1. Building Your SUSP Team Part II

2. Learning Objectives
Define your SUSP team composition and roles and responsibilities of team members
Discuss the role of the executive partner on your SUSP team
Plan for initial SUSP team meetings
Define the project ‘pre-mortem’ process and how to use it.

3. The Peri-operative SUSP Team
Understands that patient safety culture is local
Is composed of engaged frontline providers from pre, intra-, and post-operative care areas who take ownership of patient safety
Includes staff members who have different levels of experience and perspectives
Meets regularly (weekly or at least monthly)
Has adequate resources including protected time
2 to 4 hours per week for a team leader, surgeon, anesthesia, nurse, and infection preventionist
NOTE: Will make sure this is consistent with other descriptions (this was pulled from FLEXTRA)

4. SUSP Team Members Essential Team Members Surgeons Anesthesiologists
CRNAs
Circulating nurses
Scrub nurses / OR techs
Perioperative nurses
Executive partner
Nurse leaders
Enhancing Team Members
Physician assistants
Nurse educators
Anesthesia assistants
Infection preventionists
OR directors
Patient safety officers
Chief quality officers
Ancillary staff

5. Summary of points to consider in team formation
Team composition: Are we set up for success?
Group size
Skill mix (technical expertise, interpersonal skills)
Team processes: Do we interact effectively?
Communication
Leadership
Education
Conflict management
Team norms: What are our values?
Mutual trust and respect
Inclusivity
Transparency

6. Getting team composition right: SUSP Team Membership Form
Poll Question:
Have you identified all your core team members?
Yes No

7. Establishing clear roles & responsibilities: SUSP Team Formation Worksheet
Armstrong Institute, 2012

8. Engaging Executive Partners
Identify an appropriate executive partner
Contact hospital management to determine which senior executive will best fit the unit and the following criteria:
Director level or above
Available to round for at least one hour per month
Approachable and comfortable with sensitive topics
Split slide into two

9. Engaging Executive Partners
Meet with the senior executive to secure his/her commitment
Senior executive participates in the Science of Safety Training
Schedule a Kick-off Meeting
Schedule the senior executive for 1.5 hours to ensure he/she has plenty of time to spend with the team
Align priorities and gain buy-in
Attend monthly SUSP meetings
One-hour meeting, on the unit, half of time spent meeting, half of the time interacting with caregivers on the unit
Split slide into two

10. Executive Leader’s SUSP Team Role Checklist
Education
Ensure science of safety training for all current and new employees
Foster organizational learning: disseminate learning from defect lessons with expectations for local adaptation

11. Executive Leader’s SUSP Team Role Checklist (cont’d)
Policies and Procedures
Create a policy for unit level accountability: document learning from at least one defect per quarter
Assess and improve usefulness of briefing and debriefing
Quality of implementation
Surfacing and resolving defects

12. Executive Leader’s SUSP Team Role Checklist (cont’d)
Acknowledge work of teams
Celebrate success through stories in hospital newsletter
Opportunities for teams to share with management and other teams

13. Sample Agenda Items for Your Initial SUSP Team Meetings
Clarify goals and vision for the team and project
Is it clear and compelling to everyone?
Define roles and responsibilities
Does the team have all essential team members?
Complete the SUSP Team Formation Worksheet
Discuss a communication and engagement strategy
How will you communicate your vision and engage others to participate?
Icon that there is a tool for this.

14. Sample Agenda Items for Your Initial SUSP Team Meetings (cont’d)
Plan your strategy for educating staff on the science of safety
How will you ensure everyone can have access to the training?
Plan your strategy to administer your staff safety assessment
Should be done after the Science of Safety with clearly defined timeline.
Staff safety assessment can be administered right after the Science of Safety training.
First give team Vision then Voice
Develop a plan for SUSP team interactions
What will your meeting schedule look like? How will you communicate in between meetings?
Discuss safety culture assessment
Has one been conducted in the previous 12 months?
HSOPS Aug 21st and 23rd are the planning your safety assessment calls.

15. Sample Agenda Items for Your Initial SUSP Team Meetings (cont’d)
Conduct a project ‘pre-mortem’
What are the major obstacles to success and how can you proactively overcome them?
HSOPS Aug 21st and 23rd are the planning your safety assessment calls.

16. The Project Pre-Mortem
In a postmortem, an autopsy is performed to learn why a patient died.
While it may be helpful to those who perform it and hear about the results, it does not help the central figure in the medical drama—the patient.
The PreMortem Exercise is used to identify potential barriers and vulnerabilities to project success before they occur.
It builds intuition and sensitivity to future problems.

17. Pre-mortem: Step 1
Imagine that we are 1 year into the future and, despite all of the team’s efforts, the project has failed—catastrophically. Things have gone completely wrong on a number of fronts.
Now, ask:
What does the worst case scenario look like?

18. Generate the reasons for failure.
Pre-mortem: Step 2
Generate the reasons for failure.
Spend the next 10 minutes writing down all the reasons you believe this failure occurred.
Now, ask:
What could have caused our project to fail

19. Prioritize your list of potential reasons for failure.
Pre-mortem: Step 3
Prioritize your list of potential reasons for failure.
Address the top 2 or 3 items from your list that are of greatest concern.
Now, ask:
What specific actions can you take to avoid or manage these issues?

20. Pre-mortem: Step 4
Throughout your project, periodically review the potential problem list to remind yourself and the other team members of problems that may be emerging.

21. Pre-mortem Summary
Step 1: Two years out, what does the worst case scenario look like?
Step 2: What could have caused your project to fail?
Step 3: What specific actions can you take to avoid or manage these issues?
Step 4: Review and resensitize yourself to potential problems throughout the project.
Need the pre-mortem tool.

22. Action Items Actively engage your executive partner
Schedule and hold your first SUSP team meeting (if you haven’t already). Make sure to address:
Project vision, goals, and expectations
Team composition and roles and responsibilities
Conduct a project pre-mortem (second meeting)