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TeamSTEPPS – Could Organisational Change Improve Resus Management?

TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is a program that has been developed in the US, that works from the “bottom up” to implement organisational change related to patient safety and teamwork (there’s that word again).  The program is based on a site-specific, comprehensive needs-analysis, and is followed by planning, training and sustainment activities.

There is a podcast from the Victorian Quality Committee (Department of Health), in which Mary Salisbury (a pioneer developer, author and designer of TeamSTEPPS) and Dave Sainsbury, an Anaesthetist from Adelaide (who implemented a pilot program at his hospital) talk about what TeamSTEPPS is, and the benefits of implementing a program.

You can listen to the podcast here:

The proposed benefits of the TeamSTEPPS program include:

  • Improved patient/staff satisfaction
  • Reduced negative patient outcomes
  • Improved care delivery processes
  • Improved communiuctaion within and across teams

As Dave mentions, there are lots of elements of their practice that now seem self-evident, and people can’t believe they used to run their department without certain processes, however these would not have ever been thought of or implemented had it not been for the TeamSTEPPS program.

It’s not all roses however, and there are some major difficulties with TeamSTEPPS.  Because it is an organisational change program, you need buy-in from all stakeholders, from the hospital executive/management down, to fully support its implementation.  This alone can be difficult, and like all things that involve groups of people in public hospitals (dare I use the word “committees”?) it can take a long time.  You also need some “medical enthusiasts”, as they will be able to communicate the benefits to other doctors, as doctors are the hardest to convince of the need for change.

I think TeamSTEPPS is a great concept, and obviously goes to the core of a lot of the issues that stop us being able to perform resuscitation well.  The unique, site and department specific needs assessment is fundamental to addressing the local problems for that institution.  The focus on processes as well as behaviour is also positive, as  it means the new systems and ways of doing things will be cemented in place, and become “the norm” much quicker than by just targeting behaviour .  I particularly liked Dave’s comment that once the executive came to a couple of their morning briefings, it became a regular occurrence, and enhanced relationships with hospital management was an unforeseen bonus, as I really think that the complete dissociation between the doctors on the floor and  hospital management – which is how most hospitals in Australia operate – is a huge problem when it comes to implementing change.

Unfortunately most of us will work at hospitals where it’s hard enough to get a new type of bandage stocked in a dressing trolley, let alone get major process and behaviour change happening, but I think TeamSTEPPS has major potential for benefit if your organisation is willing to commit to it.

Do you have any experience with TeamSTEPPS?  Has it been tried at your hospital/ED?  What do you think of the concept?






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