Improving Patient Safety Through Teamwork

Goodall HospitalMuskie School of Public Service

Improving Patient Safety Improving Patient Safety Through LeadershipThrough Leadership

and Teamworkand Teamwork

Goodall HospitalGoodall HospitalMuskie School of Public ServiceMuskie School of Public Service

Background

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

Grant Specifics

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

Teamwork Training

• MedTeams• Crew Resource Management• Project structure

– Train the Trainer– Emergency Department training– Inclusion of Sanford Fire Dept. paramedics– Engagement of management

Project Specifics

• How we did the training

• Who we trained and why

• Where we plan to train next

Some examples of MedTeams® Concepts

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

Project evaluation components

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

Challenges (so far)• Roll-out issues

• Choice of trainers• Sustainability for training (staff Turnover) $$

• Physician role in training, uptake• Leadership turnover

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

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

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

Opportunities

• Patient satisfaction• Formative evaluation - make course

corrections along the way, project direction shared with Muskie

Next Steps

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

Questions?Contact info:

Mary Finneganmfinnegan@goodallhospital.org

Cheryl Ciechomskicciechomski@goodallhospital.org

Judy Tupperjtupper@usm.maine.edu