# Presentation: 729659

## Improving Teamwork in Healthcare

**Karen Frush, MD** -Duke University Health System;
**Christine Goeschel RN, MPA, MPS** - Johns Hopkins University
**Jeanne-Marie Guise, MD, MPH – **Oregon Health Sciences University
-  **Heidi King** - Department of Defense
*AHRQ Annual Conference*
*September 28, 2007*

## Teamwork Is All Around Us

**Teamwork Is All Around Us**

**Notes:**
Teamwork truly is all around us and is practiced in many different settings- hospitals, clinics, in the military- active duty and reserve, combat and non combat, and as we prepare to head to our respective homes later today- many of you may have recreational team events to look forward to from children’s soccer to the Redskin’s football. Patients across the world are safer in healthcare delivery systems where teamwork principles are practiced on a daily basis. 

## Evolution of TeamSTEPPS- Train the trainer success

**AHRQ**** ****High Reliability Program ( HRO)**
**12 Healthcare Systems**
**69 Individuals**

**Civilian Training**
**470 trainers and staff  **
**Over 1500 attendees of Essentials Course**
**ACHE**
**Harvard Colloquium**
**Ardent Health System**
**ERM Conference Singapore, **
**Turkey and JCR**

**Department of Defense**

**AHRQ **
**Patient Safety Improvement Corp**
**200 Individuals**
**14 QIOs**

**Notes:**
Before we jump to our speakers, I would like to provide an updates on Team training from our Agency.  Last week our Patient Safety Improvement Corp completed traning of 200 individuals and 14 QIOs.  This is in addition to previous work with 12 healthcare systems in the High Reliability Program, and the work AHRQ co-sponsors with the Department of Defense.   In addition, our Team STEPPS program has been delivered to about 2000 individuals through  the Department of Defense Civilian training program. So our efforts continue to multiply graduates.

## Improving Teamwork in Healthcare

- Heidi King, Department of Defense
- Karen Frush, Duke University
- Christine Goeschel, Johns Hopkins
- Jeanne-Marie Guise, OHSU

**Notes:**
Our first presenter today will be Heidi King. Ms. Heidi King is the Deputy Director for the Department of Defense Patient Safety Program and Director for the Healthcare Team Coordination Program within TRICARE Management Activity.  Ms. King was the lead architect in the development of TeamSTEPPSTM, an evidence-based system aimed at optimizing patient outcomes and promoting a culture of safety. 
Following Ms. King’s presentation, we will hear from Dr. Karen Frush, the Chief Patient Safety Officer of Duke University Health System. Dr Frush is a pediatirican and graduate of the University Of Pittsburgh School Of Nursing, and  the Duke University School of Medicine.  Dr. Frush is a Master Trainer for the Department of Defense TeamSTEPPS team training program, and she serves on the Pediatric Patient Safety Expert Panel for Joint Commission Resources.  
Our third speaker today will be Christine A. Goeschel (Go. Shull) Chris is a registered nurse and director of patient safety and quality initiatives for the Johns Hopkins University School of Medicine’s Quality and Safety Research Group (QSRG). Previously, Chris was Executive Director of the Michigan Health and Hospital Association’s Keystone Center for Patient Safety & Quality, 

And our final presenter, Dr Jeanne-Marie Guise( GEEZ), has traveled here today from Oregon Health Science’s University. Dr. Guise is Director of Oregon’s State Obstetric and Pediatric Research Collaborative and the Director of Health Services and Outcomes Research for Oregon’s National Center of Excellence in Women’s Health. The central theme of Dr Guise’s research focuses on improving the quality of care and safety for women and children related to childbirth.  
Our plan for today’s session is to have each speaker present for about 15 minutes.  We will allow 2-3 questions after each speaker, but after 5 minutes of questions, I will formally ask that we defer the others to the end and then transition to our next speaker.   We will have time at the end for any remaining questions.  

## Common Themes

- Team training comes in multiple formats
- No “drive by” solution
- Customizable
- Adaptable
- Team work moves culture and is measurable
- Team training applies across all areas of healthcare, all specialties and clinical care areas
- Team training can be used with all levels of providers- not just nurses or doctors.
- Start with one part/aspect and evolve to meet needs
- Leadership and coaching counts
- A learning process- not a definitive solution

**Notes:**
Team training comes in multiple formats
No “drive by” solution
Customizable
Adaptable
Team work moves culture and is measurable
Team training applies across all areas of healthcare, all specialties and clinical care areas
Team training can be used with all levels of providers- not just nurses or doctors.
Start with one part/aspect and evolve to meet needs
Leadership and coaching counts
A learning process- not a definitive solution

## 	A journey of 1000 miles starts with a single step...in the right direction