Table 1 Overview of team training and implemented TeamSTEPPS tools and strategies—and their related key principles
From: A complex teamwork intervention in a surgical ward in Norway
Year Month | Tools and strategies Team competencies | Explanations of the team training and the tools and strategies implemented | Profession group Implementation |
|---|---|---|---|
2016 May | Patient safety and TeamSTEPPS five key principles | Six hours of compulsory team training: didactics, discussions, role-play and high-fidelity simulation training | All healthcare personnel |
2016 May | Closed-loop Communication | To ensure that information conveyed by the sender is understood by the receiver as intended. The sender has to ensure verification from the receiver | All healthcare personnel Critical information—especially regarding orally medicating orders |
2016 June | SBAR Communication | A technique for communicating critical information that requires immediate attention and action concerning a patient’s condition. SBAR: S = Situation B = Background A = Assessment R = Request/Recommendation | All healthcare personnel For example, by a deteriorating patient |
2016 August | Briefs Leadership | Sharing the plan: Short session prior to start? To share the plan, discuss team formation, assign roles and responsibilities, establish expectations and climate, anticipate outcomes and likely contingencies | Nursing staff Start of every shift |
2016 September | Huddles Leadership | Monitoring and modifying the plan: Ad hoc meeting to reestablish situational awareness, reinforce plans already in place and assess the need to adjust the plan | All healthcare personnel Daily after rounding by the patient whiteboard—the rounding physician and nursing staff—lead by a registered nurse |
2016 October | Cross monitoring Situation monitoring | A harm error reduction strategy that involves: (1) Monitoring actions of other team members; (2) Providing a safety net within the team; (3) Ensuring that mistakes or oversights are caught quickly and easily, and (4) “Watching each other’s back” | Registered nurses Mandatory control by two registered nurses with intravenous I.V. medication administration |
2016 November | TeamSTEPPS 4 team competencies | TeamSTEPPS refresher training; classroom team training | Nursing staff (75 min) and physicians (20 min) |
2017 January | Debriefs Leadership | Reviewing the Team’s Performance. Informal information exchange session designed to improve team performance and effectiveness through lessons learned and reinforcement of positive behaviors | Nursing staff Once a week with Unit Nurse Manager |
2017 January | Task assistance Mutual support | Helping others with tasks builds a strong team. Key strategies include: (1) Team members protect each other from work overload, (2) Effective teams place all offers and requests for assistance in the context of patient safety, and (3) Team members foster a climate where it is expected that assistance will be actively sought and offered | Nursing staff Distribution of workload, number of patients |
2017 February | STEP Situation Monitoring | A tool for monitoring situations in the delivery of healthcare. Status of the patient (S), Team members (T), Environment (E), Progress toward the goal (P) | Nursing staff Updated electronic care plan |
2017 March | Two challenge rule Mutual support | Empowers all team members to “stop the line” if they sense or discover an essential safety breach. When an initial assertive statement is ignored: (1) It is the team members’ responsibility to assertively voice concern at least two times to ensure that it has been heard, (2) The team member being challenged must acknowledge that concern has been heard, and (3) If the safety issue still hasn’t been addressed, the team member has to take a stronger course of action and utilize supervisor or chain of command | All healthcare personnel Anyone: Speak-up until heard when seeing a situation that may threaten patient safety |
2017 May | TeamSTEPPS 4 team competencies | TeamSTEPPS refresher training; classroom team training | Nursing staff (75 min) |
2017 May | I-PASS Communication | The transfer of information (along with authority and responsibility) during transitions in care across the continuum. It includes an opportunity to ask questions, clarify, and confirm. I = Illness severity, P = Patient summary, A = Action list, S = Situation awareness and contingency planning, S = Synthesis by receiver | Nursing staff Handoffs with focus on patient safety risks |