modified TeamSTEPPS 10 28 29. However, methodological constraints still prevents us from directly correlating team training to clinical outcomes 30…”

Section: Discussionsupporting

confidence: 84%

Building a culture of safety through team training and engagement

2012

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Medical errors continue to occur despite multiple strategies devised for their prevention. Although many safety initiatives lead to improvement, they are often short lived and unsustainable. Our goal was to build a culture of patient safety within a structure that optimised teamwork and ongoing engagement of the healthcare team. Teamwork impacts the effectiveness of care, patient safety and clinical outcomes, and team training has been identified as a strategy for enhancing teamwork, reducing medical errors and building a culture of safety in healthcare. Therefore, we implemented Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), an evidence-based framework which was used for team training to create transformational and/or incremental changes; facilitating transformation of organisational culture, or solving specific problems. To date, TeamSTEPPS (TS) has been implemented in 14 hospitals, two Long Term Care Facilities, and outpatient areas across the North Shore LIJ Health System. 32 150 members of the healthcare team have been trained. TeamSTEPPS was piloted at a community hospital within the framework of the health system's organisational care delivery model, the Collaborative Care Model to facilitate sustainment. AHRQ's Hospital Survey on Patient Safety Culture, (HSOPSC), was administered before and after implementation of TeamSTEPPS, comparing the perception of patient safety by the heathcare team. Pilot hospital results of HSOPSC show significant improvement from 2007 (pre-TeamSTEPPS) to 2010. System-wide results of HSOPSC show similar trends to those seen in the pilot hospital. Valuable lessons for organisational success from the pilot hospital enabled rapid spread of TeamSTEPPS across the rest of the health system.

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Section: Discussionsupporting

confidence: 84%

Building a culture of safety through team training and engagement

2012

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“…We identified very few studies that evaluated the attitudinal impact of staff as long as 1 year after training,6 10 20 44–46 with one study investigating outcomes 18 months later 17. In our study, we found that improved teamwork attitudes persisted 2 years after our interventions.…”

Section: Discussionmentioning

confidence: 61%

“…As in other medical fields, there is an assumption that neonatal clinicians will acquire teamwork skills through observation and experience. Formal teamwork training of clinicians has been shown to lead to fewer errors and better clinical outcomes in several clinical areas, including the emergency room department,3–5 operating room,4 6–11 antepartum obstetrics unit,12 13 delivery room14–19 and intensive care units 20. These findings have prompted numerous organisations including The Joint Commission and the Institute of Medicine21–23 to recommend team training as an effective strategy for curtailing medical errors.…”

Section: Introductionmentioning

confidence: 99%

Building collaborative teams in neonatal intensive care

et al. 2013

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The complex multidisciplinary nature of neonatal intensive care combined with the numerous hand-offs occurring in this shift-based environment, requires efficient and clear communication and collaboration among staff to provide optimal care. However, the skills required to function as a team are not typically assessed, discussed, or even taught on a regular basis among neonatal personnel. We developed a multidisciplinary, small group, interactive workshop based on Team STEPPS to provide staff with formal teamwork skills, and to introduce new team-based practices; 129 (95%) of the eligible 136 staff were trained. We then compared the results of the pretraining survey (completed by 114 (84%) of staff) with the post-training survey (completed by 104 (81%) of participants) 2 years later. We found an improvement in the overall teamwork score from 7.37 to 8.08 (p=<0.0001) based on a range of poor (1) to excellent (9). Respondents provided higher ratings in 9 out of 15 team-based categories after the training. Specifically, staff found improvements in communication (p=0.037), placed greater importance on situation awareness (p=<0.00010), and reported that they supported each other more (p=<0.0001). Staff satisfaction was rated higher post-training, with responses showing that staff had greater job fulfilment (p=<0.0001), believed that their abilities were being utilised properly (p=0.003), and felt more respected (p=0.0037). 90% of staff found the new practice of team meetings to help increase awareness of unit acuity, and 77% of staff noted that they had asked for help or offered assistance because of information shared during these meetings. In addition to summarising the results of our training programme, this paper also provides practical tools that may be of use in developing team training programmes in other neonatal units.

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“…TeamSTEPPS is a training program developed by the United States Department of Defense and the AHRQ that encompasses leadership, situation monitoring, mutual support and communication. 7,80,198 The TeamSTEPPS Teamwork Perception Questionnaire is a second instrument associated with this curriculum that measures individuals' perceptions of organizational teamwork. 216 Few tools (12, 16 %) reported response process, which included training raters to correctly use tools.…”

Section: Description and Validity Evidence For Teamwork Assessment Toolsmentioning

confidence: 99%

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

et al. 2013

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OBJECTIVE: Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. DATA SOURCES: We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. STUDY ELIGIBILITY: Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. STUDY APPRAISAL AND SYNTHESIS METHODS:Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. RESULTS: Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. LIMITATIONS: Review is limited to quantitative assessments of teamwork in internal medicine. CONCLUSIONS:There is strong validity evidence for several published tools assessing teamwork in internal medicine. However, few teamwork assessments have been directly linked to patient outcomes. 3,4 Recognizing this, the Institute of Medicine, the Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), and others have made teamwork a top priority in their recommendations for improving healthcare. [5][6][7][8][9] Teamwork is also prominently positioned within the American Board of Internal Medicine (ABIM) requirements for maintenance of certification for internists, 10 as well as the Accreditation Council for Graduate Medical Education's core competencies, 11 milestones, 12 and medical student competencies. 13 As such, every physician at the undergraduate, graduate, and continuing professional level must demonstrate competency in teamwork.While there is broad agreement on the imperative to improve teamwork, there is littl...

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Evaluating Efforts to Optimize TeamSTEPPS Implementation in Surgical and Pediatric Intensive Care Units

Cited by 114 publications

References 9 publications

Building a culture of safety through team training and engagement

Building a culture of safety through team training and engagement

Building collaborative teams in neonatal intensive care

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

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