Evaluation of TeamSTEPPS® Within a Cardiac Procedural Unit to Improve Teamwork and Patient Safety

BACKGROUND: Communication and teamwork between members of the non-provider patient care team in the cardiac procedural unit were observed to be unbalanced and at times ineffective. Team members additionally expressed concerns regarding efficiency and accuracy in patient hand-off, specifically between units. Staff role satisfaction was deteriorating. The goal of this study was to improve teamwork and communication among the staff of the cardiac catheterization and electrophysiology lab. Participation in this initial, single-unit phase would include the non-physician staff of that unit. METHODS: Bandura’s Social Cognitive Theory was the theoretical framework utilized for this project. Theory selection was based on desire to evaluate the progression of staff as a unit rather than individuals which was proving ineffective in the past. Leadership assessment of service line communication noted deficits in teamwork and communication skills particularly with patient hand-off most specifically between units. Leadership and departmental educational representatives conferred and based on experience recommended a trial of TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety) program initiation. A literature review was performed to evaluate program applications and available assessment tools. Multiple applications of TeamSTEPPS® are noted but none within a dynamic procedural unit caring for a diverse ambulatory, acute, critical and emergent patients. INTERVENTION: Staff was surveyed via the TeamSTEPPS® Teamwork Perceptions Questionnaire (T-TPQ) immediately before and post three hours of TeamSTEPPS® Essential course education. They were additionally surveyed at four- and eight- weeks post education. Documentation of their teamwork perceptions was recorded, and their behavior observed over the eight-week project time frame. RESULTS: Analysis by way of repeated measures ANOVA compared mean scores of individuals over time and was performed by matched pairings based on demographics. TeamSTEPPS® education resulted in statistically and clinically significant increases in teamwork perceptions from pre- to post-education and post-education to eight weeks assessments reflective of change and sustainability. CONCLUSIONS: TeamSTEPPS® education is effective in improving teamwork and communication perceptions immediately and at eight weeks in a dynamic cardiac procedural unit. Keywords: TeamSTEPPS, teamwork, communication, patient safety, T-TPQ, perceptions