Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) is an evidence based teamwork system aimed at optimizing patient care by improving communication and teamwork skills. TeamSTEPPS® has five key principles which are based on team structure and four teachable-learnable skills

1. TeamSTEPPS®
Team Strategies & Tools to
Enhance Performance & Patient Safety

2. Objectives
• Identify how the TeamSTEPPS® program advances the mandate of
SHIFT to Safety
• Have fun learning about TeamSTEPPS® and its benefits

3. What is TeamSTEPPS®?
An evidence-based teamwork system aimed at optimizing patient
outcomes by improving communication and other teamwork skills
among healthcare professionals; a powerful solution to improve patient
safety
Goal: To produce highly effective medical teams that optimize the use
of information, people, and resources to achieve the best clinical
outcomes for our patients

4. TeamSTEPPS® is International

5. TeamSTEPPS ®
Basic Overview of Key Strategies
Team Strategies and Tools to Enhance Performance and Patient Safety
Program elements:
• Framework and competencies
• Tools and strategies
• Curriculum modules, courses & other resources

6. Shift Towards a Culture of Safety
Three Continuous Phases
Image source: AHRQ. TeamSTEPPS 2.0 Leadership Brief

7. CPSI’s role in TeamSTEPPS®
• CPSI is launching TeamSTEPPS® in the fall of 2017
• CPSI is partnering with organizations currently using
TeamSTEPPS® to support, measure, and build capacity within the
growing TeamSTEPPS® Canadian community
• CPSI will partner with Patients for Patient Safety Canada to position
patients and families as central team members in the
TeamSTEPPS® curricula

8. TeamSTEPPS ® Overview
Framework and Competencies
Knowledge
• Shared Mental Model
Attitudes
• Mutual Trust
• Team Orientation
Performance
• Adaptability
• Accuracy
• Productivity
• Efficiency
• Safety
Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide

9. TeamSTEPPS® Overview
Framework and Competencies
Multi-Team System for
Patient Care
Safe and efficient care
involves the coordinated
activities of a multi-team
system.
Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide

10. TeamSTEPPS®
Key principles
Team Structure
Leadership
Situation Monitoring
Mutual Support
Communication
Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide

11. TeamSTEPPS®
Tools and strategies
Image source: AHRQ. TeamSTEPPS 2.0 Pocket Guide

12. How hazardous is healthcare?
Most airline
pilots believe
they make
mistakes.
In healthcare,
only 30 per cent
of providers
believe they
make mistakes.
Source: R.Amaberti & L.Leape

13. Teams!

14. Why do errors occur?
Excessive Professional Courtesy
• Giving someone of a higher rank too much respect
Halo Effect
• Great reputation/experience of a colleague clouds our judgement
Passenger Syndrome
• Just along for the ride
Hidden Agenda
• When a team member makes suggestions or decisions based on
information/desires, of which the rest of the team is unaware

15. Why do errors occur?
Complacency
• When teams become comfortable with the task at hand – can range
from the most routine to the most complex
High-risk Phase
• A procedure or time when a critical error can occur
Task or Target Fixation
• Forgetting the big picture – generally occurs with a strong pressure
to perform, workload is high, or during a stressful event

16. Miracle on the Hudson
https://www.youtube.com/wat
ch?v=jZPvVwvX_Nc

17. Most Frequently Identified Root
Causes of Sentinel Events
67% of
sentinel events
The Joint Commission©. Office of Quality Monitoring

19. TeamSTEPPS® exercise #1
Goal: You have 1 minute to build the tallest tower.
Roles: Runners and Builders
Rules:
• Blocks are located in the bins
• Runners retrieve blocks from bins but may only take
5 blocks at a time
• Builders build the tower using the pattern of 1 large,
3 small blocks, repeat
• No two blocks of the same colour may touch
• Runners are not allowed to build, builders are not
allowed to run
• All unused materials must be returned to the bins
before ‘TIME’ is called

20. Impact of Communications on
Team Performance

21. TeamSTEPPS®
Team Strategies and Tools to Enhance Performance
and Patient Safety
• Communication is the cornerstone of patient safety
• It will take training for good communication techniques to become
ingrained in the medical culture and the norm in all settings

22. Communication
http://youtube.com/watch?v=0M
UsVcYhERY

23. Putting it all together
Image source: AHRQ. TeamSTEPPS 2.0. Mod 3: Communication

24. TeamSTEPPS® exercise #2
Goal: You have 2 minutes to build the tallest tower.
Roles: Runners and Builders
Rules:
• You have 30 seconds to conduct a brief
• Runners retrieve blocks from bins but may only take
5 blocks at a time
• You must follow the pattern outlined in the algorithm
provided
• Runners are not allowed to build, builders are not
allowed to run
• All unused materials must be returned to the bins
before ‘TIME’ is called

25. Trust
https://www.youtube.com/wat
ch?v=wPOgvzVOQig

26. What is this?

27. What is this?

28. How do we get a shared mental model?
When:
• Briefs
• Huddles
• Debriefs
• Handoffs
How:
• SBAR
• Call-outs
• Check backs

29. Shared mental model?

30. Tools for leading teams
Briefs
• Short session prior to start to share the plan
• Assign roles, establish expectations, anticipate outcomes
Huddles
• Ad hoc planning to re-establish/reinforce and assess or adjust plans
Debriefs
• Information exchange designed to improve team performance

31. Handoff
The transfer of information (along with authority and responsibility)
during transitions in care across the continuum; to include an
opportunity to ask questions, clarify, and confirm

32. Two challenge rule
Invoked when an initial assertion is ignored…
It is your responsibility to assertively voice your concern at least
two times to ensure that it has been heard.
The member being challenged must acknowledge. If the outcome is
still not acceptable:
• Take a stronger course of action
• Use supervisor or chain of command

33. Two challenge rule (cont.)
Empower any team member to “stop the line” if they sense or discover
a breach of safety.
This is an action never to be taken lightly, but it requires immediate
cessation of the process and resolution of the safety issue.

35. Teamwork Questions?
https://www.youtube.com/wat
ch?v=DvVEeoKrm48