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TeamSTEPPS OBGYN: A Department Initiative
Audrey Perry, CNMW, IPECS Initiative Jane Hooker, Director, Patient Safety Mark B. Woodland, MS, MD
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TeamSTEPPS Departmental Goals
Explore evidence based communication methods Recognize barriers to situational leadership Develop shared techniques to resolve conflict Shared mental model/ language of team work
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TeamSTEPPS Teamwork Attitudes Survey
Participants (n=76) RN (4), CNM (19), NP (11), PA (7), MD (26), Resident (9) General positive attitudes toward communication best practices General positive attitude toward team based best practices
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PreSurvey Results:
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TeamSTEPPS Director Patient Safety Observations
Project Began Sharing Information on Communication and Patient Safety Communication breakdowns figured in 30% of all malpractice claims between Communication breakdowns occurred in all settings 44% IP, 48% Medical Offices, 8% ED Miscommunication occurs between all roles TJC findings reveal communication primary root cause in over 70% of Sentinel Events 75% of these events ended with the death of the patient
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TeamSTEPPS Director Patient Safety Observations
Over-arching issues from the literature Language (different between professions and EMR**) Education (lack of knowledge, skills) Social status (hierarchy) Personal styles Culture Generational gaps/Historical context Pace of work and life Rapid pace of evolution of science in medicine
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TeamSTEPPS Chair Observations
Unique experience for an entire department to highlight OPPE (Ongoing Professional Performance Evaluation). Different providers engaged differently. Majority of providers saw the value of the exercise and the message in communication. Action items were identified to help improve communication to enhance patient experience, safety and quality of care. Here are a few: Optimize electronic communication - Electronic communication has many advantages and many disadvantages. Disadvantages decrease provider satisfaction and can adversely impact patient experience, quality and safety of care. Enhance human to human communication – Human to human communication is essential to know that communication has happened. Facilitate Documentation - Documentation of communication is also essential. Close Communication Loops - Open loops in communication must be closed and this is responsibility of all providers. Promote provider professionalism - Part of provider professionalism is to stay engaged, take responsibility for duties and actions, and promote patient safety and quality.
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TeamSTEPPS: Unanticipated Consequences
General acceptance of program 37 Physicians, 37 APC’s, 16 Residents, 36 Nurses Collaborative engaged IP work group Enhanced provider relationships Institutional endorsement/promotion In situ development of best practice fixes Others….. Summit Response and Debrief
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TeamSTEPPS Team Summary Themes
Barriers to communication uncomfortably with disagreement/ conflict in hierarchical culture lack of standardized language/ communication to address disagreements lack of role clarity technology overload Tools to enhance communication build respect/ relationships standardized communication tool to address disagreements/ concerns/ safety issue time out prior to delivery DESC Departmental communication quarterly, breakdown silos of communication
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Action Items:
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The road ahead….
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