TeamSTEPPS is a teamwork system developed jointly by the Department of Defense (DoD)and the Agency for Healthcare Research and Quality (AHRQ) to improve institutional collaboration and communication relating to patient safety. Show
Instructor Outline: Team StructureInstructor Note: In this module, you will present information about the structure of teams. Although team structure does not address team competencies, it is important for participants to learn concepts such as the inclusion of the patient as a member of the team and the components of a multi-team system in terms of planning their TeamSTEPPS implementation. The Team Structure module includes the content provided in the outline below. More content is available than can likely be covered in the time provided; therefore, optional content and activities are noted. It is strongly recommended that instruction not focus solely on lecture, but also includes exercises, videos, and other activities. As such, instructors should use the information below to plan how the module will be taught within the time available.
Additional Resources: Below are sources of additional information and videos you may want to use to customize this module to your participants.
Contents
ObjectivesSay: Upon completion of this module, you will be able to:
Return to Contents TeamSTEPPS Teamwork SkillsSay: Team structure refers to the composition of an individual team or of a multi-team system. Team structure is an integral part of the teamwork process. A properly structured patient care team is an enabler for and the result of effective communication, leadership, situation monitoring, and mutual support. Proper team structure can promote teamwork by including a clear leader, involving the patient, and ensuring that all team members commit to their roles in effective teamwork. It is important to identify and recognize the structure of teams, because teamwork cannot occur in the absence of a clearly defined team. Further, understanding a team's structure and how multiple teams interact in a unit is critical for planning the implementation of TeamSTEPPS tools and strategies. It is critical to know which teams are targeted for TeamSTEPPS; who on the team will adopt the TeamSTEPPS intervention; and how the intervention may affect other teams in the care environment. Return to Contents What Defines a Team?Say: To effectively understand team structure, let's begin with defining a "team." A team is different from a group. A group can achieve its goal through independent individual contributions. Real-time coordination of tasks between individuals is not required. A team, however, consists of two or more people who interact dynamically, interdependently, and adaptively toward a common and valued goal, have specific roles or functions, and have a time-limited membership. During the temporal life of a team, the team's mission is of greater value than the goals of the individual members. Team members:
The teamwork skills you will learn in this course will provide team members with tools and strategies for being effective team members. Return to Contents (Optional) Exercise: Teams and TeamworkSay: Let's look at the team in your own work area. Please take a few minutes to complete the Teams and Teamwork Exercise Sheet. If you are sitting near your fellow team members, you may work on this exercise together. If you are not sitting with your team, please complete it on your own. I'll ask a few of you to share your work with the rest of the class in a few minutes. Do: Give the participants several minutes to complete their sheets. During the discussion, you may wish to document responses on a flipchart or whiteboard. Discussion:
Return to Contents Partnering With the PatientSay: It is critical to acknowledge that a patient care team is not complete without the patient. Patients and their families should be embraced and valued as contributing partners to patient care. Throughout this course, you will learn several teamwork skills, tools, and strategies that can easily be adapted for use by patients and their families. Thinking about how to include patients is an important part of your TeamSTEPPS implementation planning. Examples of effective strategies for involving patients in their care include:
A number of organizations provide information, materials, and suggested strategies related to patient engagement, including AHRQ, the DoD Patient Safety Program, the Joint Commission, the National Patient Safety Foundation (NPSF), the U.S. Department of Health and Human Services (DHHS), the Institute for Healthcare Improvement (IHI), and Consumers Advancing Patient Safety (CAPS). Example resources:
Return to Contents Clinical Team ResponsibilitiesSay: Working with patients and families as true partners includes:
There are also resources available for patients and families. For example, the Josie King Call Line—Condition Help ("Condition H") program enables parents and family members to call for immediate help if they feel the patient is not receiving adequate medical attention. For more information, go to: Maryland Patient Safety or Joint Commission. Return to Contents Patient and Family ResponsibilitiesSay: The responsibilities of patients and their families as part of the team differ from those of the clinical team members. Patient and family responsibilities include:
Discussion:
