SSM Health Care’s Foundation of Safety and Care

1. SSM Health Care’s Foundation of Safety and Care STEPPS: Producing Effective Medical Teams to Achieve Optimal Patient Outcomes AHRQ Annual Conference Sept. 10, 2008 Andy Kosseff, MD SSM Health Care Medical Director

2. Why is STEPPS So Important Now • Fragmentation of care • Multiple initiatives – are patients safer • Electronic health records • Care giving doctors and nurses are the heart of a safety culture

3. SSM’s Progress • Started TeamSTEPPS training in Oct., 2007 • Have trained 400 clinicians on 3 pilot units • Established outcomes measurement plan for each unit trained • Will train another 300 clinicians in 2008

4. STEPPS Outcome Measures • Number of serious and sentinel events • Adverse Outcome Index (OB) /Trigger tool • AHRQ Patient Safety Culture Survey • Patient, physician, and nurse satisfaction surveys • Nurse turnover rate

5. Additional Aspects of STEPPS Training • It is acceptable communication training • It sets a standard for performance on clinical units – agreed upon by bedside clinicians

6. Operationalizing STEPPS • Prework Introduction to Administrative Council Introduction to doctors and nurses on unit to be trained Measurement Start training • Implementation Coaches to sustain implementation Monthly STEPPS Steering Team meeting Sequential tools and concepts implementation Outcome data feedback Train new doctors and nurses

7. SSM Customization • Focus on core teams • Use clinical cases from units being trained • Make initial Fundamentals training 4 hours • Use as a foundation of safety and care

8. What We Should Have Known • Doctors and nurses on both sides of the podium • Training is the easy part • Not all STEPPS trainers are trainers • Understand advocacy and assertion clearly • Separate teamwork training from EHR implementation

9. SSM’s STEPPS Future • Intensive support for all trained units • Train our own trainers • Simulation training • Broad use of STEPPS on all clinical units

10. The End Please contact Andy Kosseff for further information or discussion Andy_Kosseff_MD@ssmhc.com 608-238-1337