TeamSTEPPS in Long-Term Care

T EAM STEPPS 05.2 Mod Page 2 TeamSTEPPS Why Long-Term Care? Long-term care environment is unique “Patients” are called Residents Care Teams: multi-disciplinary, include non- clinical staff Approximately 16,000 nursing homes and 1.6M nursing home residents across the country

T EAM STEPPS 05.2 Mod Page 3 TeamSTEPPS Focus of Long-Term Care Version Text and associated training materials made relevant to the long-term care environment Language meaningful to long-term care Exercises, scenarios, tests and videos center around chronic medical or rehabilitation circumstances Graphics and pictures reflect nursing home staff, care and environment

T EAM STEPPS 05.2 Mod Page 4 TeamSTEPPS Long-Term Care Team

T EAM STEPPS 05.2 Mod Page 5 TeamSTEPPS Nurse Assistant Chef Rosie the Housekeeper Social Worker Therapeutic Recreation/Activity Staff Nurse Administrator

T EAM STEPPS 05.2 Mod Page 6 TeamSTEPPS Implementation Evidence tested with long-term care leadership and staff Adjust for audience, including education level and English proficiency Share experiences and stories Supplement lectures with exercises Hold brief yet frequent learning sessions Focus on communication skills 6

T EAM STEPPS 05.2 Mod Page 7 TeamSTEPPS Long-Term Care Videos Two videos created Long-term care – subtle decline in a resident over a 24 hour period Sub-acute care –possible Myocardial Infarction/Pulmonary Embolism in a resident receiving physical therapy 14 of 15 TeamSTEPPS skills were highlighted Time-Out is not a skill deemed necessary for most nursing homes

T EAM STEPPS 05.2 Mod Page 8 TeamSTEPPS Conflict Resolution & Patient Safety Conflict between an Activities Staff and a Nurses Aide TeamSTEPPS Skills Used: Two-Challenge Rule DESC Script 8

T EAM STEPPS 05.2 Mod Page 9 TeamSTEPPS Two-Challenge Rule Invoked when an initial assertion is ignored… It is your responsibility to assertively voice your concern at least two times to ensure that it has been heard The member being challenged must acknowledge If the outcome is still not acceptable Take a stronger course of action Use supervisor or chain of command 9

T EAM STEPPS 05.2 Mod Page 10 TeamSTEPPS Two-Challenge Rule in Action 10

T EAM STEPPS 05.2 Mod Page 11 TeamSTEPPS Conflict Resolution: DESC Script A constructive approach for managing and resolving conflict D—Describe the specific situation E—Express your concerns about the action S—Suggest other alternatives C—Consequences should be stated Ultimately, consensus shall be reached. 11

T EAM STEPPS 05.2 Mod Page 12 TeamSTEPPS Let’s “DESC-It!” 12 Have timely discussion Frame problem in terms of your own experience Use “I” statements to minimize defensiveness Avoid blaming statements Critique is not criticism Focus on what is right, not who is right

T EAM STEPPS 05.2 Mod Page 13 TeamSTEPPS DESC Script in Action 13

T EAM STEPPS 05.2 Mod Page 14 TeamSTEPPS New in Long-Term Care Version Videos and Discussions Discussion questions about videos and use of skills Exercises, Scenarios Care planning group exercise Multi-disciplinary scenarios Non-clinical examples and scenarios Non-clinical application of TeamSTEPPS skills and techniques 14

T EAM STEPPS 05.2 Mod Page 15 TeamSTEPPS Contact Information Qualidigm: Michelle Pandolfi Ann Spenard Abt Associates: Donna Hurd