Improving Patient Safety Through Teamwork

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Improving Patient Safety Through Teamwork
Improving Patient Safety Through Leadership and
Teamwork

• Goodall Hospital
• Muskie School of Public Service

Goodall Hospital Muskie School of Public Service
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Background

• Goodall Hospital Strategic Plan, Quality Plan
• Hospital Survey on Patient Safety Culture
• Donaghue Foundation RFP
• Topic Selection
• Proposal process
• Funded projects

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Grant Specifics

• Leadership involvement
• Project goals
• Academic partner
• Teamwork training
• Formative evaluation
• Dissemination

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Teamwork Training

• MedTeams
• Crew Resource Management
• Project structure
• Train the Trainer
• Emergency Department training
• Inclusion of Sanford Fire Dept. paramedics
• Engagement of management

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Project Specifics

• How we did the training
• Who we trained and why
• Where we plan to train next

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Some examples of MedTeams Concepts

• Shared mental model
• Call outs
• Check back
• Cross-monitoring
• DESC
• Huddles
• Debriefs

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Project evaluation components

• Qualitative interviews with staff
• Patient Satisfaction surveys
• Quality of Care surveys
• AHRQ Culture of Safety survey
• Process evaluation
• Lessons learned, dissemination

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Challenges (so far)

• Roll-out issues
• Choice of trainers
• Sustainability for training (staff Turnover)
• Physician role in training, uptake
• Leadership turnover

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Challenges (so far)

• Financial pressures
• Lay-offs
• Economic downturn has led to increase in ER
  utilization and unreimbursed care
• Convincing staff that this is not a fad
• Setting clear expectations

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Opportunities (so far)

• Leadership support
• Tie-in with patient safety culture improvement
  goals
• Skill building
• Increased communication at both management and
  unit level about teamwork behaviors
• Common language
• Engagement with paramedics

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Opportunities

• Starting to hard-wire teamwork behavior through
  hospital policies and procedures
• Code of conduct
• Job descriptions
• HR performance evaluations (peer and supervisor)
• meeting agenda items
• root cause analysis
• Skills fair

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Opportunities

• Patient satisfaction
• Formative evaluation - make course corrections
  along the way, project direction shared with
  Muskie

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Next Steps

• Spread within hospital to other units
• Evaluation continues
• Retraining
• More trainers
• Dissemination activities
• Results

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Questions?

• Contact info
• Mary Finnegan
• mfinnegan_at_goodallhospital.org
• Cheryl Ciechomski
• cciechomski_at_goodallhospital.org
• Judy Tupper
• jtupper_at_usm.maine.edu