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How do you spell better teamwork and communication? TeamSTEPPS®!

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Canadian Patient Safety Institute
Canadian Patient Safety Institute

What do the Canadian Patient Safety Institute (CPSI), the Agency for Healthcare Research & Quality (AHRQ) in the United States, and the Michael Garron Hospital in Toronto have in common? All three organizations have seen the benefits to patient safety when implementing the evidence-based teamwork and communication framework, TeamSTEPPS (Team Strategies and Tools for Effective Performance and Patient Safety). Full details: https://goo.gl/8Y2PHc

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How do you spell better teamwork and communication? TeamSTEPPS®! November 30, 2017
Objectives of the call: 3 • Learn more about the experience of each organization on their TeamSTEPPS journey. • Discover how each organization has been working to implement TeamSTEPPS. • Learn how you can use TeamSTEPPS to improve teamwork, communication and patient safety in your practice and your organization.
Jennifer Braun Chris Hund Guest Speakers from the American Hospital Association:
TeamSTEPPS® in the U.S. AHA Team Training Chris Hund, MFA and Jen Braun, MPH
6 WHAT IS TEAMSTEPPS? Team Strategies and Tools to Enhance Performance and Patient Safety • An evidence-based teamwork system designed to improve: quality, safety and efficiency of health care • Practical and adaptable • Provides ready-to-use materials for training and ongoing teamwork
7 GOAL Produce highly effective teams who optimize the use of information, people and resources to achieve the best outcomes.
WHY NOW? 8 • Cause of death in the United States: • Heart disease: 611,000 • Cancer: 585,000 • Medical error: 251,000 • COPD: 149,000 • Suicide: 41,000 • Firearms: 34,000 • Motor vehicle: 34,000 Makary, M., & Daniel, M. (2016). Medical Error – The Third Leading Cause of Death in the U.S. BMJ, 353.
HISTORY OF TEAMSTEPPS IN THE U.S. Patient Safety and Quality Improvement Act of 2005 Executive Memo from President DoD MedTeams® ED Study Institute for Healthcare Improvement 100K lives Campaign “To Err is Human” IOM Report TeamSTEPPS® 1995 1999 2001 2003 2004 2005 JCAHO National Patient Safety Goals 2006 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
TEAMSTEPPS ACROSS THE CARE CONTINUUM 10 • Versions: Core Curriculum, Office-Based Care, Long-Term Care, Rapid Response, LEP • All available for free at www.ahrq.gov/teamstepps
NATIONAL IMPLEMENTATION OF TEAMSTEPPS 11 • Courses • In-person at our Regional Training Centers • Online • National conference • Technical assistance • Monthly webinars • Hotline • New content development • Evaluation
SUCCESS OF NATIONAL IMPLEMENTATION 12 42,688 participants in the national program 6,419 participants at Master Training Courses 32,976 individuals attended monthly webinars 3,293 attendees at six national conferences
REGIONAL TRAINING CENTERS 13
SUCCESS STORY: METROHEALTH 14 • Background • Implemented TeamSTEPPS in 2013 • Became a RTC in 2014 • Successes • Staff training • Reduced C. difficile by 36% • Reduced blood clots which resulted in cost savings of nearly $500,000 • OR and Central Sterilization increased the quality of their trays from 30% to almost 100%
WHAT NEXT? AHA’S TEAM TRAINING 15 • Commitment to continuing to offer: • Courses at Regional Training Centers across the United States • An annual conference • Free monthly webinars • Growing the movement by: • Fostering partnerships with a diverse group of individuals and organizations • Creating new, innovative material • Working to support implementation at individual health systems
TEAM TRAINING NATIONAL CONFERENCE 16
CONTACT INFORMATION 17 Web: www.aha.org/teamtraining Email: TeamTraining@aha.org Phone: 312-422-2609
Debbie Gillis Karen Chapman Guest Speakers from Michael Garron Hospital:
TeamSTEPPS Implementation at MGH November 2017 Create Health. Build Community.
