Communication and Collaboration: Creating a Culture of Teamwork Through the Use of TeamSTEPPS Strategies

Sunday, June 16, 2013

Title: Communication and Collaboration: Creating a Culture of Teamwork Through the Use of TeamSTEPPS Strategies

Ryman Hall B4 (Gaylord Opryland)
Suzanne Lundeen, RNC, PhD , Ben Taub General Hospital, Women's and Infant's Services, Harris Health System, Houston, TX
Maureen Padilla, DNP, RNC-OB, NEA-BC , Ben Taub General Hospital, Women's and Infant's Services, Harris Health System, Houston, TX

Discipline: Advanced Practice (AP), Childbearing (CB), Professional Issues (PI)

Learning Objectives:
  1. Describe the TeamSTEPPS process that is aimed at creating and sustaining a culture of safety.
  2. Identify how the “snapshot” teamwork technique improves patient safety and satisfaction within an organization.
  3. Describe nursing practice implications based on the TeamSTEPPS approach to collaboration.
Submission Description:
Purpose for the program:

To improve patient safety and satisfaction by implementing an evidence-based system to enhance communication and teamwork skills among health care professionals.

Proposed change:

TeamSTEPPS is an innovative program that works to solidify collaboration among the healthcare team to achieve the best outcomes for patients.  A multidisciplinary group committed to changing the culture of the department attended the TeamSTEPPS master training course. The team identified communication as a recurring problem that threatened patient safety and satisfaction. The team then developed the department-wide “snapshot” as an intervention to improve communication.

Implementation, outcomes and evaluation:

The Women’s Services department consists of high-risk labor and delivery, well-baby nursery, level 2 and level 3 neonatology units, mother-baby couplet unit and perinatal special care unit. Direct patient care providers from the departmental units attended the TeamSTEPPS fundamentals four hour interactive workshop. This workshop provided hands-on learning experience of the TeamSTEPPS philosophy as well as an opportunity to practice the TeamSTEPPS behaviors and “snapshot”.

At 0800 and 2000 daily, the obstetric faculty member on duty conducts the interdisciplinary department-wide “snapshot.” The snapshot is a scripted report that begins with the OB faculty giving the L&D big picture report. Next, the L&D team lead nurse reports on inductions, surgeries, expected patients, antepartum unit census/concerns, OB triage status, patients waiting for beds and staffing. The OR nurse then discusses concerns about scheduled cases and the mother-baby team lead nurse reports census, discharges and concerns. The nurse midwife and family medicine resident report on admitted patients and bring to light any concerns they may have. Next, Anesthesia discusses the OR cases, epidurals infusing, problem epidurals and anticipated high risk cases. Neonatology then has an opportunity to discuss any concerns. To close the snapshot, the Obstetric faculty clearly states: “If any team member sees anything unsafe or not in the best interests of our patients, we expect you to speak up.  If you are unable to get a timely or effective response, call me, obstetric faculty, Dr.  _______.”

Improved communication has been evidenced by expediting safe mother-baby discharges during periods of increased census, improved operating room productivity, timely and effective neonatology consultations and accessibility and accountability of the obstetric faculty member on-duty.

Implications for nursing practice:

Effective collaboration and communication are essential elements of professional nursing. The department-wide “snapshot” encourages nurses to be actively involved in the multidisciplinary healthcare team and make valuable, evidence-based contributions to patient safety and satisfaction. 

Keywords: TeamSTEPPS, safety, communication, collaboration