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Developed by Department of Defense (DoD) Patient Safety Program (PSP) in partnership with the Agency for Healthcare Research and Quality (AHRQ), TeamSTEPPSTeam Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based teamwork system designed to improve the quality, safety and efficiency of healthcare. TeamSTEPPS consists of a collection of instructions, materials and tools to help drive a successful teamwork initiative from the initial planning to implementation through to sustainment. The system is designed to improve patient safety using a three-phase approach: Phase I Assessment: Facility determines organizational readiness; Phase II Planning, Training & Implementation: Facility “decides what to do” and “makes it happen;” and Phase III Sustainment: Facility spreads the improvements in teamwork performance, clinical processes and outcomes resulting from the TeamSTEPPS initiative.TeamSTEPPS is a robust, evidence-based system designed to improve communication and teamwork skills among health care professionals.
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The T-TPQ, as described by AHRQ, is a self-report survey that measures an individual’s perception of group level teamwork skills within a medical unit or department. It was developed to align five core teamwork dimensions on which TeamSTEPPS is based:
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- Team structure
- Leadership
- Situation monitoring
- Mutual support
- Communication
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Offering various ready-to-use tools, materials and resources, TeamSTEPPS can be tailored to address the specific needs of an organization to seamlessly incorporate its principles into all areas of a health care system. In fact, it is only by fully integrating the tools that TeamSTEPPS offers into our day-to-day activities that Military Health System (MHS) leadership, frontline staff and patient safety professionals will truly benefit from leveraging this methodology. A great example of this is the work and research that the U.S. Army Medical Command (MEDCOM) conducted regarding the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ). Highlights of this work were presented at the 2016 National TeamSTEPPS Conference this past June.
Through data collected from 2011 to 2015 and the submission of over 60,000 surveys to conduct a comprehensive Army-wide facility and unit assessment, the MEDCOM team was able to demonstrate that the T-TPQ:
- Is an effective tool for measuring perceptions of teamwork
- Is a tool that enhances and has positive impact for patient safety
Based on these findings, which were published on the British Journal of Quality and Safety in 2014, the MEDCOM put the T-TPQ data to work by:
- Developing annual enterprise-wide U.S. Army Medical Department-wide goals
- Providing facilities with the T-TPQ data to use in the development of their annual TeamSTEPPS/Patient Safety Plans
- Utilizing the data for their improvement goal and performance improvement projects
U.S. Army Reserve 1st Lt. John Gotta, a South Kingstown, Rhode Island native and emergency room nurse with the 399th Combat Support Hospital, 804th Medical Brigade, 3d Medical Command (Deployment Support) makes sure it is clear before delivering a shock to a simulated casualty during an exercise held April 2, 2016 at the Mayo Clinic Multidisciplinary Simulation Center in Rochester, Minnesota. The purpose of the exercise was for the 399th CSH Soldiers to practice the DoD mandated framework known as TeamSTEPPS. (Photo by Staff Sgt Andrea Merritt)
Because TeamSTEPPS serves as an integral resource to help DOD leadership, frontline staff and patient safety professionals achieve various MHS strategic priorities, including high reliability, the MEDCOM will continue to leverage the TeamSTEPPS tools and the T-TPQ in 2016 and onward to:
- Gather even more key teamwork assessment data to drive improvement across all Army facilities
- Align TeamSTEPPS tools to the High Reliability Organization (HRO) principles
- Conduct quarterly TeamSTEPPS regional coaching calls to include T-TPQ data review and recommendations
As demonstrated by the MEDCOM efforts described above, the application, implementation and sustainment of TeamSTEPPS and the T-TPQ are crucial elements in accomplishing the MHS goal of becoming a full-fledged HRO. All of us: leadership, frontline staff and patient safety teams must collaborate to address gaps, improve processes and fully leverage the impact effective teamwork can have on patient care. By doing this, we will not only create change – we will make change stick so that we can deliver excellence every single time.
The DoD PSP team commends the MEDCOM for its implementation of TeamSTEPPS and the T-TPQ. It is this type of well-thought out and carefully planned application of TeamSTEPPS that will continue to move MHS forward and towards becoming a high performing, highly reliable health care system.
Learn more about the U.S. Army Medical Command and TeamSTEPPS.
CITATION: Keebler, J.R. Salas E. 2014. Validation of a Teamwork Perceptions Measure to Increase Patient Safety. British Journal of Quality and Safety.