Goals • Review current state of TeamSTEPPS implementation at MGH. • Share stories and lessons learned about the implementation of TeamSTEPPS Tools in the MGH ICU. • How you can do it too!
TeamSTEPPS Implementation Journey at MGH 2014 Development of competency framework. Sets groundwork for need for enabling behaviours. 2015 Roll-out of selected communication tools to RNs, RPNs, PCAs. Embedded in orientation. Master Trainer certified in ICU. 2016 Roll-out of communication tools to IPP staff. ICU pilot. Chief of Staff Quality and Safety Team 2017 Development of a Quality Plan Integration of TeamSTEPPS tools in competency renewal and resuscitation programs
2015 Initial Training: Communication Tools • Feedback • CUS
Lessons Learned • Giving feedback – challenging skill • Constant reinforcement • Leadership engagement
Implementation of TeamSTEPPS Tools In the MGH ICU November 2016
TeamSTEPPs Tools Implemented in MGH ICU Team Briefing CUS SBAR Bedside Safety Check List Closed Loop Feedback (“Call-Back”) Team Huddle Critical Event Debriefing
Quality and Safety Planning • Engagement-all stakeholders • Review of present state, including incident reports, patient safety survey, work being done • Our Goal: Thoughtfulness not to create new work and to increase our coordinated efforts for alignment across the organization
You can do it too! • Start Simple • Repetition/embed it • Make it Stick
Start Simple and Make it Easy • Leadership involvement • Briefing - template • CUS • SBAR • Closed Loop Communication • Huddles • Debriefing - template
Repetition • Reintroduce/ remind • Reinforce • Integrate into other programs or training
• Include in debriefings • Accountability feedback – annual reviews • Embed into organizational standards • Physician and leadership engagement Make it Stick
Our Priorities High Performing Teams Speak Up for Safety Early Warning Systems System Team Individual
Guiding Principles and Alignment with Corporate Priorities and Opportunities • Optimizes the use of information, people and resources • Increases team awareness and clarify team roles and responsibilities = alignment with strategic directions of the organization
Next Steps: • Confirm roles and responsibilities to coordinate our focus • Align with our QIP process including metrics • Monitor and early planning for sustainability • Develop corporate implementation plan including evaluation strategy Build capacity for future roll-out by training additional master trainers
Create Health. Build Community. 825 Coxwell Avenue Toronto, Ontario M4C 3E7 T: 416.461.8272 F: 416.469.6106 www.tegh.on.ca Questions?
Tricia Swartz Guest Speakers from the Canadian Patient Safety Institute:
Patient safety movement 1999 “To Err Is Human” IOM Report 2001 2002 Halifax Symposia on Medical Error CPSI established (SHN in 2005) 2003 “Build a Safer System” report 2004 Canadian Adverse Events Study 2017201620112006 DoD MedTeams® ED Study 1995 PFPSC groundwork & established 1.36 2015 Three ground breaking reports released which necessitated a change in thinking
• Cancer 75,112 • Heart Disease 49,891 • Patient Safety Incidents – 28,000 • Cerebrovascular Disease – 13,400 • Chronic Lower Respitory Disease – 11,976 • Accidents – 11,425 • Diabetes Mellitus 7,045 Why now? Statistics Canada (Table 102-0561) 2013; RiskAnalytica
• Risk Analytica diagram Cost to our system
• Patient safety incidents resulted in 28,000 death across Canada in acute and homecare (2013) Over the next 30 years • 400,000 pt. safety incidents (PSI) within home care and acute care • This equates to an additional 2.75 billion in healthcare costs • The Patient Safety Incidents and costs incurred as considered preventable Patient safety today and future
• TeamSTEPPS Canada Master Trainer Education Centres Pilot project to launch January 2018 in partnership with Health Quality Council of Alberta • TeamSTEPPS Canada call series and community building details to be announced soon • TeamSTEPPS Master Trainer education through CPSI What’s Next?
