TEAM STEPPS Flashcards
The third leading cause of death is
medical errors
Students and working professionals should develop and maintain proficiency in five core areas:
- Delivering patient‐centered care
- Working as part of interdisciplinary teams • Practicing evidence‐based nursing
- Focusing on quality improvement
- Using information technology
Team members ability to:
• Anticipate needs of others
• Adjust to each other’s actions and the changing environment
• Have a shared understanding of how a procedure or plan of care should happen
Team work
Effective team leaders:
Are responsible for ensuring that team members are sharing information,
monitoring situational cues, resolving conflicts, and helping each other PRN
• Manage resources
• Facilitate team actions by communicating
• Develop norms for information sharing
• Ensure team members are aware of situational changes to plan
Supporting teams:
• Backup and fill in for each other
• Are self correcting
• Compensate for each other
• Reallocate functions
• Distribute and assign work thoughtfully
• Regularly provide feedback to each other
mutual support
Actively scan and assess elements of a “situation”
situation monitoring
Team members with good communication skills can:
Communicate accurate and complete information in a clear & concise manner • Seek information from all sources
• Readily anticipate and share information
• Provide status update
• Verify information received
Why Teamwork?
Reduce clinical errors
• Improve patient outcomes
• Improve process outcomes • Increase patient satisfaction • Increase staff satisfaction
• Reduce malpractice claims
• 3 activities that promote teamwork:
brief
huddles
debriefs
Brief: address the following questions
- Who is on the team?
- All members understand and agree upon goals?
- Roles & responsibilities are understood?
- What is our plan of care?
- Staff and provider’s availability throughout the shift? • Workload among team members?
- Availability of resources?
Huddle addresses
Problem solving
• Hold ad hoc, “touch‐base” meetings to regain situation awareness
• Discuss critical issues and emerging events
• Anticipate outcomes
and likely contingencies
• Assign resources
• Express concerns
Debrief addresses the following questions
Communication was clear?
• Role & responsibilities understood?
• Situation awareness maintained?
• Workload distribution equal?
• Task assistance requested or offered?
• Were errors made or avoided? Availability of resources?
• What went well, what should change, what should improve?
2 steps that involve situation monitoring:
Cross monitoring
STEP
IM SAFE checklist
An error reduction strategy that involves:
• Monitoring actions of other team members
• Providing a safety net within the team
• Ensuring mistakes or oversights are caught quickly and easily • “Watching each others backs”
cross monitoring
STEP:
Status of the patient
Team members
Environment
Progress
IM SAFE
illness medication stress Alcohol and drugs Fatigue Eating and elimination
FEEDBACK SHOULD BE
timely respectful specific directed towards improvement considerate
Team members protect each other from work overload situations
• Effective teams place all offers & supports in terms of patient safety
• Team members foster a climate that assistance is actively sought & offered
task assistance
t is your responsibility to assertively (not aggressively) voice concerns at least two (2) times
• Team member being challenged must acknowledge
• IF the outcome is still not acceptable: • Take a stronger course of action
• Utilize supervisor or chain of command
• Empower all team members to “stop the line” if they sense/discover an essential safety breach
TWO CHALLENGE RULE
CUS
concerned
uncomfortable
Safety
Addressing conflict • Win‐Win situation • Team members, team, and patient • Commitment to a common mission • Involved full and open communication • Meet objectives/goals without compromising • Maintain relationships
collaboration
Communication includes
SBAR call out check back handoff I pass the baton
SBAR-
situation
background
assessment
recommendation
Informs all teams members simultaneously during emergent situation • Helps team members anticipate next step
• Direct responsibility to a specific person for carrying out the task
• Example:
• Leader: “Airway status?”
• Resident: “Airway clear”
• Leader: “Breath sounds?”
• Resident: “Breath sounds decreased RLL.” • Leader: “BP?”
• Resident: “BP is 90/62”
call out
Closed loop communication to ensure information was conveyed by sender and receiver understood
• Steps include
• Sender initiates the message
• Receiver accepts the message and provides feedback
• Sender double‐checks to ensure that the message was received
• Example:
• HCP: “Give 1 mg Morphine IV push now” • Nurse: “1 mg Morphine IV push now”
• HCP: “That is correct”
check back
Transfer of information during transition of care • Change of shift
• Patient transfer
• Opportunity to ask questions, clarify, & confirm
handoff
I PASS THE BATON
Introduction PAtient Assessment situation safety concerns background actions timing ownership next
