National Implementation of
TeamSTEPPSTM
David P. Baker, PhD
American Institutes for Research
James Battles
Agency for Healthcare Research and Quality
Heidi King
Department of Defense
AcademyHealth
Project Purposes
 To transition evidence-based best practices into tools
and strategies that maximize team performance in
the delivery of healthcare
 To disseminate these tools and strategies throughout
healthcare
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Purpose 1
To transition evidence-based best practices into tools
and strategies that maximize team performance in
the delivery of healthcare
Making Research Relevant!
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Project Drivers
 To Err is Human
 NDAA 2001
 National Patient Safety Goals
 IHI
 NQF
 All cite the need for team training
in healthcare
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AHRQ/DoD Initiatives
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Activities began in 2002
AHRQ issued PSO Task Order
Contract to American Institutes of
Research (AIR)
Expert Panel
Comprehensive Literature Review
Case Study Analysis
Journals/Articles
Presentations
Clinical Measures of Teamness
(RAND evaluation contract Mod)
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Medical Team Training Curriculum
TeamSTEPPS
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Edited Handbook
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EvidenceBased
Methods
Principles and
Guidelines
Tools for
Training and
Measurement
AcademyHealth
Collaboration Products
Teamwork &
Simulation
Relevant Evidence
Teamwork in
Healthcare
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Teamwork in
Professional
Education
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Results
 Need for Public Domain Curriculum
and Support Materials
 Dueling Team Training in DoD elsewhere in
Healthcare
 Training materials not readily available
 Need to get evidence base into practice
 Need to focus on actual training not development of
materials
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TeamSTEPPSTM
 AHRQ and DoD public
domain curriculum for
teaching teamwork to
healthcare professionals
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Developed in the DoD
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Released in Fall 2006
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National standard for team
training in healthcare
 Initiative based on evidence
 Designed to be customizable
to the institution
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TeamSTEPPS Framework
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Curriculum Content
BARRIERS
 Inconsistency in Team
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Membership
Lack of Time
Lack of Information Sharing
Hierarchy
Defensiveness
Conventional Thinking
Complacency
Varying Communication Styles
Conflict
Lack of Coordination and
Follow-Up with Co-Workers
Distractions
Fatigue
Workload
Misinterpretation of Cues
Lack of Role Clarity
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TOOLS and
STRATEGIES
Brief
Huddle
Debrief
STEP
Cross Monitoring
Feedback
Advocacy and Assertion
Two-Challenge Rule
CUS
DESC Script
Collaboration
SBAR
Call-Out
Check-Back
Handoff
TEAMSTEPPS 05.2
OUTCOMES
 Shared Mental Model
 Adaptability
 Team Orientation
 Mutual Trust
 Team Performance
 Patient Safety!!
AcademyHealth
Purpose 2
To disseminate these tools and strategies throughout
healthcare
Making Research Accessible!
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AcademyHealth
National Implementation of
TeamSTEPPSTM
 Federally funded project (AHRQ and DoD)
 Objectives:
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Create a national infrastructure to support the
dissemination and implementation of TeamSTEPPSTM
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Develop new tools, techniques, and measures to advance
and sustain TeamSTEPPSTM principles
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Support and sustain TeamSTEPPSTM
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Evaluate program impact – locally and nationally
TEAMSTEPPS 05.2
AcademyHealth
Team Resource Centers and the National
Implementation Team
Minnesota -TRC
Delmarva
AIR
Lumetra
Carilion TRC
Creighton TRC
Duke TRC
Booz | Allen | Hamilton
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Team Resource Centers
 Train 1200 Master Trainers/Change Agents
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CMS Quality Improvement Organizations (QIOs)
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AHRQ High Reliability Organizations (HROs)
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AHRQ ACTION Partners (120 institutions)
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AHRQ Patient Safety Improvement Corps (PSIC)
 Implement and demonstrate TeamSTEPPSTM Tools and
Strategies
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SBAR
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Standardized handoffs
 Conduct research on the link between effective teamwork and
clinical outcomes
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Progress
 Training began end of January 2008
 425 participants had registered for training as of June 1
 Training Statistics
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Total trained to date – 271
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Number of institutions they represented – 59
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Number of individuals from QIOs – 122
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Number of QIOs represented – 29
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Technical Assistance
1-800- XXX-XXXX
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User Support
Meetings and Conferences
 Quarterly teleconferences
 Topically driven webinars
 TeamSTEPPS Collaborative
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2007 AIR
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2008 Duke
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2009 Creighton
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June
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National meeting of
program participants
AcademyHealth
Information Dissemination
www.ahrq.gov/teamstepps
 About TeamSTEPPS
 Readiness Assessment
 Tools and Materials
 Spotlight
 More to come!
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Summary
 Large-scale effort to transition the best evidence
available into practical, user friendly tools.
 National training initiative to push this into the health
system
 More information:
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www.ahrq.gov/teamstepps
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teamsteppscontact@air.org
TEAMSTEPPS 05.2