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

2. T EAM STEPPS 05.2 Mod 1 05.2 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

3. T EAM STEPPS 05.2 Mod 1 05.2 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)

4. T EAM STEPPS 05.2 Mod 1 05.2 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

5. T EAM STEPPS 05.2 Mod 1 05.2 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: https://tslms.org https://tslms.org

6. T EAM STEPPS 05.2 Mod 1 05.2 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 www.TeamSTEPPSportal.org www.TeamSTEPPSportal.org

7. T EAM STEPPS 05.2 Mod 1 05.2 Page 7 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 7 Help Line (312) 422-2609 Or email: AHRQTeamSTEPPS@aha.orgAHRQTeamSTEPPS@aha.org

8. T EAM STEPPS 05.2 Mod 1 05.2 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

9. T EAM STEPPS 05.2 Mod 1 05.2 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

10. T EAM STEPPS 05.2 Mod 1 05.2 Page 10 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 10 Who is MetroHealth?

11. T EAM STEPPS 05.2 Mod 1 05.2 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

12. T EAM STEPPS 05.2 Mod 1 05.2 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

13. T EAM STEPPS 05.2 Mod 1 05.2 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. 1035 “students”

14. T EAM STEPPS 05.2 Mod 1 05.2 Page 14 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 14 Patient Care at MetroHealth Care provided in 2014 28,000 inpatients 2,900 newborns delivered Over 1,000,000 visits in outpatient centers Over 107,000 visits to the Emergency Department

15. T EAM STEPPS 05.2 Mod 1 05.2 Page 15 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 15 How to Get Started: Select your “Champion” and “Change Team”

16. T EAM STEPPS 05.2 Mod 1 05.2 Page 16 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 16

17. T EAM STEPPS 05.2 Mod 1 05.2 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

18. T EAM STEPPS 05.2 Mod 1 05.2 Page 18 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 18

19. T EAM STEPPS 05.2 Mod 1 05.2 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

20. T EAM STEPPS 05.2 Mod 1 05.2 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?”

21. T EAM STEPPS 05.2 Mod 1 05.2 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

22. T EAM STEPPS 05.2 Mod 1 05.2 Page 22 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 22 Unit Change Team

23. T EAM STEPPS 05.2 Mod 1 05.2 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

24. T EAM STEPPS 05.2 Mod 1 05.2 Page 24 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 24 Target Administration for Buy-In

25. T EAM STEPPS 05.2 Mod 1 05.2 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.

26. T EAM STEPPS 05.2 Mod 1 05.2 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.

27. T EAM STEPPS 05.2 Mod 1 05.2 Page 27 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 27

28. T EAM STEPPS 05.2 Mod 1 05.2 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”

29. T EAM STEPPS 05.2 Mod 1 05.2 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

30. T EAM STEPPS 05.2 Mod 1 05.2 Page 30 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 30 Examples of MetroHealth’s Administrative Buy-In

31. T EAM STEPPS 05.2 Mod 1 05.2 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.”

32. T EAM STEPPS 05.2 Mod 1 05.2 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

33. T EAM STEPPS 05.2 Mod 1 05.2 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

34. T EAM STEPPS 05.2 Mod 1 05.2 Page 34 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 34 Master Trainers

35. T EAM STEPPS 05.2 Mod 1 05.2 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

36. T EAM STEPPS 05.2 Mod 1 05.2 Page 36 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 36 Preparing Departments for Implementation

37. T EAM STEPPS 05.2 Mod 1 05.2 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

38. T EAM STEPPS 05.2 Mod 1 05.2 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.

39. T EAM STEPPS 05.2 Mod 1 05.2 Page 39 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 39 TeamSTEPPS

40. T EAM STEPPS 05.2 Mod 1 05.2 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

41. T EAM STEPPS 05.2 Mod 1 05.2 Page 41 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 41 Engaging Staff

42. T EAM STEPPS 05.2 Mod 1 05.2 Page 42 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 42

43. T EAM STEPPS 05.2 Mod 1 05.2 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

44. T EAM STEPPS 05.2 Mod 1 05.2 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”

45. T EAM STEPPS 05.2 Mod 1 05.2 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…

46. T EAM STEPPS 05.2 Mod 1 05.2 Page 46 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 46 Magical

47. T EAM STEPPS 05.2 Mod 1 05.2 Page 47 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 47 Questions and Answers

48. T EAM STEPPS 05.2 Mod 1 05.2 Page 48 TeamSTEPPS ® Fostering Buy-in: Front Lines to C-Suite Slide 48 Thank You! For more information, please contact our team at: AHRQTeamSTEPPS@aha.org