1. TeamSTEPPS Pre-Training Webinar May 18, 2012

2. T EAM STEPPS 05.2 Mod 1 05.2 Page 2 TeamSTEPPS Pre-Training Webinar David P. Baker, PhD Vice President, Health Practice Research, IMPAQ International IMPAQ is part of HRET’s National Implementation Program Team Previous Work on TeamSTEPPS Led TeamSTEPPS development team Project Director for numerous TeamSTEPPS initiatives Supported internal TeamSTEPPS implementation in Pediatrics, Trauma, Pharmacy, IPE, and L&D Conducted research on the impact of TeamSTEPPS Master TeamSTEPPS Trainer

3. T EAM STEPPS 05.2 Mod 1 05.2 Page 3 TeamSTEPPS Pre-Training Webinar Acknowledgements Project Sponsors Jim Battles, PhD (AHRQ) Heidi King, MS (DoD) Project Team Health Research & Educational Trust (HRET) Steve Hines, PhD (Project Director) Chris Hund, MA (Project Manager) IMPAQ International Booz Allen Hamilton (BAH) Kathryn Schulke (Team Lead)

4. T EAM STEPPS 05.2 Mod 1 05.2 Page 4 TeamSTEPPS Pre-Training Webinar Take Away Messages TeamSTEPPS Public domain resource based on the evidence Customizable and adaptable Producing positive results Being a Master Trainer Involves More Than Participating in Training Success with TeamSTEPPS Depends Upon Proper Preparation, an Understanding of the Need, and a Commitment to Change

5. T EAM STEPPS 05.2 Mod 1 05.2 Page 5 TeamSTEPPS Pre-Training Webinar Goals of the Pre-Training Webinar Describe the Importance of TeamSTEPPS and the TeamSTEPPS Master Trainer Program Describe What Participants in TeamSTEPPS Master Training Should do Prior to Training Describe the TeamSTEPPS Master Training Describe What Happens After TeamSTEPPS Master Training

6. T EAM STEPPS 05.2 Mod 1 05.2 Page 6 TeamSTEPPS Why is TeamSTEPPS Training Important?

7. T EAM STEPPS 05.2 Mod 1 05.2 Page 7 TeamSTEPPS Pre-Training Webinar Improves Teamwork What is a Team? –A minimum of two or more individuals –Assigned specific roles and tasks –Share a common goal –Perform tasks that are interdependent The Delivery of Safe and Efficient Care Requires Teamwork

8. T EAM STEPPS 05.2 Mod 1 05.2 Page 8 TeamSTEPPS Pre-Training Webinar 8 Over 300 Articles and 10,000 Teams Results Overall, team training was shown to have a moderate, positive effect on team outcomes (ρ =.38) Accounted for 14.4% of variance Effect of team training was moderated by outcome type Cognitive (ρ =.41) – 16.8% of variance Affective (ρ =.35) – 12.3% of variance Process (ρ =.44) – 19.4% of variance Performance (ρ =.37) – 13.7% of variance Meta-Analysis Results (Salas et al., 2008)

9. T EAM STEPPS 05.2 Mod 1 05.2 Page 9 TeamSTEPPS Pre-Training Webinar What is Teamwork? INPUTS Task Characteristics Team Member Characteristics OUTPUTS Products of Teamwork PROCESS Interaction Coordination

10. T EAM STEPPS 05.2 Mod 1 05.2 Page 10 TeamSTEPPS Pre-Training Webinar Components of Teamwork Team Members Cognitions Knowledge “Think” Behaviors Skills “Do” Attitudes Affect “Feel”

11. T EAM STEPPS 05.2 Mod 1 05.2 Page 11 TeamSTEPPS Pre-Training Webinar Skills Team Leadership –Direct/Coordinate team members Communication –Information exchange between a sender and receiver Mutual Performance Monitoring –Tracking fellow team members’ performance Back-up Behavior –Assisting team members in task performance

12. T EAM STEPPS 05.2 Mod 1 05.2 Page 12 TeamSTEPPS Pre-Training Webinar Attitudes and Knowledge Mutual Trust –A shared belief that team members will perform their roles and protect the interest of teammates Team Orientation –A belief that a team approach is better than an individual one Shared Mental Models –A shared understanding of the relation between the tasks and the team

13. T EAM STEPPS 05.2 Mod 1 05.2 Page 13 TeamSTEPPS Pre-Training Webinar Levels of KSA Competencies Individual - Task-Level –Held by an individual –The KSAs necessary to perform specific tasks Individual - Team-Level –Team KSAs that are held by an individual –The team competencies an individual brings to a team –Transferable across teams Team - Team-Level –Team KSAs held by a team –Unique KSAs that develop within the team/not transfer

14. T EAM STEPPS 05.2 Mod 1 05.2 Page 14 TeamSTEPPS Pre-Training Webinar Producing Effective Teams Select the Right Individuals for the Team Modify Team Tasks, Workflow, Structure Provide Support, Resources, Performance Aids Build Team Member Knowledge, Skill, and Attitude Competencies (KSAs) - TEAM TRAINING

