TeamSTEPPS 2.0 ESSENTIALS COURSE
TeamSTEPPS 2.0 ESSENTIALS COURSESUBSECTIONS TeamSTEPPS Framework and KeyPrinciplesTeam StructureCommunicationLeading TeamsSituation MonitoringMutual SupportTeam Performance Observation ToolSummaryTIME: 2 hours
TeamSTEPPS 2.0EssentialsCourseINSTRUCTOR OUTLINE: ESSENTIALSCOURSEInstructor Note: This course is designed to teachTeamSTEPPS Fundamentals to staff who do not engage in thedirect delivery of care, but rather contribute essential informationto the ongoing delivery of safe care. As such, participants in thiscourse are not intended to further train others.It is important to note that the TeamSTEPPS Essentials Course isnot interchangeable with the Fundamentals Course, nor is theEssentials Course a substitute for the basic education and skillpractice offered through the Fundamentals Course.The outline below provides instructors with information in planningthe instruction of the Essentials Course.ContentPage #Approx. Time52 mins2. TeamSTEPPS Frameworkand Key Principles6-75 mins3. Team Structure8-95 mins4. Communication: SBAR,Call-Out, Check-Back,Handoff, and I PASS theBATON10 - 1420 mins5. Leading Teams: EffectiveLeaders, Team Events,Briefs, and Debriefs15 - 1915 mins6. Situation Monitoring:STEP, Cross-Monitoring,and I’M SAFE20 – 2420 mins7. Mutual Support: TaskAssistance, Feedback,Advocacy and Assertion,Conflict Resolution25 – 3015 mins8. Team PerformanceObservation Tool31 - 325 mins9. Tools and StrategiesSummary and Exercise33 - 3520 mins1. Learning ObjectivesMODULETIME:2 hoursMATERIALS: SBAR Video(Nursing toPhysician;SBAR INPTMED2.mpg) Brief Video 2(Brief LandD 2.mpg) Video Vignette(INPTSURGSuccess CompleteVignette.mpg) Flipchart orWhiteboard(Optional) Markers(Optional)Continued TeamSTEPPS 2.0 Essentials Course3
TeamSTEPPS 2.0EssentialsCourseINSTRUCTOR OUTLINE: ESSENTIALSCOURSE (Continued)Additional Resources: Below are sources of additionalinformation and videos you may use to customize this course toyour participants’ needs. TeamSTEPPS DVD: The TeamSTEPPS DVD includesSpecialty Scenarios and additional videos that can be usedto customize your instruction. TeamSTEPPS Long-Term Care Version: Includes videosspecific to the use of some of the TeamSTEPPS tools andstrategies in the long-term care setting. ulumtools/teamstepps/ltc/ TeamSTEPPS Primary Care Version: Includes videosspecific to the use of some of the TeamSTEPPS tools andstrategies in the primary care setting. ulumtools/teamstepps/primarycare/ TeamSTEPPS Rapid Response Systems Module (RRS):Includes videos specific to the use of some of theTeamSTEPPS tools and strategies by Rapid ResponseTeams. ulumtools/teamstepps/rrs/ DoD Patient Safety Program Toolkits: Providesinformation about specific TeamSTEPPS tools andstrategies, such as SBAR, briefs, huddles, and debriefs. Services/Toolkits Comprehensive Unit-Based Safety Program (CUSP)“Implement Teamwork and Communication”Module: Includes information and videos on some of thetools and strategies taught in TeamSTEPPS. 4TeamSTEPPS 2.0 Essentials Course
OBJECTIVESTeamSTEPPS 2.0EssentialsCourseSAY:Following this course, you will be able to: Discuss the TeamSTEPPS framework and key principles; Describe the components of a multi-team system (MTS); Describe four communication tools and strategies; Describe effective team leader skills and three tools forleading teams; Define situation monitoring; Describe techniques for facilitating situation monitoring; Describe five tools and strategies for facilitating mutualsupport; Identify tools for use in conflict resolution; Describe observable behaviors associated with effectiveteam performance; Summarize barriers to teamwork; tools and strategies toovercome teamwork barriers; and potential outcomes;and Apply TeamSTEPPS tools and strategies to a clinical scenario.TeamSTEPPS 2.0 Essentials Course5
