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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