Implementation Planning
Indiana MT Objectives Identify the challenges facing your organization Will TeamSTEPPS help make this better? Identify implementation plan and site Identify the team involved in change Define challenge the TeamSTEPPS implementation will address Mod 3 06.1 Page 2 T EAM STEPPS 05.2
Indiana MT Shift Towards a Culture of Safety Mod 3 06.1 Page 3 T EAM STEPPS 05.2
Indiana MT TeamSTEPPS Create a Change Team 1 Action Define the Problem/Challenge or Opportunity for Planning 2 Improvement At-A-Glance 3 Define the Aim(s) of your TeamSTEPPS Intervention Identify Priority Problem/ 4 Define the TeamSTEPPS Intervention Challenge or Opportunity from Step 2 Develop Plan for Testing the Effectiveness of Your 5 TeamSTEPPS Intervention 6 Develop Implementation Plan Develop a Plan for Sustained Continuous Improvement 7 8 Develop a Communication Plan Incorporate Feedback Putting it All Together: 9 from Key Writing the TeamSTEPPS Action Plan Personnel Review your TeamSTEPPS Action Plan 10 with Key Personnel Mod 3 06.1 Page 4 T EAM STEPPS 05.2
Indiana MT What is your aim? Mod 3 06.1 Page 5 T EAM STEPPS 05.2
Indiana MT Step 1: Define the Main Problems, Challenges and Opportunities Step 2: Define the Problem, Reasons for Change/Data/Key Factors Challenge, Opportunity Reasons for Change A. RCAs B. Near misses Main Problems, Challenges, Opportunities C. Adverse events D. Patient outcomes lots of physician changeover E. Complaints F. FMEAs G. Staff concerns opportunity-acceptance of docs Regulatory & Guidance lots of seasoned staff (but turnover coming!) A. JCAHO / AAAHC B. National PS Goals C. CMS & Other Quality Measures feel a bit isolated D. NQF Safe Practices E. DoD / Service-Specific Data, Key Factors More ED patients (new comm issues) A. Site Assessment “we have already this way” syndrome B. PS Culture Survey (AHRQ) C. Data & Measures D. S-W-O-T Analyses E. Productivity Gone from slow to fast F. Workload G. Seasonal staffing H. Changing * Leadership * Key personnel I. Experience levels J. Deployments K. Other factors…… . Mod 3 06.1 Page 6 T EAM STEPPS 05.2
Indiana MT Facilities where implementation will take place Today ’ s Date: ___________ Units/Service Lines Facility: ________________ _______________________ _______________________ _______________________ _______________________ _______________________ Mod 3 06.1 Page 7 T EAM STEPPS 05.2
Indiana MT Step 2: Guiding Coalition, Executive Sponsor and Change Team Executive Sponsor, Guiding Coalition Executive Sponsor(s): Choose the Executive Sponsor and Guiding Coalition Names:___________________ Dawn Scott Step 1: Create the Change Team Choose the members: (influence/willingness) Physician(s)_____________________ Nurse(s) _____________________ Change Team Members: Admin? ______________________ Technologist?____________________ Knowledge expert_________________ Kim Patient Safety, Risk Manager_________ Other key person(s) _______________ Encourage the physician and nurse champions Stephanie (RN manager) Creating an Effective Team Pt safety coaches Need 3 levels of expertise: A. System leadership Authority, Power Shelley Overcome barriers B. Technical expertise Clinical areas Wood and Lynch? Improvement Data C. Day-to-day leadership Dr. Williams Respected Understands processes (IHI Breakthrough Series Guide) Mod 3 06.1 Page 8 T EAM STEPPS 05.2
Indiana MT Step 3: Define Aim(s) Decide Change Type Exactly what you plan to Incremental change OR achieve with intervention Transformational change Step 3: Define Aims of TeamSTEPPS Intervention What will be achieved? (make this specific, measureable, realistic, time- bound) Who will be involved? When and where the change will occur? Aims should be time-specific and measurable! Mod 3 06.1 Page 9 T EAM STEPPS 05.2
Indiana MT Step 4: Design a TeamSTEPPS Intervention Type of Change Type of Change: Incremental Change: Targeted Intervention(s) PDSA-- continuous improvement model Targeted change based on defined need Fewer resources required Leadership support Unit(s) of focus. Clinical champions Measure Selects theme-based tools/strategies such as “team events” or “communication” Which TeamSTEPPS tools/strategies Mod 3 06.1 Page 10 T EAM STEPPS 05.2