15. T EAM STEPPS 05.2 Mod 1 05.2 Page 15 TeamSTEPPS What is TeamSTEPPS and the National Implementation Program?

16. T EAM STEPPS 05.2 Mod 1 05.2 Page 16 TeamSTEPPS Pre-Training Webinar TeamSTEPPS ® AHRQ and DoD public domain curriculum for teaching teamwork to healthcare professionals Developed by AHRQ and DoD Released in Fall 2006 National standard for team training in healthcare Initiative based on evidence derived from team performance…leveraging more than 25 years of research in military, aviation, nuclear power, business and industry Designed to be customizable to the institution

17. T EAM STEPPS 05.2 Mod 1 05.2 Page 17 TeamSTEPPS Pre-Training Webinar 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 guidance on how to teach TeamSTEPPS to others in your organization Prepares You to Serve as a Leader for Implementing TeamSTEPPS within Your Organization

18. T EAM STEPPS 05.2 Mod 1 05.2 Page 18 TeamSTEPPS Pre-Training Webinar John Kotter 8 Steps of Change

19. T EAM STEPPS 05.2 Mod 1 05.2 Page 19 TeamSTEPPS Pre-Training Webinar National Implementation Program Prior Efforts: Created a national infrastructure to support the adoption of TeamSTEPPS (Jan 2008 – Aug 2009) Quality Improvement Organizations Patient Safety Improvement Corps Early adopters Current Efforts: Support the spread of TeamSTEPPS nationally (Sep 2009 - Present) Open to all healthcare institutions

20. T EAM STEPPS 05.2 Mod 1 05.2 Page 20 TeamSTEPPS Pre-Training Webinar National Implementation Team North Shore Long Island Jewish TRC Duke TRC Presbyterian St. Luke’s TRC Minnesota -TRC University of Washington TRC Tulane University TRC HRET BAH IMPAQ

21. T EAM STEPPS 05.2 Mod 1 05.2 Page 21 TeamSTEPPS Pre-Training Webinar Other Available Resources AHRQ Website (http://teamstepps.ahrq.gov/)http://teamstepps.ahrq.gov/ Program overview Training curricula (Essentials course; Fundamentals course; measures; new modules) Materials to download and/or order TeamSTEPPS Implementation Guide Measurement tools TeamSTEPPS National Conference Updated information available at http://teamstepps.ahrq.gov/nationalconference.htm http://teamstepps.ahrq.gov/nationalconference.htm

22. T EAM STEPPS 05.2 Mod 1 05.2 Page 22 TeamSTEPPS Pre-Training Webinar Questions and Answers To Ask a Question: Use the Q&A panel located on the right side of your screen Type your question into the text field Please keep the “Send To” option defaulted to ALL PANELISTS Click ‘Send’

23. T EAM STEPPS 05.2 Mod 1 05.2 Page 23 TeamSTEPPS What Should You Do Before the Training?

24. T EAM STEPPS 05.2 Mod 1 05.2 Page 24 TeamSTEPPS Pre-Training Webinar Identify Specific Areas for Improvement Define the Need that is Driving Your Organization to Consider TeamSTEPPS What are the areas for improvement? In which units/organizations are the improvements needed? Determine Whether Stronger Teamwork and Safety Culture is an Appropriate Strategy for Addressing Your Organization’s Needs

25. T EAM STEPPS 05.2 Mod 1 05.2 Page 25 TeamSTEPPS Pre-Training Webinar Identify Specific Areas for Improvement Review Existing Data RCAs, near miss events, FMEAs Culture survey Patient satisfaction Conduct a Site Assessment Interviews, observation Leadership Magic Wand Exercise Information will be Useful During Implementation Planning

26. T EAM STEPPS 05.2 Mod 1 05.2 Page 26 TeamSTEPPS Pre-Training Webinar Learn About Other TeamSTEPPS Efforts in Your Organization Gather Knowledge Related to Other Uses of TeamSTEPPS within Your Organization Has leadership already been involved in any TeamSTEPPS efforts? Have other units/areas of your hospital already implemented aspects of TeamSTEPPS? If so, which ones, and were they successful? Are there TeamSTEPPS tools and/or strategies your organization already knows and/or uses?

27. T EAM STEPPS 05.2 Mod 1 05.2 Page 27 TeamSTEPPS Pre-Training Webinar Involve Organizational Leaders Share Information to Promote Awareness of TeamSTEPPS http://teamstepps.ahrq.gov/ Guide to Action Conduct a Briefing with Hospital or System- Level Leaders Customizable leadership briefing http://teamstepps.ahrq.gov/abouttoolsmaterials.htm http://teamstepps.ahrq.gov/abouttoolsmaterials.htm Identify Potential Change Agents/Partners in Your Organization Not just executives, but informal leaders who can effect change

28. T EAM STEPPS 05.2 Mod 1 05.2 Page 28 TeamSTEPPS Pre-Training Webinar Determine Readiness Factors for Consideration Which units/areas are most ready for and in need of TeamSTEPPS? Is/are there any unit(s) in which TeamSTEPPS can be implemented now? Is the timing right in terms of avoiding competition with other major initiatives or changes? In which units/areas can success be expected, and later used as an example for spreading TeamSTEPPS in the organization?

