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Enhancing Performance and Patient Safety: Strategies and Tools in Action

This AHRQ-funded project by UNCHCS/RTI partnership focuses on the adoption and implementation of strategies and tools to improve performance and patient safety. The training program includes topics such as effective team structure, leadership skills, situation monitoring, and effective communication. Learn how to overcome barriers to teamwork and develop the necessary skills for team performance.

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Enhancing Performance and Patient Safety: Strategies and Tools in Action

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  1. Strategies and Tools to Enhance Performance and Patient SafetyAdoption in ActionAHRQ funded projectUNCHCS/RTI partnership READY Training OR 6

  2. Teamwork Is All Around Us

  3. Objectives • Describe effective team structure • Describe effective leadership and leadership skills • Describe the relationship between situation monitoring, shared mental models, and team effectiveness • Describe effective verbal and task related mutual support • Describe effective communication skills • Recognize barriers to effective teamwork

  4. Why Do Errors Occur—Some Obstacles • Excessive professional courtesy • Halo effect • Passenger syndrome • Hidden agenda • Complacency • High-risk phase • Strength of an idea • Task (target) fixation • Workload fluctuations • Interruptions • Fatigue • Multi-tasking • Failure to follow up • Poor handoffs • Ineffective communication • Not following protocol

  5. Patient Core Team Contingency Teams Coordinating Ancillary Team Services Administration Multi-Team System for Patient Care

  6. Required Skills for Team Performance • Leadership • Situation Awareness • Mutual Support • Communication

  7. Effective Team Leaders • Organize the team • Articulate clear goals • Make decisions through collective input of members • Empower members to speak up and challenge, when appropriate • Actively promote and facilitate good teamwork • Skillful at conflict resolution

  8. Team Events • Briefs – planning • Huddles – problem solving • Debriefs – process improvement Leaders are responsible to assemble the team and facilitate team events But remember… Anyone can request a brief, huddle, or debrief

  9. Briefing/Time Out • Team membership and roles • Clinical status of the patient • Team goals and potential pitfalls • Resources

  10. Team Huddles

  11. Debriefs • Debriefs should be conducted for the following reasons: • So team members learn from actual situations • So learning takes place collectively • So team members can exchange information • So teams can improve performance

  12. Delegation of Resources Delegation is a means of managing resources whereby information, equipment, and key staff are allocated to specific tasks. Delegation is a skill that anyone can learn.

  13. Modeling Teamwork • Effective team leaders utilize the team skills in their daily practice and encourage team behaviors by: • Sharing information • Displaying appropriate communication, monitoring, and support behaviors • Helping team members achieve the effective team performance using the same behaviors • Encouraging active participation by all team members

  14. Required Skills for Team Performance • Leadership • Situation Awareness • Mutual Support • Communication

  15. A Continuous Process

  16. How can I contribute to a Shared Mental Model? • Routinely update others • Acknowledge deviations or changes in the situation • Alert team to actual or potential problems • Verbalize a course of action • Request needed information

  17. When to Share? • Briefs • Huddles • Debriefs • Shift Changes • Handing off care to another

  18. Required Skills for Team Performance • Leadership • Situation Awareness • Mutual Support • Communication

  19. Mutual Support Mutual support is the essence of teamwork • Protects team members from work overload situations that may reduce effectiveness and increase the risk of error • Mutual support consists of helping your fellow teammates by offering assistance • Two kinds of mutual support • Task related • Verbal

  20. I’M SAFE Checklist I = Illness M = Medication S = Stress A = Alcohol and Drugs F = Fatigue E = Eating, Elimination, and Emotions

  21. Required Skills for Team Performance • Leadership • Situation Awareness • Mutual Support • Communication

  22. Please Use CUS Wordsbut only when appropriate! 26

  23. SBARq • SBARq is a technique for communicating clearly and concisely. • Communicate the following information: • Situation • Background • Assessment • Recommendation • Any Questions?

  24. Be Complete and Brief

  25. Be Clear

  26. Be Timely

  27. Check Back Sender verifies that the message was received Sender initiates the message

  28. Callout • A strategy used to communicate important or critical information. • It informs all team members simultaneously during emergency situations • It helps team members anticipate next steps • On you unit, what information would you want called out?

  29. Next Stepps • Begin practicing the teamwork skills – plan to use at least one skill during your next work day • You will get coaching from unit based master trainers • Coach and give feedback to each other!

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