TeamSTEPPS Implementation: Fostering Buy-in from the Front Lines to the C-suite February 25, 2015

T EAM STEPPS 05.2 Mod Page 2 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 2 Rules of Engagement Audio for the webinar can be accessed in two ways: 1.Through the phone (*Please mute your computer speakers) 2.Through your computer A Q&A session will be held at the end of the presentation Written questions are encouraged throughout the presentation and will be answered during the Q&A session To submit a question, type it into the Discussion Area and send it at any time during the presentation The lines may open for call-in questions during the Q&A session

T EAM STEPPS 05.2 Mod Page 3 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 3 Acknowledgements Project Sponsors Jim Battles, PhD (AHRQ) Heidi King, MS (DoD) Project Team Health Research & Educational Trust (HRET) Barb Edson (Project Director) Chris Hund (Project Manager) IMPAQ International David Baker (Team Lead)

T EAM STEPPS 05.2 Mod Page 4 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 4 TeamSTEPPS Master Training Two-day training course Train-the-trainer approach Prepares you to serve as a TeamSTEPPS Master Trainer by Providing instruction on TeamSTEPPS tools and strategies Providing an opportunity to develop and plan your TeamSTEPPS implementation Prepares you to serve as a leader for implementing TeamSTEPPS within your organization

T EAM STEPPS 05.2 Mod Page 5 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 5 Upcoming TeamSTEPPS Events Monthly Webinars Scheduled through September 2015 Topics, speakers, and registration information will be posted on the portal Register now for the March webinar: Coaching Teamwork Behaviors: Strategies to Reinforce TeamSTEPPS Skills Master Training Courses Registration available for April and May 2015 courses Online Course Availability Not able to travel? TeamSTEPPS 2.0 Online Master Trainer Course now available Register and enroll at:

T EAM STEPPS 05.2 Mod Page 6 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 6 Upcoming TeamSTEPPS Events (Cont’d) Annual Conference June 16-18, 2015 Denver, Colorado at the Westin Downtown Denver Learn more and register for all events at

T EAM STEPPS 05.2 Mod Page 7 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 7 Help Line (312) Or

T EAM STEPPS 05.2 Mod Page 8 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 8 Today’s Presenter Robert Smith, Ph.D. Director, Medical Staff Assistance Program, MetroHealth System Assistant Professor of Psychiatry, Case Western Reserve University, School of Medicine and MetroHealth System Organizational Champion for TeamSTEPPS Director, TeamSTEPPS Regional Training Center

T EAM STEPPS 05.2 Mod Page 9 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 9 Objectives Describe strategies for gaining buy-in for TeamSTEPPS from executive staff Discuss the engagement of physicians and other staff Discuss how buy-in and other factors are used to determine the readiness of a unit or department for TeamSTEPPS implementation

T EAM STEPPS 05.2 Mod Page 10 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 10 Who is MetroHealth?

T EAM STEPPS 05.2 Mod Page 11 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 11 Serving Cuyahoga County in Cleveland since 1837 One of the largest healthcare organizations in Northeast Ohio 700-bed medical center 17 community health centers MetroHealth

T EAM STEPPS 05.2 Mod Page 12 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 12 Over 476 Primary Care/ Specialty Physicians 1,230 Registered Nurses 145 Advanced Practice Nurses

T EAM STEPPS 05.2 Mod Page 13 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 13 Twenty-four Residency Programs 374 Interns/Residents Fifteen Fellowship Programs 55 Fellows 1 st and 2 nd Year Medical Students, etc “students”

T EAM STEPPS 05.2 Mod Page 14 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 14 Patient Care at MetroHealth Care provided in ,000 inpatients 2,900 newborns delivered Over 1,000,000 visits in outpatient centers Over 107,000 visits to the Emergency Department

T EAM STEPPS 05.2 Mod Page 15 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 15 How to Get Started: Select your “Champion” and “Change Team”

T EAM STEPPS 05.2 Mod Page 16 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 16

T EAM STEPPS 05.2 Mod Page 17 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 17 Champion Passionate Confident Respected, knowledgeable, influential Able to dedicate time Willing to own the project and take risks Comfortable making presentations Understands culture and politics

T EAM STEPPS 05.2 Mod Page 18 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 18

T EAM STEPPS 05.2 Mod Page 19 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 19 Change Team Influential and passionate Respected by peers Understands culture and politics Has access to information and resources Models leadership and communication Represents all key areas

T EAM STEPPS 05.2 Mod Page 20 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 20 Change Team Tasks Determine department’s/organization’s “real” interest Review literature Talk with organizations that have implemented TeamSTEPPS Ask “what is our commitment?”

