Back to list of SPOTLIGHTS

AHRQ and DoD Announce TeamSTEPPS


Carolyn M. Clancy, M.D.
Director
Agency for Healthcare Research and Quality

"TeamSTEPPS is a federal partnership to promote teamwork and enhance patient safety in the clinical setting."

Teams play an important role in the delivery of health care in virtually every setting. However, the quality and effectiveness of care can vary greatly depending upon how well a team functions. Effective teamwork is not a given, but a goal that requires training and cultivation. In a recent article, Allan S. Frankel, M.D., and colleagues noted: "Currently, we can assure our patients that their care is always provided by a team of experts, but we cannot assure our patients that their care is always provided by expert teams.1

To that end, the Agency for Healthcare Research and Quality (AHRQ) has collaborated with the Department of Defense (DoD) to explore the field of medical teamwork. Recently, we announced the availability of a new resource for training health care providers in better teamwork calledTeamSTEPPS – Strategies and Tools to Enhance Performance and Patient Safety. TeamSTEPPS itself is a product of successful teamwork between two federal agencies to foster a culture of patient safety in as many health care settings as possible. The goal of this comprehensive teamwork training support system is to improve the ability of teams to respond quickly and effectively to whatever situations arise, whether they occur in emergency departments, labor and delivery suites, or other settings.

The Institute of Medicine’s (IOM)1999 report, To Err Is Human: Building a Safer Health System, identified poor teamwork and faulty communication as major sources of preventable errors and called for interdisciplinary team training programs to promote patient safety.2 TeamSTEPPS has been developed in response to the IOM’s findings.

Evidence Based and Field Tested
TeamSTEPPS offers a flexible, evidence-based toolkit designed to enable health care facilities and providers improve patient safety through enhanced communication and other teamwork skills. The new training package capitalizes on DoD’s expertise in medical and non-medical team performance, and on AHRQ’s research in the fields of patient safety and health care quality. The program is more than just a one-shot training session that any health care provider can implement. A TeamSTEPPS initiative occurs in three continuous phases: (1) assessment; (2) planning, training, and implementation; and (3) sustainment. Each phase incorporates key actions: set the stage, decide what to do, make it happen, and make it stick.3

TeamSTEPPS is unique compared with other team training programs; it not only describes what to do to improve health care quality and patient safety through teamwork, but also guides users through the implementation process and provides instructional resources. It has undergone extensive field testing in the DoD’s Military Health System (MHS) and several civilian organizations. It was designed to train health care professionals who work not only in high-stress situations such as surgical suites, emergency departments, and intensive care units, but also in ambulatory care settings, including physicians' offices.

Another important feature is that TeamSTEPPS may be implemented in full or in part. The training materials have stand-alone modules to choose from depending on what best meet the organization’s specific teamwork needs and resource availability. I encourage all health delivery systems, large and small, to take advantage of the TeamSTEPPS program to provide your patients with expert health care teams.

Elements of TeamSTEPPS

TeamSTEPPS is based on four core competency areas:

• Team leadership — the ability to direct and coordinate activities of team members, assess team performance, assign tasks, develop team knowledge and skills, motivate team members, plan and organize, and establish a positive team atmosphere.
• Situation monitoring (or mutual performance monitoring) — the capacity to develop common understandings of the team environment and apply appropriate strategies to monitor teammate performance accurately.
• Mutual support (or back-up behavior) — the ability to anticipate other team members' needs and to shift workload among members to achieve balance.
• Communication — including the efficient exchange of information and consultation with other team members.

The TeamSTEPPS toolkit incorporates a number of useful strategies. It is meant to encourage situational awareness and communication by all members of the team and to foster mutual respect among team members, regardless of their roles. The program offers resources for all stages of the program including:

1. Three types of training curricula.
2. A course management guide.
3. Multimedia course materials.
4. TeamSTEPPS implementation guide.
5. Measurement tools for post implementation assessment.

For more information on how to obtain a copy of the TeamSTEPPS program please go online to http://www.ahrq.gov/qual/teamstepps/.

References

1. Frankel, A. S., Leonard, M. W., & Denham, C. R. (2006). Fair and just culture, team behavior, and leadership engagement: The tools to achieve high reliability. Health Services Research, 41(4, Part II), 1690-709.
   
   
2. Institute of Medicine (IOM). To err is human: Building a safer health system. Kohn LT, Corrigan JM, Donaldson MS (Eds.). Washington, DC: National Academy Press; 1999.

   Kotter J, Rathgeber, H. Our iceberg is melting: Changing and succeeding under any conditions. New York, NY: St. Martin's Press; 2006.