TeamSTEPPS 2.0EssentialsCourseTeamSTEPPS FRAMEWORKSAY:TeamSTEPPS stands for: Team Strategies and Tools to EnhancePerformance and Patient Safety.TeamSTEPPS focuses on specific skills supporting teamperformance principles, including training requirements,behavioral methods, human factors, and cultural changedesigned to improve quality and patient safety.Within this course, teamwork concepts are introduced, includingspecific tools and strategies for improving communication andteamwork, reducing chance of error, and providing safer patientcare.More than 30 years of research and evidence have beenaccumulated on teams and team performance in diverse areas,such as aviation, the military, nuclear power, health care,business, and industry. TeamSTEPPS has evolved from researchin these high-risk fields to the health care environment, a highrisk, high-stakes environment in which poor performance maylead to serious consequences or death.Based on research, we know what defines a team, what teamworkrequires, how to train team members, and how to manage teamperformance. Researchers have linked team training programs toimproved attitudes, increased knowledge, and improvedbehavioral skills. For example, a meta-analysis published in 2008(Salas, et al., 2008) included a comprehensive search of teamtraining literature from 1955 through 2007 and examined over 300empirical articles. Although this meta-analysis was not specific toteam training in health care, its results demonstrated evidence thatteam training had a moderate, positive effect on team outcomes.TeamSTEPPS is built upon an evidence-based frameworkcomposed of four teachable, learnable skills: communication,leadership, situation monitoring, and mutual support—the core ofthe TeamSTEPPS model. The red arrows depict a two-waydynamic interplay between the four core skills and the teamrelated outcomes of enhanced knowledge, positive attitudes, andexceptional performance.Encircling the four skills is the patient care team, whichrepresents not only the patient and direct caregivers, but alsothose who play a supportive role within the health care deliverysystem.6TeamSTEPPS 2.0 Essentials Course
KEY PRINCIPLESTeamSTEPPS 2.0EssentialsCourseInstructor Note: The key principles presented on this slidealign with the five core modules presented in the TeamSTEPPSFundamentals Course.SAY:There are five key principles presented in this course. Theseprinciples correspond with the TeamSTEPPS Fundamentalscourse modules, which provide more indepth instruction to directcare staff. In this course, we will highlight key concepts from eachmodule. Team Structure – Identifies the components of a multiteam system that must work together effectively to ensurepatient safety. Communication – Process by which information is clearlyand accurately exchanged among team members. Leadership – The ability to coordinate the activities of teammembers by ensuring team actions are understood, changesin information are shared, and team members have thenecessary resources. Situation Monitoring – Process of actively scanning andassessing situational elements to gain informationunderstanding, or to maintain awareness to supportfunctioning of the team. Mutual Support – The ability to anticipate and support otherteam members’ needs through accurate knowledge abouttheir responsibilities and workload.TeamSTEPPS 2.0 Essentials Course7
TeamSTEPPS 2.0EssentialsCourseTEAM STRUCTURESAY:Team structure refers to the composition of a team. In healthcare, multiple teams are involved in patient care. This model isknown as a multi-team system or MTS.Each team within an MTS is responsible for various parts ofpatient care, but all must act in concert to ensure quality patientcare.A key component of the MTS is the patient. Patients are part ofthe patient care team and should be embraced and valued ascontributing partners to patient care.In addition to the patient, the multi-team system is composed ofseveral different teams. Core TeamCore Teams consist of team leaders and team members whoare involved in the direct care of the patient. Core Teammembers include direct care providers and continuityproviders. Continuity providers are those who manage thepatient from assessment to disposition, such as casemanagers. The Core Team is based where the patientreceives care. Coordinating TeamThe Coordinating Team is the group responsible for:– Day-to-day operational management;– Coordination functions; and– Resource management for Core Teams. Contingency TeamsContingency Teams are:– Formed for emergent or specific events;– Time limited; for example, a Code Team, Disaster ResponseTeam, or Rapid Response Team; and– Composed of team members drawn from a variety of CoreTeams.Continued 8TeamSTEPPS 2.0 Essentials Course
