improving patient safety through teamwork goodall hospital muskie school of public service improving...
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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
