# Presentation: 478821

##  TeamSTEPPSTM 

**National Implementation**
**Creighton as a **
**Living Lab & TRC**

## Creighton’s Search for Team Training

- High Quality
- Accessible
- Cost effective

- Private companies offer Team Training - Quality? Cost?
- TeamSTEPPs
- Met our needs

**Clear Organizational Roles and Actions**

## Effective Teamwork Fundamentals

- Team structure
- Leadership
- Situation monitoring
- Mutual support
- Communication

- Combine this with a “culture of safety”

##  Impact Evaluation  

**Level 1 – Reaction**
**Did the participants like the training? **
**What do they plan to do with what they learned?**

**Level 2 – Learning**
**What skills, knowledge, or attitudes changed after training? By how much?**

**Level 3 – Behavior / Training Transfer**
**Did the participants change their behavior on-the-job based on what they learned?**

**Level 4 – Results**** **
**Did the change in behavior positively affect the organization?**

**Level 5 – Return on Investment**
**Was the training worth the cost?**

**Kirkpatrick’s Model**** **

- In FY 08-09, TeamSTEPPS will:
- Continue to collect quantitative data for Level 1 and Level 2 evaluation
-  **Develop and implement standardized Level 3 & 4 assessment tools**
** ****Include sustainment as part of system-wide evaluation **

## CUMC Surgical Scores Pre- and Post TeamSTEPPS Training

**Scores**

**Notes:**
SCIP indicators
The SCIP indicators were measured on a monthly basis. They included prophylactic antibiotic administration within on hour prior to incision, antibiotic selection, antibiotic discontinued within 24 hours, VTE prophylaxis order, and VTE prophylaxis administered.
Rates of compliance for January, February, and March were considered to be pre the TeamSTEPPS intervention. Thought the training took place in February, the change team did not start meeting until March; thus, any subsequent procedural changes followed. Monthly CSCIP scores represented the degree to which the appropriate procedures were completed relative to the number of cases. Pre- and post- scores were analyzed by means of the Wilcoxon Signed-Ranked Test to examine the changes in SCIP scores prior to and after the introduction of the TeamSTEPPS model.

## CUMC Surgical Scores Pre- and Post TeamSTEPPS Training

**Scores**

**Notes:**
SCIP indicators
The SCIP indicators were measured on a monthly basis. They included prophylactic antibiotic administration within on hour prior to incision, antibiotic selection, antibiotic discontinued within 24 hours, VTE prophylaxis order, and VTE prophylaxis administered.
Rates of compliance for January, February, and March were considered to be pre the TeamSTEPPS intervention. Thought the training took place in February, the change team did not start meeting until March; thus, any subsequent procedural changes followed. Monthly CSCIP scores represented the degree to which the appropriate procedures were completed relative to the number of cases. Pre- and post- scores were analyzed by means of the Wilcoxon Signed-Ranked Test to examine the changes in SCIP scores prior to and after the introduction of the TeamSTEPPS model.

## Employee Communication and Teamwork Engagement Ratings by Area

**Employee Communication and Teamwork Engagement Ratings by Area**

**Score**

- Both OR scores showed significant change (p<0.05)

**Notes:**
From the Employee Engagement Survey scores on teamwork and communication dimensions were evaluated for the OR and the PACU. Teamwork dimensions included items such as “Employees in my department work well together” while the communication dimension include items such as “Employees in my department work well together”. Both of these items are related to TeamSTEPPS principles and training.
The survey is administered yearly in the fall. We used the October 2006 as a pre-measure and the Oct0ber 2007 measure as a past-measure. A Wilcoxon Signed-Rank Test evaluated the difference between the pre- and post-measures.

## Safety Culture Survey:Overall Patient Safety Grade

## Things “fall between the cracks” when transferring patients

- %

- Safety Culture Survey: Handoffs

**Notes:**
Reversed question positive responses are disagree answers

## Outpatient Surgical Patient  Satisfaction Scores

## Outpatient Surgical Patient  Satisfaction Scores

## Outpatient Surgical Patient  Satisfaction Scores

## Outpatient Surgical Patient  Satisfaction Scores

## Outpatient Surgical Patient  Satisfaction Scores

## What is a culture?

- “Shared values (what is important) and beliefs (how things work) that interact with an organization’s structures and control systems to produce behavioral norms (the way we do things around here).”

## National Implementation Project

- Goals:
- Create a national infrastructure to support the adoption of TeamSTEPPS
- Quality Improvement Organizations
- Patient Safety Improvement Corps
- Make training available to early adopters!
- ACTION Partners
- Academic Medical Centers
- Others
- Spread TeamSTEPPS

## National Implementation Team

- Carilion TRC

- Duke TRC

- Creighton TRC

- Minnesota -TRC

- AIR

- Lumetra

- Delmarva

- Booz | Allen | Hamilton

## Program Progress

| Organization | Registered | Trained |
| --- | --- | --- |
| QIO | 173 | 148 |
| AHRQ ACTION | 190 | 102 |
| AHRQ HRO Network | 5 | 5 |
| Academic Health
Profession Program | 12 | 5 |
| Patient Safety Organization | 21 | 8 |
| Other | 140 | 71 |
| Total (as of August 31st) | 546 | 344 |

## Creighton’s Role as a TRC

- Provide a Team Resource Center where training can be conducted
- Serve as a living lab where training is given
- Trainees can take from the lessons learned at Creighton because of our rollout
- After training our staff serves as expert resources for all those trained in this program
- 79 Master Trainers trained at Creighton thus far.

## Feedback on Our Work