TeamSTEPPS for Office-Based Care Implementation Planning Office-Based Care

TeamSTEPPS for Office-Based Care Implementation Planning Office-Based Care

TeamSTEPPS for Office-Based Care Implementation Planning Office-Based Care Objectives Describe the steps involved in implementing TeamSTEPPS in an office-based care setting Discuss possible barriers at each step for the practices that will be recruited Mod Page1 205.2 Page 2 TEAMSTEPPS 05.2 Office-Based Care Shift Toward a Culture of Safety Mod Page1 305.2 Page 3 TEAMSTEPPS 05.2 Office-Based Care

Key Principles of Implementation The Implementation module is based on the principle of improving patient safety and quality of care by improving health care team processes. Key activities include: Mod Page1 405.2 Page 4 Identifying a recurring problem or opportunity for improvement Developing a flowchart or map of the process Studying the process to identify risk points Implementing interventions aimed at eliminating risk points Testing the intervention Sustaining positive changes TEAMSTEPPS 05.2 Office-Based Care 10 Steps of Implementation Planning 1. Create a Change Team

2. Define the problem, challenge, or opportunity for improvement 3. Define the aims of your TeamSTEPPS intervention 4. Design a TeamSTEPPS intervention 5. Develop a plan to test the effectiveness of your TeamSTEPPS intervention 6. Develop an implementation plan 7. Develop a plan for sustained continuous improvement 8. Develop a communications plan 9. Develop a TeamSTEPPS Implementation Plan timeline 10. Review your TeamSTEPPS Implementation Plan with key stakeholders and modify according to input Mod Page1 505.2 Page 5 TEAMSTEPPS 05.2 Office-Based Care Describe the Targeted Office Name of targeted office area: Key Actions: Describe the targeted office area Office area name

Size in terms of number of rooms or appointments Number of staff by profession Size of office area: Number of staff within office area: Physicians: Nurses: Other: Mod Page1 605.2 Page 6 TEAMSTEPPS 05.2 Office-Based Care Step 1: Create a Change Team Key Actions: Members Select a multidisciplinary Change Team

Ensure representation from different leadership levels Ensure at least one member has completed TeamSTEPPS Master Training Ensure one member has experience in performance improvement Mod Page1 705.2 Page 7 TEAMSTEPPS 05.2 TeamSTEPPS Trained? Office-Based Care Step 2: Define Problem or Opportunity for Improvement Key Actions:

What existing information will you review? Review office performance 1. and safety data 2. Incident reports AHRQ Medical Office Survey on Patient Safety Culture 3. Office process and outcome measures Review RCAs and/or FMEAs Ask office staff Conduct Magic Wand exercise What new information will you collect? 1. 2. 3.

What are the main problems and opportunities? 1. 2. 3. Mod Page1 805.2 Page 8 TEAMSTEPPS 05.2 Office-Based Care Example: Problem Definition Problem: Suboptimal communication among office staff when ordering and receiving test results Team Process: Mod Page1 905.2 Page 9 What: Communication of critical information about the patient and the desired test Who: Physicians, nurses, external providers, office manager, and receptionist

When: From ordering the test through receiving the results and notifying the patient Where: In the office TEAMSTEPPS 05.2 Office-Based Care Step 3: Define Aims of TeamSTEPPS Intervention Team Process Aim(s) Key Actions: 1. Develop one to three measurable 2. aims 3. What do you hope to achieve? Team Outcome Aim(s) Who will be involved?

1. When and where will the 2. improvements occur? Consider including team process, team outcome, and office outcome aims 3. Clinical Outcome Aim(s) 1. 2. 3. Mod Page1 10 05.2 Page 10 TEAMSTEPPS 05.2 Office-Based Care Step 4: Design a TeamSTEPPS Intervention Key Actions: List the risk points you intend to address Flowchart or map the process

1. during which the target problem/ challenge/opportunity occurs 2. Identify risk points 3. Determine which TeamSTEPPS List the TeamSTEPPS tools and strategies that will be implemented tools or strategies will work best to eliminate the risk points State what tools and strategies will be implemented; who will use them, when and where Evaluate your TeamSTEPPS intervention for potential benefits and negative effects 1. 2. 3. List the order in which the tools and strategies will be implemented 1.