29. T EAM STEPPS 05.2 Mod 1 05.2 Page 29 TeamSTEPPS Pre-Training Webinar Organizational Readiness Assessment Available Online (http://teamstepps.ahrq.gov/readiness/)http://teamstepps.ahrq.gov/readiness/ Uses Yes/No Questions to Assess Readiness Questions based on the TeamSTEPPS program and elements required for successful implementation and sustainment of change efforts Provides Rationale for Questions and Additional Information Summarizes Readiness Provides Tips and Suggestions for Enhancing Organizational Readiness

30. T EAM STEPPS 05.2 Mod 1 05.2 Page 30 TeamSTEPPS Pre-Training Webinar Identify Who to Send to Training It is Important to Send the Right Individuals Responsible for driving the change Represent all professions Supported by leadership Ensure the Identified Trainees are Aware of the Goals of the Training

31. T EAM STEPPS 05.2 Mod 1 05.2 Page 31 TeamSTEPPS What Will TeamSTEPPS Master Training be Like?

32. T EAM STEPPS 05.2 Mod 1 05.2 Page 32 TeamSTEPPS Pre-Training Webinar Organization of the Training Curriculum Two-Day Course Includes Various Instructional Strategies Information lectures and stories Interactive exercises Implementation workshop

33. T EAM STEPPS 05.2 Mod 1 05.2 Page 33 TeamSTEPPS Pre-Training Webinar Training Materials Provided TeamSTEPPS Instructor Guide Binder of instructor and trainee materials CD/DVD of multimedia materials Pocket Guide Guide to Action TeamSTEPPS for Rapid Response Systems DVD

34. T EAM STEPPS 05.2 Mod 1 05.2 Page 34 TeamSTEPPS Pre-Training Webinar Day 1 - Core Elements 34

35. T EAM STEPPS 05.2 Mod 1 05.2 Page 35 TeamSTEPPS Pre-Training Webinar Tools and Strategies TOOLS and STRATEGIES Brief Huddle Debrief STEP Cross Monitoring Feedback Advocacy and Assertion Two-Challenge Rule CUS DESC Script Collaboration SBAR Call-Out Check-Back Handoff OUTCOMES Shared Mental Model Adaptability Team Orientation Mutual Trust Team Performance Patient Safety!! BARRIERS Inconsistency in Team Membership Lack of Time Lack of Information Sharing Hierarchy Defensiveness Conventional Thinking Complacency Varying Communication Styles Conflict Lack of Coordination and Follow-Up with Co-Workers Distractions Fatigue Workload Misinterpretation of Cues Lack of Role Clarity

36. T EAM STEPPS 05.2 Mod 1 05.2 Page 36 TeamSTEPPS Pre-Training Webinar Day 2 – Coach, Implement, Sustain

37. T EAM STEPPS 05.2 Mod 1 05.2 Page 37 TeamSTEPPS Pre-Training Webinar Implementation Planning Workshop Plan How TeamSTEPPS will be Integrated into Your Organization What is the specific need to address? Who will be responsible for driving the change? Where is buy-in required? What TeamSTEPPS tools and/or strategies will be targeted? The Product of the Workshop will be a Draft Plan for Implementing TeamSTEPPS in Your Organization

38. T EAM STEPPS 05.2 Mod 1 05.2 Page 38 TeamSTEPPS What Happens After the Training?

39. T EAM STEPPS 05.2 Mod 1 05.2 Page 39 TeamSTEPPS Pre-Training Webinar Role of a Master Trainer Make it Happen, Make it Stick! Use the Planning Conducted During Training to Take Action When Your Return Serve as a Change Agent Train TeamSTEPPS to Others in Your Organization

40. T EAM STEPPS 05.2 Mod 1 05.2 Page 40 TeamSTEPPS Pre-Training Webinar Access to Additional TeamSTEPPS Resources TeamSTEPPS National Conference User Support Network http://teamsteppsportal.com/ Announcements and events Tools and resources for use Webinars Discussion forum Submit a request for support

41. T EAM STEPPS 05.2 Mod 1 05.2 Page 41 TeamSTEPPS Pre-Training Webinar Questions and Answers To Ask a Question: Use the Q&A panel located on the right side of your screen Type your question into the text field Please keep the “Send To” option defaulted to ALL PANELISTS Click ‘Send’

42. T EAM STEPPS 05.2 Mod 1 05.2 Page 42 TeamSTEPPS Pre-Training Webinar Thank You! For more information, please contact our team at: AHRQTeamSTEPPS@aha.org