Team STEPPS vs. Civilian Best Practices, Article Review Example

TeamSTEPPS is a useful method to improve the communication skills of teams working in the health care industry. A formal evaluation of the program indicated that it allowed employees to become more productive during meetings, ultimately contributing to an increased sense of patient safety culture (Stead et al., 2009). Ultimately, it was concluded that TeamSTEPPs is advantageous compared to its civilian “best practices” counterparts because it is a defined framework that has demonstrated success in observational studies. Furthermore, while a majority of health care institutions are committed to implementing programs that enhance the ability of their staff to work as a team, the analysis of the success of these programs are often inadequate. There is an overwhelming quantity of research that confirms TeamSTEPPs is effective.

A recent study aimed to determine whether TeamSTEPPs is capable of promoting accountable care (Gittell et al., 2014). The research team hypothesized that this would be the case because it promotes a culture of teamwork at various levels and therefore solves as a reasonable method to employ to prevent conflicts. This project validated the use of TeamSTEPPs as an intervention to increase team efficacy across the board, which has a variety of practical implications including the ability to diagnose and pinpoint opportunities that will enhance shared knowledge and timely communication.

An additional factor that the Gittel et al. study promotes is that TeamSTEPPs is a defined method that therefore be applied in studies in a manner that is consistent throughout experimental examination. Its civilian “best practices” counterparts are less measurable in this sense due to a lack of regular and defined practice throughout the medical community. In this particular situation, the research team compares the efficacy of TeamSTEPP to measures of teamwork identified by professionals including Valentine, Nembhard, and Edmondson using psychometric criteria. Therefore, aside from being a useful method in itself, it is easy to improve upon this method in a manner that is productive for each individual health care institution.

Civilian “best practices” counterparts show less potential for being effective. These programs are regularly developed, but tend to be revised or altered over time. Furthermore, they are typically not adopted by a broad range of health care institutions. A recently published article entitled “The development of a rubric for peer assessment of individual teamwork skills in undergraduate midwifery students” introduces a new method that can be utilized by industry professionals in order to foster improved teamwork skills (Hastie et al., 2014). This method introduces the concept of TeamUP, which was designed to address the need to address the teamwork skills of students. However, this plan closely mirrors TeamSTEPPs without being as inclusive. Furthermore, there are few studies that demonstrate its long term success.

While the TeamUP technique was formed as a consequence of empirical evidence that demonstrated a need for the establishment of team building framework among midwifery students, the design of this technique appears to be rushed and not thoroughly researched (Parratt et al., 2014). The study that identified the need for the development of TeamUP found that team based assignments should have should have peer-marking, help clarify what is meant by teamwork, develop communication skills, and promote learning. A reasonable solution to these concerns would have been the implication of TeamSTEPP, which was already well established. Therefore a primary issue in the failure of civilian “best practices” counterparts is often inadequate research on the topic of teamwork and communication.

Although civilian “best practices” counterparts are inadequate compared to TeamSTEPPs, organized teamwork programs are more likely beneficial than none. For example, a recent article “The Nurses’ Form of Organizational Communication: What is the Role of Gossip” claims that when a structured communication system is not provided, conversation will occur between employees nonetheless, and it is possible that this communication will be counterproductive (Atluntas et al., 2014). The authors claim that it is necessary to control gossip in the workplace due to the detrimental impacts that it can have towards teamwork. It was found that a majority of nurses use gossip in order to discuss working conditions when they do not feel satisfied. A reasonable solution to this problem would be the implementation of TeamSTEPPs. Since the first step of the site assessment is establishing an organization-level change team, the afflicted health care institutions will have the potential to alter the negative organizational culture. This includes addressing gossip and collaborating to determine how the problems discussed can be resolved.

An additional issue that is frequently encountered in the health care practice is the failure of nurses and other members of staff to pass on important information at the end of their shifts. Since the field is of rushed nature, the health care staff tends to rush home after work without providing their replacements with adequate information concerning their cases. A major issue with this practice is that even when it’s accomplished, its done inconsistently so that some health care professionals enter their shift more aware of their cases than others (Lee et al., 2014). The second phase of TeamSTEPPs focuses on planning, training, and implementation. Therefore, it can be tailored to each individual organization to counter these communication problems. The training process will establish a standardize way to communicate this information that is deemed maximally effective by the organization.

