Improving Patient Safety Through Teamwork
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This document discusses teamwork in healthcare and its importance for patient safety. It describes how teamwork skills are often taught through simulations but clinical experience is limited for undergraduates. The intervention described uses a film about a patient falling through the cracks followed by workshops using scenarios to practice and debrief teamwork skills. Key concepts emphasized include shared understanding of goals and plans, involving patients as part of the team, and skills like adaptation, trust, and psychological safety. The overall goal is to apply teamwork knowledge to improve patient outcomes and safety.
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Improving Patient Safety Through Teamwork
- 1. Teamwork in Healthcare Making patients safer W. Ward Flemons MD
- 2. The origins of Teamwork CUMMING SCHOOL OF MEDICINE 2
- 3. Improving healthcare safety CUMMING SCHOOL OF MEDICINE 3
- 4. Teaching Teamwork to undergraduates ▪ Team STEPPS designed as an organizational strategy ▪ Skills are not well defined – can they be tested? ▪ Physician oriented ▪ Passive learning (slides) > > Active learning ▪ Undergraduates have limited or no clinical experience ▪ Team skills are ‘soft’ skills ▪ Often learned during simulation BUT . . . . ▪ Cognitive overload – learning clinical skills 1st priority CUMMING SCHOOL OF MEDICINE 4
- 5. Teamwork – the Essentials CUMMING SCHOOL OF MEDICINE Team Scheme TeamSTEPPS Canada™ Fundamentals Core teamwork skills 1.4 Team Scheme Leadership/ Membership Leader is clearly iden3fied/ Team roles are understood Leader priori+zes tasks and delega3on is balanced Leader ar3culates goals/ members seek clarifica3on Leader does not become task-focused Leader facilitates team communica3on, situa3on monitoring, and decision making Communica3on Essen3al informa3on is communicated through the team leader Communica+on is clear, concise and direct àuse names or eye contact Ac3ons and tasks are verbalized (call -outs) Communica3on is “closed-loop” Handoffs are organized and effec3ve Situa3on Monitoring A mental model is shared àbrief and huddle as needed Pa3ent status is frequently reassessed à is there progression towards the stated goal? Challenges are an+cipated àCall for help early Team members cross-monitor one another Resources are u3lized appropriately (personnel, equipment, cogni3ve aids) Collabora3ve Decision Making/ Mutual Support Decisions are made for progression to end goal à collec+ve input from team Members are asser+ve, when necessary, to advocate for pa3ent’s safety Members promote and facilitate good teamwork à task assistance à feedback Conflicts are effec3vely managed and resolved All team members share equal responsibility for achieving goals Adapted from: CIHC Na3onal Interprofessional Competency Framework and TeamSTEPPS5
- 6. The intervention CUMMING SCHOOL OF MEDICINE Team SchemeTeam Scheme Leadership/ Membership Leader is clearly iden3fied/ Team roles are understood Leader priori+zes tasks and delega3on is balanced Leader ar3culates goals/ members seek clarifica3on Leader does not become task-focused Leader facilitates team communica3on, situa3on monitoring, and decision making Communica3on Essen3al informa3on is communicated through the team leader Communica+on is clear, concise and direct àuse names or eye contact Ac3ons and tasks are verbalized (call -outs) Communica3on is “closed-loop” Handoffs are organized and effec3ve Situa3on Monitoring A mental model is shared àbrief and huddle as needed Pa3ent status is frequently reassessed à is there progression towards the stated goal? Challenges are an+cipated àCall for help early Team members cross-monitor one another Resources are u3lized appropriately (personnel, equipment, cogni3ve aids) Collabora3ve Decision Making/ Mutual Support Decisions are made for progression to end goal à collec+ve input from team Members are asser+ve, when necessary, to advocate for pa3ent’s safety Members promote and facilitate good teamwork à task assistance à feedback Conflicts are effec3vely managed and resolved All team members share equal responsibility for achieving goals Adapted from: CIHC Na3onal Interprofessional Competency Framework and TeamSTEPPS + Falling Through the Cracks: Greg’s Story https://gregswings.ca/fttc-gregsstory/ 6
- 7. The intervention CUMMING SCHOOL OF MEDICINE ▪ Workshops 1 2 3Scenarios SBAR Advocacy & Assertion Teamwork skills - debrief Good examples Missed opportunities What if . . . . ? Teaching scenes Teamwork skills - practice 7
- 8. Our assessment CUMMING SCHOOL OF MEDICINE ▪ The film puts all learners in the same experience ▪ Team Scheme allows us to reinforce skills & concepts ▪ Key concepts —Shared mental model (Goal and Plan) —Patients are part of the team (an equal part!) —Adapt —Trust —Psychological safety 8
- 9. Applying Teamwork Knowledge CUMMING SCHOOL OF MEDICINE Team Scheme Leadership/ Membership Leader is clearly iden3fied/ Team roles are understood Leader priori+zes tasks and delega3on is balanced Leader ar3culates goals/ members seek clarifica3on Leader does not become task-focused Leader facilitates team communica3on, situa3on monitoring, and decision making Communica3on Essen3al informa3on is communicated through the team leader Communica+on is clear, concise and direct àuse names or eye contact Ac3ons and tasks are verbalized (call -outs) Communica3on is “closed-loop” Handoffs are organized and effec3ve Situa3on Monitoring A mental model is shared àbrief and huddle as needed Pa3ent status is frequently reassessed à is there progression towards the stated goal? Challenges are an+cipated àCall for help early Team members cross-monitor one another Resources are u3lized appropriately (personnel, equipment, cogni3ve aids) Collabora3ve Decision Making/ Mutual Support Decisions are made for progression to end goal à collec+ve input from team Members are asser+ve, when necessary, to advocate for pa3ent’s safety Members promote and facilitate good teamwork à task assistance à feedback Conflicts are effec3vely managed and resolved All team members share equal responsibility for achieving goals Team Scheme 9
- 10. The Co-pilot Collective CUMMING SCHOOL OF MEDICINE ▪ Bringing people together to create change ▪ http://gregswings.ca/the-co-pilot-collective/ 10
- 11. Teamwork in Healthcare Making patients safer