Questions

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How do you spell better teamwork and communication? TeamSTEPPS®!

  • 1. How do you spell better teamwork and communication? TeamSTEPPS®! November 30, 2017
  • 2.
  • 3. Objectives of the call: 3 • Learn more about the experience of each organization on their TeamSTEPPS journey. • Discover how each organization has been working to implement TeamSTEPPS. • Learn how you can use TeamSTEPPS to improve teamwork, communication and patient safety in your practice and your organization.
  • 4. Jennifer Braun Chris Hund Guest Speakers from the American Hospital Association:
  • 5. TeamSTEPPS® in the U.S. AHA Team Training Chris Hund, MFA and Jen Braun, MPH
  • 6. 6 WHAT IS TEAMSTEPPS? Team Strategies and Tools to Enhance Performance and Patient Safety • An evidence-based teamwork system designed to improve: quality, safety and efficiency of health care • Practical and adaptable • Provides ready-to-use materials for training and ongoing teamwork
  • 7. 7 GOAL Produce highly effective teams who optimize the use of information, people and resources to achieve the best outcomes.
  • 8. WHY NOW? 8 • Cause of death in the United States: • Heart disease: 611,000 • Cancer: 585,000 • Medical error: 251,000 • COPD: 149,000 • Suicide: 41,000 • Firearms: 34,000 • Motor vehicle: 34,000 Makary, M., & Daniel, M. (2016). Medical Error – The Third Leading Cause of Death in the U.S. BMJ, 353.
  • 9. HISTORY OF TEAMSTEPPS IN THE U.S. Patient Safety and Quality Improvement Act of 2005 Executive Memo from President DoD MedTeams® ED Study Institute for Healthcare Improvement 100K lives Campaign “To Err is Human” IOM Report TeamSTEPPS® 1995 1999 2001 2003 2004 2005 JCAHO National Patient Safety Goals 2006 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
  • 10. TEAMSTEPPS ACROSS THE CARE CONTINUUM 10 • Versions: Core Curriculum, Office-Based Care, Long-Term Care, Rapid Response, LEP • All available for free at www.ahrq.gov/teamstepps
  • 11. NATIONAL IMPLEMENTATION OF TEAMSTEPPS 11 • Courses • In-person at our Regional Training Centers • Online • National conference • Technical assistance • Monthly webinars • Hotline • New content development • Evaluation
  • 12. SUCCESS OF NATIONAL IMPLEMENTATION 12 42,688 participants in the national program 6,419 participants at Master Training Courses 32,976 individuals attended monthly webinars 3,293 attendees at six national conferences
  • 14. SUCCESS STORY: METROHEALTH 14 • Background • Implemented TeamSTEPPS in 2013 • Became a RTC in 2014 • Successes • Staff training • Reduced C. difficile by 36% • Reduced blood clots which resulted in cost savings of nearly $500,000 • OR and Central Sterilization increased the quality of their trays from 30% to almost 100%
  • 15. WHAT NEXT? AHA’S TEAM TRAINING 15 • Commitment to continuing to offer: • Courses at Regional Training Centers across the United States • An annual conference • Free monthly webinars • Growing the movement by: • Fostering partnerships with a diverse group of individuals and organizations • Creating new, innovative material • Working to support implementation at individual health systems
  • 17. CONTACT INFORMATION 17 Web: www.aha.org/teamtraining Email: TeamTraining@aha.org Phone: 312-422-2609
  • 18. Debbie Gillis Karen Chapman Guest Speakers from Michael Garron Hospital:
  • 19. TeamSTEPPS Implementation at MGH November 2017 Create Health. Build Community.
  • 20. Goals • Review current state of TeamSTEPPS implementation at MGH. • Share stories and lessons learned about the implementation of TeamSTEPPS Tools in the MGH ICU. • How you can do it too!