TEAM STRUCTURE (Continued)TeamSTEPPS 2.0EssentialsCourseSAY:Ancillary Services consist of individuals who: Provide direct, task-specific, time-limited care to patients; Support services that facilitate care of the patients; and Are often not located where the patients receive theirroutine care.Ancillary Services are primarily a service delivery team whosemission is to support the Core Team. In general, an AncillaryServices team functions independently.Support Services are primarily a service-focused team whosemission is to create efficient, safe, comfortable, and cleanhealth care environments, which impact the patient careteam, market perception, operational efficiency, and patientsafety.ASK: What are the Ancillary and Support Services in your facility?SAY:Administration includes the executive leadership of a unit orfacility and has 24-hour accountability for the overall function andmanagement of the organization. Administration shapes theclimate and culture for a teamwork system to flourish by: Establishing and communicating vision; Developing and enforcing policies; Setting expectations for staff; Providing necessary resources for successful implementation; Holding teams accountable for team performance; and Defining the culture of the organization.TeamSTEPPS 2.0 Essentials Course9
TeamSTEPPS 2.0EssentialsCourseSBARSAY:Within and across components of a multi-team system,communication is critical to the effectiveness of a team and toensuring patient safety. TeamSTEPPS provides severalcommunication strategies that can be used to ensure effectivecommunication.The first technique is SBAR. SBAR provides a standardizedframework for members of the health care team tocommunicate about a patient's condition. You may also refer tothis as the ISBAR where “I” stands for “Introductions.”SBAR is an easy-to-remember tool that is useful for framing anyconversation, often a critical one requiring a clinician's immediateattention and action. In phrasing a conversation with anothermember of the team, consider presenting the:VIDEO TIME: Situation—What is happening with the patient?1:35 minutes Background—What is the clinical background? Assessment—What do I think the problem is?MATERIALS: SBAR Video(Nurse toPhysician;SBAR INPTMED2.mpg) Recommendation—What would I recommend?Let’s look at a short video clip in which the SBAR technique is used.DO:Play the video by clicking the director icon on the slide.DISCUSSION: How did the SBAR technique improve communicationbetween the nurse and physician?– The nurse identified herself and the reason she was calling.– The physician was quickly made aware of Mrs. Everett’sdeteriorating situation.– The nurse provided the background of the DVT diagnosisand all current labs.– The recent assessment of the patient has led the nurse to callthe physician with her concerns.– The nurse initiated a recommendation for additional labs, anda plan was discussed for future care.10TeamSTEPPS 2.0 Essentials Course
CALL-OUTTeamSTEPPS 2.0EssentialsCourseSAY:Another communication tool is the call-out.A call-out is a tactic used to communicate critical informationduring an emergent event. Critical information called out in thesesituations helps the team anticipate and prepare for vital nextsteps in patient care. It also benefits a recorder when presentduring a code or emergent event. One important aspect of a callout is directing the information to a specific individual.TeamSTEPPS 2.0 Essentials Course11
TeamSTEPPS 2.0EssentialsCourseCHECK-BACKSAY:A check-back is a closed-loop communication strategy used toverify and validate information exchanged. The strategy involvesthe sender initiating a message, the receiver accepting themessage and confirming what was communicated, and the senderverifying that the message was received.As shown in the example on the slide, the doctor communicatesan instruction, the nurse repeats it back, and the doctor closes theloop by verifying that the nurse received the message accurately.12TeamSTEPPS 2.0 Essentials Course