2. 3. Mod Page1 11 05.2 Page 11 TEAMSTEPPS 05.2 Office-Based Care Step 5: Develop a Plan for Testing Your TeamSTEPPS Intervention Who is responsible? Key Actions: Identify who on your Change Team will be responsible for data collection, analysis, and presentation (generation of graphs and charts) Identify a measure and define target ranges for that measure Measure before and after you implement TeamSTEPPS Consider Kirkpatricks taxonomy when selecting measures Mod

Page1 12 05.2 Page 12 At what level will you measure and what measures will you use? 1. Level IReactions 2. Level IILearning 3. Level IIIBehavior 4. Level IVResults TEAMSTEPPS 05.2 Office-Based Care Step 6. Develop an Implementation Plan Who will attend the training sessions? Key Actions: What skills will you train? Determine who needs to be trained on what TeamSTEPPS skills and by when Develop a training plan for When will the training sessions occur and for how long? each audience Determine if refresher training

Where will the sessions occur? is needed Create training timelines How will you train (method of presentation, tools, supplies)? What are the logistics to consider? Mod Page1 13 05.2 Page 13 TEAMSTEPPS 05.2 Office-Based Care Determine How Coaches May Be Used Number needed: Key Actions: Determine how coaches will be used to facilitate sustainment Mod Page1 14 05.2 Page 14 When will coaches be trained? How will coaches be trained?

How many are needed? When and how they will be trained? How will coaches be used? How they will be used? Expectations for the role of coaches What are the expectations for the role of coaches? TEAMSTEPPS 05.2 Office-Based Care Step 7: Develop a Sustainment Plan Identify Components of a Monitoring Plan: Key Actions:

For your monitoring plan, determine: Measures and target outcomes Data source (e.g., existing QI database) Resources required (money, time, equipment, personnel, expertise) Person(s) responsible for implementation and oversight 1. Measures and Targeted Outcomes 2. Data Sources 3. Resource Requirements Determine how data from your monitoring plan will be used to continually improve processes and performance Mod Page1 15

05.2 Page 15 TEAMSTEPPS 05.2 4. Individual Responsible Office-Based Care Step 8: Develop a Communications Plan Key Actions: Develop a communication plan: Identify goals for communication with this group. What do you want to achieve? Who will receive the information? What information will you communicate? When and how often will you communicate? How will you communicate (e.g., reports, presentations, e-mails)? Mod Page1 16 05.2 Page 16 Who are the stakeholders? 1.

2. What do you want to achieve? 1. 2. What information will you communicate? 1. 2. When will you communicate? 1. 2. How will you communicate? 1. 2. TEAMSTEPPS 05.2 Office-Based Care Step 9. Develop an Implementation Plan Timeline Step Lead 1. Identify the Change Team 2. Define the Main Problems 3. Define TeamSTEPPS Aims 4. Describe the Intervention 5. Develop a Test Plan 6. Develop an Implementation Plan 7. Develop a Monitoring Plan 8. Develop a Communication Plan

Mod Page1 17 05.2 Page 17 TEAMSTEPPS 05.2 Completion Date Resources Required Office-Based Care Change Team Meetings Purpose Mod Page1 18 05.2 Page 18 Lead TEAMSTEPPS 05.2 Meeting Date Office-Based Care Step 10: Review Your Plan With Key

Stakeholders Key Actions: Identify stakeholders who could contribute significantly to the Implementation Plan Ask key stakeholders to review your Action Plan and to provide input Modify your Action Plan Who are the key stakeholders that need to review the plan? 1. 2. 3. 4. 5. based on their input, if needed Mod Page1 19 05.2 Page 19 TEAMSTEPPS 05.2 Office-Based Care

TeamSTEPPS Implementation Planning Exercise Break into teams if appropriate Develop your Action Plan based on the 10-step process Be ready to present and discuss your Action Plan with the larger group Mod Page1 20 05.2 Page 20 TEAMSTEPPS 05.2

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