  • 21. TeamSTEPPS Implementation Journey at MGH 2014 Development of competency framework. Sets groundwork for need for enabling behaviours. 2015 Roll-out of selected communication tools to RNs, RPNs, PCAs. Embedded in orientation. Master Trainer certified in ICU. 2016 Roll-out of communication tools to IPP staff. ICU pilot. Chief of Staff Quality and Safety Team 2017 Development of a Quality Plan Integration of TeamSTEPPS tools in competency renewal and resuscitation programs
  • 22. 2015 Initial Training: Communication Tools • Feedback • CUS
  • 23. Lessons Learned • Giving feedback – challenging skill • Constant reinforcement • Leadership engagement
  • 24. Implementation of TeamSTEPPS Tools In the MGH ICU November 2016
  • 25. TeamSTEPPs Tools Implemented in MGH ICU Team Briefing CUS SBAR Bedside Safety Check List Closed Loop Feedback (“Call-Back”) Team Huddle Critical Event Debriefing
  • 26. Quality and Safety Planning • Engagement-all stakeholders • Review of present state, including incident reports, patient safety survey, work being done • Our Goal: Thoughtfulness not to create new work and to increase our coordinated efforts for alignment across the organization
  • 27. You can do it too! • Start Simple • Repetition/embed it • Make it Stick
  • 28. Start Simple and Make it Easy • Leadership involvement • Briefing - template • CUS • SBAR • Closed Loop Communication • Huddles • Debriefing - template
  • 29. Repetition • Reintroduce/ remind • Reinforce • Integrate into other programs or training
  • 30. • Include in debriefings • Accountability feedback – annual reviews • Embed into organizational standards • Physician and leadership engagement Make it Stick
  • 31. Our Priorities High Performing Teams Speak Up for Safety Early Warning Systems System Team Individual
  • 32. Guiding Principles and Alignment with Corporate Priorities and Opportunities • Optimizes the use of information, people and resources • Increases team awareness and clarify team roles and responsibilities = alignment with strategic directions of the organization
  • 33. Next Steps: • Confirm roles and responsibilities to coordinate our focus • Align with our QIP process including metrics • Monitor and early planning for sustainability • Develop corporate implementation plan including evaluation strategy Build capacity for future roll-out by training additional master trainers
  • 34. Create Health. Build Community. 825 Coxwell Avenue Toronto, Ontario M4C 3E7 T: 416.461.8272 F: 416.469.6106 www.tegh.on.ca Questions?
  • 35. Tricia Swartz Guest Speakers from the Canadian Patient Safety Institute:
  • 36. Patient safety movement 1999 “To Err Is Human” IOM Report 2001 2002 Halifax Symposia on Medical Error CPSI established (SHN in 2005) 2003 “Build a Safer System” report 2004 Canadian Adverse Events Study 2017201620112006 DoD MedTeams® ED Study 1995 PFPSC groundwork & established 1.36 2015 Three ground breaking reports released which necessitated a change in thinking
  • 37. • Cancer 75,112 • Heart Disease 49,891 • Patient Safety Incidents – 28,000 • Cerebrovascular Disease – 13,400 • Chronic Lower Respitory Disease – 11,976 • Accidents – 11,425 • Diabetes Mellitus 7,045 Why now? Statistics Canada (Table 102-0561) 2013; RiskAnalytica
  • 38. • Risk Analytica diagram Cost to our system
  • 39. • Patient safety incidents resulted in 28,000 death across Canada in acute and homecare (2013) Over the next 30 years • 400,000 pt. safety incidents (PSI) within home care and acute care • This equates to an additional 2.75 billion in healthcare costs • The Patient Safety Incidents and costs incurred as considered preventable Patient safety today and future
  • 40. • TeamSTEPPS Canada Master Trainer Education Centres Pilot project to launch January 2018 in partnership with Health Quality Council of Alberta • TeamSTEPPS Canada call series and community building details to be announced soon • TeamSTEPPS Master Trainer education through CPSI What’s Next?