HANDOFFTeamSTEPPS 2.0EssentialsCourseSAY:When a team member is temporarily or permanently relieved ofduty, there is a risk that necessary information about the patientmight not be communicated. The handoff strategy is designed toenhance information exchange at critical times such as transitionsin care. More importantly, it maintains continuity of care despitechanging caregivers.A proper handoff includes the following: Transfer of responsibility and accountability—Whenhanding off, it is your responsibility to know that the personwho must accept responsibility is aware of assumingresponsibility. Similarly, you are accountable until both partiesare aware of the transfer of responsibility. Clarity of information—When uncertainty exists, it is yourresponsibility to clear up all ambiguity of responsibility beforethe transfer is completed. Verbal communication of information—You cannotassume that the person obtaining responsibility will read orunderstand written or nonverbal communications. Acknowledgment by receiver—Until it is acknowledged thatthe handoff is understood and accepted, you cannotrelinquish your responsibility. Opportunity to review—Handoffs are a good time toreview and have a new pair of eyes evaluate the situationfor both safety and quality.Additionally, handoffs include the transfer of knowledge andinformation about: The degree of certainty and uncertainty regarding a patient;for example, whether a diagnosis has been confirmed; The patient’s response to treatment; Recent changes in condition and circumstances; and The plan of care, including contingencies.It is important to highlight that both authority and responsibility aretransferred in a handoff. As identified in root cause analyses ofsentinel events and poor outcomes, lack of clarity about who isresponsible for care and decisionmaking has often been a majorcontributor to medical error.TeamSTEPPS 2.0 Essentials Course13
TeamSTEPPS 2.0EssentialsCourseI PASS THE BATONSAY:Each facility should determine a standard protocol for deliveringhandoffs and make the protocol known to staff. “I Pass the Baton"provides one option for conducting structured handoffs.IIntroduction—Introduce yourself and your role/job(include patient)PPatient—Name, identifiers, age, sex, locationAAssessment—Presenting chief complaint, vital signs,symptoms, and diagnosisSSituation—Current status/circumstances, including codestatus, level of uncertainty, recent changes, response totreatmentSSafety Concerns—Critical lab values/reports, socioeconomic factors, allergies, alerts (falls, isolation, etc.)THE14BBackground—Comorbidities, previous episodes, currentmedications, family historyAActions—What actions were taken or are required?Provide brief rationaleTTiming—Level of urgency and explicit timing andprioritization of actionsOOwnership—Who is responsible (nurse/doctor/team)?Include patient/family responsibilitiesNNext—What will happen next? Anticipated changes?What is the plan? Are there contingency plans?TeamSTEPPS 2.0 Essentials Course
EFFECTIVE TEAM LEADERSTeamSTEPPS 2.0EssentialsCourseSAY:Another critical aspect of teamwork is effective team leadership.Team leaders are well-informed team members who makedecisions and take actions. Team leaders establish the goals ofthe team and help maintain its focus.There are two types of leaders: designated and situational. For ateam to function successfully, a leader must be designated. Inmost clinical situations, the physician in charge is the designatedteam leader. Situational leaders emerge at designated times,such as during anesthesia induction, and at spontaneous times,for instance, the first responder to a code.When leading teams, both designated and situational teamleaders must possess a set of effective skills regardless of thetype of team they are leading or the situation in which they areleading it. At its core, leading teams involves the followingactivities: Identifying a goal and defining a plan to achieve the goal; Assigning tasks and responsibilities; Sharing the plan; Monitoring the plan and progress toward the goal; Modifying the plan and communicating changes to allteam members; and Reviewing the team’s performance.It is critical that when leading teams, designated and situationalleaders also: Establish “rules of engagement” under which team memberswill operate and perform their roles; Manage and allocate resources effectively to ensureteam members have what they need to be successful; Provide feedback to team members regarding their assignedresponsibilities and progress toward the team’s goal; Facilitate information sharing among team members; Encourage team members to assist one another when needed; Facilitate conflict resolution; and Model effective teamwork.TeamSTEPPS 2.0 Essentials Course15