Furthermore, gossip fostered by members of staff is capable of generating a generally negative attitude towards their place of work. As a consequence of this behavior, the staff becomes unmotivated to put effort into their work. In health care, this is particularly dangerous because the impact of word can directly impact the lives of many people. Therefore, a study was conducted to determine whether the TeamSTEPPs training initiative would result in “improved attitudes toward teamwork among nursing staff on an inpatient hospital unit” (Vertino, 2014). It was found that this program contributed to improved attitudes in teamwork in addition to five components of teamwork including team structure, leadership, situation monitoring, mutual support, and communication. This is an ideal manner to ensure that employees remain motivated and dedicated to their vocations.

As discussed above, team attitude is related to team performance. In addition to improving overall employee attitude, TeamSTEPPs has demonstrated the ability of trauma teams to perform well. Trauma teams must deal with fast paced decisions and work in order to succeed. Therefore, in order to increase this potential the TeamSTEPPs program can be used to improve communication between health care staff in a time dependent manner. For this purpose, the program has established simulation based training for professionals in high risk situations (Harvey et al., 2013). Studies that use this method as an intervention have demonstrated that the model contributed to the improvement of trauma team performance and patient outcomes.

Aside from studies conducted in order to validate the TeamSTEPPs method as a whole, there have been many studies that pertain to the analysis of individual components of the technique. This is advantageous compared to civilian “best practices” counterparts because even when communication techniques are analyzed, they are not done so in depth. In order to assess TeamSTEPPs’ efficacy of measurement and training, the program developers studied it in terms of the Medical Team Performance Assessment Tool (Lineberry et al., 2013). Furthermore, they have experimentally validated their Teamwork Perceptions Questionnaire (Castner, 2012). Both tools were shown to be consistent and reliable.

Since TeamSTEPPs, unlike a majority of civilian “best practices” counterparts can be tailored to a variety of situations, it has been largely successful in a variety of specialty care units. Although its use in trauma care has been discussed above, it also has documented benefit in improving teamwork efforts in neonatal resuscitation (Sawyer et al., 2013). A sample size of 42 health care professionals were delivered TeamSTEPPs training, which included a simulation with an event-based approach. Performance errors and successful completion of tasks were used to measure teamwork skills. It was found that application of this training technique helped improve team structure, leadership, situation monitoring, mutual support, and communication. Furthermore, less errors were observed and tasks were accomplished in a more efficient manner.

Just as the TeamUP method was established in order to compensate for the lack of training of medical students, TeamSTEPPs had already responded by establishing a surgical simulation curriculum for senior medical students (McCoy et al., 2012). This demonstrates that TeamSTEPPs can be modified not only to suit a variety of medical professions, but also to the training of students. It is essential to implement the program early so that medical students have the potential to develop teamwork and communication skills throughout their training. If teamwork problems can be addressed before they are significantly formed, then they could be effectively prevented.

A variety of articles that discuss the implementation of TeamSTEPPs focus on patient safety. This is a growing problem because health care professionals are frequently asked to work long shifts and therefore have diminished focus at different points of their work day. Therefore, their ability to communicate and think as sharply decreases as well. TeamSTEPPs is a reasonable method that can be used to reestablish patient safety because it makes tasks clear for the whole research team. A recent study has established that this method both helps reduce incidents and makes the health care staff believe that their performance has improved (Johnson et al., 2012). It is therefore important to continue to analyze the relevance of this technique to a variety of other research institutions, as TeamSTEPPs appears to increase patient safety across the board.

Although TeamSTEPPs was established in the United States and is currently supported by the U.S. Department of Health and Human Services, additional countries have taken interest in its benefits. Studies recently completed in Taiwan have helped confirm the efficacy of TeamSTEPPs because it has allowed the program to be applied to a more diverse patient and staff sample. Different countries have different standards of health, and the validation of this program abroad indicates that the teamwork and communication skills it teaches can potentially be universal. In this study, the TeamSTEPPS Teamwork Attitudes Questionnaire and Safety Attitudes Questionnaire was provided to 407 nurses and 76 physicians, who reported the need for improved communication and teamwork in order to improve hospital practices (Li, 2003). The survey results were consistent with similar studies conducted in the United States. Therefore, TeamSTEPPs is applicable not only across medical field, but across countries with differing standards of medical practice.

A final consideration of the value of TeamSTEPPs compared to other programs is the ability to continue to optimize it. Since TeamSTEPPs was created to adjust to a variety of different applications, it is necessary for health care institutions to continue to personalize it to suit their needs. In an academic medical center’s pediatric and surgical ICUs, TeamSTEPPs was modified to effectively train staff, generate clinical outcome objectives, and evaluate progress (Mayer et al., 2011). Since there is a need to generate quick progress in these units, a 2.5 hour version of the program was implemented to train employees and to teach objectives. It was found that TeamSTEPPs was able to reduce the duration of surgery by 33%, which allowed the medical center to deem the program as effective even when modified. Therefore, as long as the backbone of TeamSTEPPs is implemented into training programs, there is an increased likelihood for success. It is possible that implementing a longer version of the program would be even more successful, but each individual health care institution is capable of defining its own needs and utilizing the program as it sees fit. Ultimately, the program has shown to be successful independent of the form used.

References

Altunta? S, Altun OS, Akyil RC. (2014). The Nurses’ Form of Organizational Communication: What Is the Role of Gossip? Contemp Nurse, 3908-3922.

Castner J. (2012). Validity and reliability of the Brief TeamSTEPPS Teamwork Perceptions Questionnaire. J Nurs Meas., 20(3):186-98.

Gittell JH, Beswick J, Goldmann D, Wallack SS. (2014). Teamwork methods for accountable care: Relational coordination and TeamSTEPPS. Health Care Manage Rev. Retrieved   from http://www.ncbi.nlm.nih.gov/pubmed/24828004

Harvey EM, Wright A, Taylor D, Bath J, Collier B. (2013). TeamSTEPPS simulation-based training: an evidence-based strategy to improve trauma team performance. J Contin Educ  Nurs., 44(11):484-5.

Hastie C, Fahy K, Parratt J. (2014). The development of a rubric for peer assessment of individual teamwork skills in undergraduate midwifery students. Women Birth, pii:    S1871-5192(14)00056-0

Johnson HL, Kimsey D. (2012). Patient safety: break the silence. AORN J., 95(5):591-601.

Lee H, Cumin D, Devcich DA, Boyd M. (2014). Expressing concern and writing it down: an experimental study investigating transfer of information at nursing handover. J Adv Nurs., doi: 10.1111/jan.12484

Li AT. (2013). Teamwork climate and patient safety attitudes: associations among nurses and comparison with physicians in Taiwan. J Nurs Care Qual., 28(1):60-7.

Lineberry M, Bryan E, Brush T, Carolan TF, Holness D, Salas E, King H. (2013). Jt Comm J Qual Patient Saf., 39(2):89-95.

Mayer CM, Cluff L, Lin WT, Willis TS, Stafford RE, Williams C, Saunders R, Short KA, Lenfestey N, Kane HL, Amoozegar JB. (2011). Evaluating efforts to optimize     TeamSTEPPS implementation in surgical and pediatric intensive care units. Jt Comm J Qual Patient Saf., 37(8):365-74.

McCoy KL, Carty SE. (2012). There is no “i” in “team”: comment on “a surgical simulation curriculum for senior medical students based on TeamSTEPPS”. Arch Surg., 147(8):766-7.

Parratt JA, Fahy KM, Hastie CR. (2014). Midwifery students’ evaluation of team-based academic assignments involving peer-marking. Women Birth, 27(1):58-63.

Sawyer T, Laubach VA, Hudak J, Yamamura K, Pocrnich A. (2013). Improvements in teamwork during neonatal resuscitation after interprofessional TeamSTEPPS training. Neonatal       Netw., 32(1):26-33.

Stead K, Kumar S, Schultz TJ, Tiver S, Pirone CJ, Adams RJ, Wareham CA. (2009). Teams communicating through STEPPS. Med J Aust., 90(11 Suppl):S128-32.

Vertino KA. (2014). Evaluation of a TeamSTEPPS© initiative on staff attitudes toward teamwork. J Nurs Adm., 44(2):97-102.