TeamSTEPPS in Long-Term Care

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TeamSTEPPS

Why Long-Term Care?

Long-term care environment is unique “Patients” are called Residents Care Teams: multi-disciplinary, include non-

clinical staff Approximately 16,000 nursing homes and 1.6M

nursing home residents across the country

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TeamSTEPPS

Focus of Long-Term Care Version

Text and associated training materials made relevant to the long-term care environment Language meaningful to long-term care Exercises, scenarios, tests and videos center

around chronic medical or rehabilitation circumstances

Graphics and pictures reflect nursing home staff, care and environment

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TeamSTEPPS

Long-Term Care Team

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TeamSTEPPS

Nurse Assistant

Chef

Rosie the Housekeeper

Social Worker

Therapeutic Recreation/Activity

Staff

Nurse

Administrator

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Implementation

Evidence tested with long-term care leadership and staff Adjust for audience, including education level and

English proficiency Share experiences and stories Supplement lectures with exercises Hold brief yet frequent learning sessions Focus on communication skills

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TeamSTEPPS

Long-Term Care Videos Two videos created

Long-term care – subtle decline in a resident over a 24 hour period

Sub-acute care –possible Myocardial Infarction/Pulmonary Embolism in a resident receiving physical therapy

14 of 15 TeamSTEPPS skills were highlighted Time-Out is not a skill

deemed necessary for most

nursing homes

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Conflict Resolution & Patient Safety

Conflict between an Activities Staff and a Nurses Aide

TeamSTEPPS Skills Used: Two-Challenge Rule DESC Script

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TeamSTEPPS

Two-Challenge Rule

Invoked when an initial assertion is ignored… It is your responsibility to assertively voice your

concern at least two times to ensure that it has been heard

The member being challenged must acknowledge If the outcome is still not acceptable

Take a stronger course of action Use supervisor or chain of command

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Two-Challenge Rule in Action

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TeamSTEPPS

Conflict Resolution: DESC Script

A constructive approach for managing and resolving conflict

D—Describe the specific situation E—Express your concerns about the action S—Suggest other alternatives C—Consequences should be stated

Ultimately, consensus shall be reached.

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Let’s “DESC-It!”

• Have timely discussion• Frame problem in terms

of your own experience• Use “I” statements to

minimize defensiveness• Avoid blaming

statements• Critique is not criticism• Focus on what is right,

not who is right

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DESC Script in Action

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New in Long-Term Care Version

Videos and Discussions Discussion questions about videos and use of

skills Exercises, Scenarios

Care planning group exercise Multi-disciplinary scenarios Non-clinical examples and scenarios Non-clinical application of TeamSTEPPS skills and

techniques

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TeamSTEPPS

Contact Information

Qualidigm: Michelle Pandolfi

mpandolfi@qualidigm.org 860-632-3735

Ann Spenard aspenard@qualidigm.org

Abt Associates: Donna Hurd

donna_hurd@abtassoc.com