Return to Contents Multi-Team System for Patient CareSay: We have discussed what defines a team, but in health care, multiple teams are involved in patient care. This slide shows the model of a multi-team system. Each team within a multi-team system is responsible for various parts of patient care, but all must act in concert to ensure quality care. A multi-team system is composed of several different teams. The multi-team system includes the Core Team, the Contingency Team, the Coordinating Team, Ancillary and Support Services, and Administration. In addition, it is important to acknowledge the patient as a critical part of the multi-team system. As we discuss each of the components of the multi-team system, think about whether each team should be included in your TeamSTEPPS implementation plan. Return to Contents Core TeamsSay: Core Teams consist of team leaders and team members who are involved in the direct care of the patient. Core Team members include direct care providers and continuity providers. Continuity providers manage the patient from assessment to disposition, such as case managers. The Core Team is based where the patient receives care. Core Teams should be small enough to ensure situation monitoring, development of situation awareness, and direct, unfiltered communication between members. To establish a shared mental model, Core Teams should be large enough to include skill overlap between members to allow for workload sharing and redistribution when necessary. Every Core Team has a leader who is readily identified by all members of the team. Core Team leadership is dynamic; Core Team leaders are required to take on different roles at various points in the plan of care. Often these may be nonleadership roles, such as supporting a nurse starting an IV. Examples of Core Teams include: Outpatient (Family Practice Clinic):
Inpatient (Tertiary Care Facility):
Inpatient (Operating Room):
Return to Contents Contingency TeamsSay: Contingency Teams are:
Contingency Teams are responsible for immediate, direct patient care during emergency situations requiring more resources than are available to the Core Team. Their role may be very specific and limited to a certain situation, such as a Code Team, or they may be responsible for a broad category of situations, such as disaster response. They generally consist of preidentified members derived from varying units or Core Teams and have limited time to prepare for emergencies. Because Contingency Team members are called together for emergent or specific events, they do not typically spend much time working together as a team. However, their individual roles are clearly defined, and leadership is designated based on patient needs and member expertise in dealing with the particular situation. Examples of Contingency Teams include: Outpatient (Family Practice Clinic):
Inpatient (Tertiary Care Facility):
Inpatient (Operating Room):
* A TeamSTEPPS Rapid Response Systems Guide is available from AHRQ. Select for more information. Return to Contents Coordinating TeamsSay: The Coordinating Team is the group responsible for:
Direct patient care may be a secondary function with the exception of small facilities. Coordinating Teams frequently include experienced personnel with a strong clinical background. This combination enhances the ability of the Coordinating Team members to rapidly assess the overall picture, anticipate the needs or potential needs between and across teams, and make priority-based decisions. Ask:
Return to Contents Ancillary and Support ServicesSay: Ancillary Services consist of individuals who:
Ancillary Services are primarily a service delivery team whose mission is to support the Core Team. In general, an Ancillary Services Team functions independently. Support Services are primarily a service-focused team whose mission is to create efficient, safe, comfortable and clean health care environments, which affect the patient care team, market perception, operational efficiency, and patient safety. Ask:
Possible Answers:
Return to Contents The Role of AdministrationSay: Administration includes the executive leadership of a unit or facility and has 24-hour accountability for the overall function and management of the organization. The Administrative Team has no responsibility in the direct delivery of care but provides the framework and guidance that ensure that each team understands its role and responsibility and has access to the necessary resources to succeed. Administration creates the climate and culture for a teamwork system to flourish by:
Administration should strive to create a learning culture where there is trust and transparency to create a safe environment to report, analyze, and share information openly. This philosophy serves to define a culture of safety; however, as examples in aviation and other high-risk industries have shown, the change will not happen overnight. Return to Contents Team Structure VideoSay: Please consider how the lack of team structure plays a role in the situation shown in this video. Do: Play the video by selecting the director icon on the slide.
Return to Contents Team Structure Video AnalysisSay: Now let's discuss what you saw in the video vignette. Discussion:
Return to Contents Exercise: Applying TeamSTEPPSInstructor Note:This slide is intended for the Master Training course only. The previous slide should be the last one shown to staff participants at your organization. Say: Now return to your TeamSTEPPS Implementation Worksheet. After the Introduction module, you identified the teamwork issue or issues that you plan to address with TeamSTEPPS . Now, think about the area in which you intend to use TeamSTEPPS to improve performance. Think about:
Do: Ask a few individuals to report on the multi-team system that will be affected by their intended TeamSTEPPS implementation.
Return to Contents What are the 4 components of a healthcare system?As illustrated in Figure 1–1, a health care de- livery system incorporates four functional components—financing, insurance, delivery, and payment that—that are necessary for the delivery of health services. The four function- al components make up the quad-function model.
What are the 4 components of a healthcare system quizlet?Financing, insurance, delivery and reimbursement are the four functional components make up the quad-function model. The four functions generally overlap, but the degree of overlapping varies between a private and government-run system and between a traditional health insurance and managed-care based system.
What are the 4 level model of the health care system?In the broadest terms, there are four major healthcare models: the Beveridge model, the Bismarck model, national health insurance, and the out-of-pocket model.
What are the main functions of a health care system?The main functions of healthcare systems and organizations in the continuum of care are financing, provision of health services, stewardship, and resource development (Frenk, Góméz-Dantes, and Moon 2014).
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