TeamSTEPPS 2.0EssentialsCourseTEAM EVENTSSAY:Leading teams involves team events that include the activities ofplanning, problem solving, and process improvement.Three strategies that team leaders can use to facilitate theseactivities and promote teamwork are: Briefs; Huddles; and Debriefs.As shown on the slide, briefs are conducted at the start of a shiftor a case, for example, to share a plan with the team. We willreview briefs in more detail shortly.Huddles are ad hoc sessions to review and modify the establishedplans. These may involve reviewing the plans to ensure all teammembers continue to be on the same page or adjusting the planbased on known or anticipated changes.Debriefs are conducted to review what has occurred, such asafter a case. These sessions are intended to improve teamperformance by identifying and reinforcing what went well andwhat can be improved. We will review debriefs in more detailshortly.16TeamSTEPPS 2.0 Essentials Course
TeamSTEPPS 2.0EssentialsCourseBRIEF CHECKLISTSAY:Briefs are a strategy for sharing the plan when leading a team.During a brief, which is sometimes referred to as a team meeting,the following information should be discussed: Team membership and roles—who is on the team and who isthe designated team leader; Clinical status of the team’s patients—the current condition,diagnosis, and status of each patient assigned to the team; The plan of care for each of the team’s patients—what is to beaccomplished, what are the expected outcomes, and who is todo it; and Issues affecting team operations—resources normally availablethat may be restricted during the current shift.Defining clear goals and a plan to achieve those goals is animportant part of the brief as well as establishing clear roles andexpectations for each team member. Successful teams measuretheir effectiveness in terms of how well they are performingagainst the established plan. The designated team leader usuallyconducts the brief, and team members actively participate.Similar to a preflight checklist used in aviation, the team leadershould cover the items on this (or a similar) checklist. Conductinga brief at the beginning of a shift or prior to a case provides anideal forum
7. Mutual Support: Task Assistance, Feedback, Advocacy and Assertion, Conflict Resolution 25 – 30 15 mins 8. Team Performance Observation Tool 31 - 32 5 mins 9. Tools and Strategies Summary and Exerc
TeamSTEPPS Released to the Public 2007 TeamSTEPPS National Implementation Program Began 2008 National Implementation of CUSP Centers for Medicare and Medicaid Services Partnership for Patients Campaign 2011 Medical Team Training TeamSTEPPS 2.0, TeamSTEPPS Online, and TeamSTEPPS for Office-Based Care 2014 TeamSTEPPS Advanced Course 2016
7 TeamSTEPPS 06.1 Essentials Course TeamSTEPPS Essentials Course EFFECTIVE TEAM LEADERS SAY: Team leaders must possess a set of effective skills regardless of the type of team that they lead. Team leaders should be able to effectively: Organize the team Articulate clear goals Make decisions based on input of team members
TeamSTEPPS in the Emergency Department to improve the management of Sepsis. Objective # 2: Understand effective methods for engaging clinicians and applying TeamSTEPPS training between departments. Objective # 3: Understand leadership essentials for successful TeamSTEPPS integration into practice.
Upcoming Team Training Events Courses. Whether you are new to TeamSTEPPS, looking for implementation assistance or something in between, we offer guidance for every step on your TeamSTEPPS journey. Register now for a Master Training course, Fundamentals course, or Next Steps wor
Simulation in TeamSTEPPS Training,” (slides 1 through 48). q. Load the PowerPoint presentation “Using Simulation in TeamSTEPPS Training” on the computer from the flash drive or CD-ROM. q. Check the equipment . to ensure that it is working properly. Check to ensure the slides can be
TeamSTEPPS 2.0: Basic Training and Beyond. Learning Objectives 2 The purpose of this activity is to enable the learner to: Differentiate the four TeamSTEPPS framework pillars which support the three domains of learning Summarize one tool or strategy within each pillarFile Size: 756KBPage Count: 31
Jan 09, 2019 · Discuss how implementing TeamSTEPPS in healthcare can lead to improved patient outcomes through better communication and teamwork. Identify the TeamSTEPPS tools associated with the 100, 200, and
»Determine if TeamSTEPPS improve team attributes. »Positive results in 5 of 7 subscales at (p .01). »TeamSTEPPS training helps to introduce a culture of safety and improve team perform