T EAM STEPPS 05.2 Mod Page 21 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 21 Quality Department OB/GYN Emergency Medicine Surgery Trauma / Burn Units Medicine Pediatrics Geriatrics PM&R Ambulatory Care Medical ICU Organizational Develop Simulation Center Communication Diversity and Inclusion Marketing MetroHealth Union Organizational Change Team

T EAM STEPPS 05.2 Mod Page 22 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 22 Unit Change Team

T EAM STEPPS 05.2 Mod Page 23 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 23 Unit Change Team Medical Director Nurse Manager Representatives of all disciplines Nursing Attendings Physical Therapy Respiratory Therapy Environmental Services Unit Secretary

T EAM STEPPS 05.2 Mod Page 24 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 24 Target Administration for Buy-In

T EAM STEPPS 05.2 Mod Page 25 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 25 Persuading Administration Research regarding Medical Teams Tell the story of TeamSTEPPS “Data tells, stories sell” “Why our organization?” Use existing internal data: quality, risk management, patient satisfaction, etc.

T EAM STEPPS 05.2 Mod Page 26 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 26 Persuading Administration Cost of errors to your organization Risk Management Data, Malpractice Data Investment / Cost Estimate resources needed, time away from work for training, etc.

T EAM STEPPS 05.2 Mod Page 27 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 27

T EAM STEPPS 05.2 Mod Page 28 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 28 Persuading Administration Expected outcome Review literature Not an educational program “A change in culture”

T EAM STEPPS 05.2 Mod Page 29 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 29 Persuading Administration Provide overview of plan Do not “oversell” Avoid tight deadlines Anticipate “results” 6 months to one year after implementation Plan for sustainability and measurement from the start

T EAM STEPPS 05.2 Mod Page 30 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 30 Examples of MetroHealth’s Administrative Buy-In

T EAM STEPPS 05.2 Mod Page 31 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 31 New MetroHealth Mission “Leading the way to a healthier you and a healthier community through service, teaching, discovery and teamwork.”

T EAM STEPPS 05.2 Mod Page 32 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 32 New MetroHealth Values Service to Others Make a Connection Teamwork Support Each Other Accountability Say What You’ll Do, and Do What You Say 32

T EAM STEPPS 05.2 Mod Page 33 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 33 New MetroHealth Values Respect Treat Everyone with Compassion and Dignity Inclusion and Diversity Embrace Individual and Cultural Differences Quest for Excellence Take Pride in Going the Extra Mile 33

T EAM STEPPS 05.2 Mod Page 34 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 34 Master Trainers

T EAM STEPPS 05.2 Mod Page 35 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 35 Carefully select your Master Trainers Respected as a team player Passion for teamwork Comfortable talking in front of a group Able to educate and facilitate discussion Creative and “fun” Able to commit time 35

T EAM STEPPS 05.2 Mod Page 36 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 36 Preparing Departments for Implementation

T EAM STEPPS 05.2 Mod Page 37 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 37 Determining “Readiness” Develop an Implementation Team Standardize your process: Brief presentation regarding TeamSTEPPS Survey the staff (AHRQ survey) Review role of instructors and ask for volunteers Return and present survey data

T EAM STEPPS 05.2 Mod Page 38 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 38 Determining “Readiness” Low return of surveys Minimal response to request for instructors Feedback – “this is just another training” Push back - “we don’t have time for this” Minimal support from Chair, Director, etc. Recognize that they may need to wait and that you may need to help them get ready.

T EAM STEPPS 05.2 Mod Page 39 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 39 TeamSTEPPS

T EAM STEPPS 05.2 Mod Page 40 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 40 Overcome Resistance Enlist Chairperson, Director, etc. Acquire survey data “Drill down” to identify issues Share survey data Conduct small focus groups to discuss staff reactions Be patient, but persistent

T EAM STEPPS 05.2 Mod Page 41 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 41 Engaging Staff

T EAM STEPPS 05.2 Mod Page 42 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 42

T EAM STEPPS 05.2 Mod Page 43 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 43 Key Elements No Consultants Program is flexible and nothing is imposed Design program to make it relevant Instructors from each area will teach staff and serve as coaches

T EAM STEPPS 05.2 Mod Page 44 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 44 Adult Learner Model of Instruction Limited lecture - avoid “death by PowerPoint” Opportunity for questions and discussion Role-play and simulation Avoid “one size fits all” Enjoyable experience - “fun”

T EAM STEPPS 05.2 Mod Page 45 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 45 If you believe and you have a quality team, You can take something wonderful and turn it into something…

T EAM STEPPS 05.2 Mod Page 46 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 46 Magical

T EAM STEPPS 05.2 Mod Page 47 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 47 Questions and Answers

T EAM STEPPS 05.2 Mod Page 48 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 48 Thank You! For more information, please contact our team at: