To change a hospital culture with teamwork training, create opportunities for team members to practice what they learned, and celebrate success as a way to promote progress, she added.
Barriers to good teamwork include inconsistency in team activity, lack of information sharing, hierarchy, defensiveness, varying communication styles, overwork, misinterpretation of cues, and confusion about one's role. The TeamSTEPPS strategies of better communication through briefs and huddles, as well as through feedback, patient advocacy, and mutual support, can combat these problems, Ms. King said, and result in mutual trust, improved performance, and patient safety.
Developing a team mentality is easier said than done. “We all train separately, and we come together and are expected to work together,” she acknowledged.
But physicians can learn the concept of better teamwork as a way to improve patient safety, said Dr. Alison Clay, who participates in TeamSTEPPS at Duke University in Durham, N.C.
TeamSTEPPS at Duke began in the pediatric ICU and it has spread to the operating room. “We are taking it to different parts of the hospital,” said Dr. Clay, an internist with appointments to the departments of surgery, and of internal medicine and pulmonary critical care at Duke. The program is likely to move next to the hospital wards and hospitalists and attending physicians, and then to clinics, she said.
The program starts with lectures and conversation and then proceeds to use of simulations and a debriefing to assess how the participants worked as a team.
Dr. Clay has participated in the TeamSTEPPS curriculum, and she has trained to coach others in teamwork building in her role as the capstone course director for fourth-year medical students.
Dr. Clay has a unique perspective on patient safety: She was a victim of a medical error at Duke when she arrived at the emergency department as a patient and went into respiratory arrest after being given a medication meant for the patient across the hall.
“That's why communication is important,” said Dr. Clay, who has shared her experience as a patient to emphasize the need for better patient safety measures.
“Concurrent with TeamSTEPPS, [there] are other efforts to teach safety involving all members of the team,” Dr. Clay noted. “People have to … be open to the concept [of] using better teamwork to solve the problem.”
For more information about TeamSTEPPS or to review and order materials, visit www.ahrq.gov/qual/teamstepps