An organization is more likely to be ready to undertake a TeamSTEPPS initiative
when it has objective information to support the need for improving specific areas.
Objective information can originate from a variety of sources, including adverse
event and near-miss reports, root cause analyses or failure modes and effects analyses,
administering the AHRQ Patient Safety Culture Survey, surveys of patient or staff
satisfaction, and unit- or site-specific process and outcome measures (patient flow,
hospital acquired infection rates, preventable deaths).
TeamSTEPPS is a teamwork system that offers a powerful solution to improving collaboration
and communication within your institution. Teamwork has been found to be one of
the key initiatives within patient safety. Patient safety experts agree that communication
and other teamwork skills are essential for providing quality health care and preventing
and mitigating medical errors. An organization that is ready to focus on teamwork
and safety is more likely to benefit from a TeamSTEPPS intervention.
If your organization is currently experiencing many changes, it may not be the ideal
moment to begin implementing the TeamSTEPPS initiative. Attempting to manage multiple
change efforts at one time may degrade your institution’s ability and employees’
willingness to implement and sustain the TeamSTEPPS effort. The program may be viewed
as a distraction rather than a solution.
The goal of TeamSTEPPS is to provide the safest and highest quality health care.
This involves optimizing a complicated delivery system of people and processes and
requires change, including recognizing the need for change, developing a culture
that will accept change, and fostering change in individuals’ approaches to the
health care delivery process. This change may involve giving people freedom and
discretion, encouraging risk-taking and speaking up, giving permission to find team-driven
solutions. Your institution must be willing to change its culture and processes
to enhance teamwork and safety.
It is essential that the leaders of your institution actively support and champion
TeamSTEPPS. Leaders needs to understand the requirements of the program (e.g., trainer
preparation and training, ongoing coaching, weekly team meetings to reinforce concepts)
and be willing to provide the personnel, time, and resources required to successfully
implement and sustain the program. In addition, it is important for leaders to understand
their role in sponsoring, evaluating, enabling, or modifying the behaviors necessary
to shape and maintain the targeted safety or teamwork behavior changes.
It is important to find individuals with the right characteristics to serve as trainers
to increase the success of the TeamSTEPPS initiative. Instructors should be:
Given that this is a culture change effort, the TeamSTEPPS initiative extends beyond
classroom teaching and calls for coaches to reinforce, monitor, and role model teamwork
principles in everyday practice. It is important to select individuals with the
right characteristics to serve as coaches to increase the likelihood of their success
and others’ receptiveness to their coaching. For coaching to be effective, one coach
is needed for every 10 staff members.
TeamSTEPPS offers a 2.5-day train-the-trainer course to educate instructors and
coaches in content fundamentals and the knowledge and training to implement and
coach the desired behaviors to achieve results.
Regardless of your institution’s plan for implementing TeamSTEPPS, some direct staff
training will be required. The full training element of the program includes up
to 6 hours of classroom learning; however, your institution may decide to train
only one segment (e.g., a specific tool or strategy) that may require 1 hour. To
preclude disruptions and scheduling problems and to maximize learning, participants
should be excused from all duties while attending class.
TeamSTEPPS provides flexibility in how it is implemented. An institution may determine
that it is best to select just one tool and implement that segment of the training
and the necessary follow-up coaching to ensure teams learn and continue to use the
tool to enhance teamwork and safety. Segments also include supplemental and interchangeable
content and examples that may be used to customize the program. In addition, institutions
may choose to have their own content and examples included. Each of these options
requires trainers to commit some time to customize the content.
For continued success, the organization needs to view the culture change as a process
rather than an event. It is important that your institution continually measure
the ongoing effectiveness of the TeamSTEPPS intervention. This enables the institution
to know whether the intervention is successful and to publicize that success to
gain additional staff buy-in or to make changes to the program. In addition, part
of the process is to identify further opportunities for patient safety and quality
improvement. Once these opportunities have been identified, the organization needs
to be willing to implement changes to address the opportunities.
To become accepted practice, positive teamwork behaviors and improvements in processes
and outcomes need to be reinforced and rewarded. Leaders, champions, instructors,
and coaches should be willing to provide ongoing feedback to others within the institution.
Successes need to be formally recognized and showcased throughout the organization.
These activities help maintain the momentum needed to sustain a culture of safety
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