Indiana MT Step 5: Measures (How will you know it worked?) Step-5: Decide Measures Existing Measures Meaningful measures to test the effectiveness of your intervention (see the recommendations) Examples • Observations • Counts (e.g. # “ Briefs ” ) New Measures • Staff Survey (pre- and post-) • Outcome measures: # times staff nurses use SBAR; rate of appropriate pre-op antibiotic usage; near-miss reports • Patient/Staff satisfaction Mod 3 06.1 Page 11 T EAM STEPPS 05.2
Indiana MT Steps 6 & 9 Action Plan Implementation: Action Plan Step 6: Develop Implementation Plan How will leadership support be Leadership support: executive and unit gained? Schedule training-education dates trainers, participants, logistics Consider marketing & communication Listen for input, adjust plan, customize Buy-in from key individuals Plan to engage the physicians, nurses Do baseline measures (survey, data, etc.) Create an implementation timeline Kotter’s Change Model 1. Create sense of urgency 2. Build the guiding team 3. Develop change vision 4. Understanding / Buy-in 5. Empower others 6. Create short-term wins 7. Don’t let up ; be relentless 8. Create a new culture A Culture of Safety Mod 3 06.1 Page 12 T EAM STEPPS 05.2
Indiana MT Steps 6 & 9 Action Plan Implementation: Action Plan, cont. Step 6: Develop Implementation Plan How will staff be engaged? Leadership support: executive and unit Schedule training-education dates trainers, participants, logistics Consider marketing & communication Listen for input, adjust plan, customize Buy-in from key individuals Plan to engage the physicians, nurses Do baseline measures (survey, data, etc.) Create an implementation timeline Kotter’s Change Model 1. Create sense of urgency 2. Build the guiding team 3. Develop change vision 4. Understanding / Buy-in 5. Empower others 6. Create short-term wins 7. Don’t let up ; be relentless 8. Create a new culture A Culture of Safety Mod 3 06.1 Page 13 T EAM STEPPS 05.2
Indiana MT Steps 6 & 9 Action Plan Implementation: Action Plan, cont. Focus on Training Issues Step 6: Develop Implementation Plan How and when will baseline data be collected? Leadership support: executive and unit Schedule training-education dates trainers, participants, logistics Consider marketing & communication Listen for input, adjust plan, customize Buy-in from key individuals Plan to engage the physicians, nurses Do baseline measures (survey, data, etc.) Create an implementation timeline Kotter’s Change Model 1. Create sense of urgency 2. Build the guiding team 3. Develop change vision 4. Understanding / Buy-in 5. Empower others 6. Create short-term wins 7. Don’t let up ; be relentless 8. Create a new culture A Culture of Safety Mod 3 06.1 Page 14 T EAM STEPPS 05.2
Indiana MT Step 7: Sustainment Plan How will the effort be sustained? Step 7: Sustainment Coaching at unit level Role modeling Monitor Report measures Continuous improvement Integrate into practices Rewards and incentives Develop spread initiatives Best practices Leadership emphasis Celebrate short-term wins Create new champions Be innovative Mod 3 06.1 Page 15 T EAM STEPPS 05.2
Indiana MT Step 8: Create Communication Plan Step 8: Communication Plan Persons and groups for support; front-line leaders, Answer: “What’s in it for me” for stakeholders Change team active in multi-channel communication Create a Communication How ill the initiative be Plan targeting major communicated? stakeholders Consider all groups, shifts, entities (e.g., night shift) Identify organizational and front-line leaders Communication plan for each group: who, what, when, how (e.g., dept. meetings, grand rounds, emails, newsletters, posters Activate change team members….state the vision Promote spread of TeamSTEPPS Mod 3 06.1 Page 16 T EAM STEPPS 05.2
Indiana MT Timeline and Milestones Phase I…………….Phase II……………..Phase III Assessment…….Planning, Training & Implementation…….Sustainment Specific milestones and dates: Specific milestones and dates: When? When? Decide Days, Weeks, Months…. Set the Stage……Decide what to do…..Make it Happen……….…Make it Stick Mod 3 06.1 Page 17 T EAM STEPPS 05.2
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