Using Team STEPPS® to Improve Teamwork and Collaboration in the Emergency Department

This session will address an education initiative to promote the adoption of Team STEPPS tools in our emergency department. The goal of this project was to create a healthy work environment that embraces Team STEPPS tools in day to day work flow. Our Emergency Department underwent an unprecedented turn-over in staff, including a new contracted team of Emergency providers, resulting in many changes in work flow, throughput and communication. The retirement of the longtime nurse manager also prompted changes in management structure, with additional senior nurse turnover. With the many changes, it was noted that collaboration and communication among staff was inconsistent, and some interventions to improve this were pursued. Our emergency department had training in Team STEPPS six years ago, with moderate degree of buy in at the time. Our clinical professional development team continued to embrace Team STEPPS concepts and weave these tools and verbiage into our simulations facility wide, including during our American Heart Association classes such as PALS, ACLS, and Neonatal resuscitation, which the ED team attend.

It was noted that a majority of the Emergency Department team had not been present during the initial Team STEPPS training, and that revitalizing this program might show improvement in teamwork skills. A plan was drafted, and presented to senior leadership, and then to the unit based council for input. We first surveyed the department using the Team STEPPS Teamwork Perception Questionnaire (T-TPQ) prior to Team STEPPS classes or introducing interventions and then again four months after the trainings. Using the results of the survey as a guide, we are implementing tools to improve identified areas of perceived inconsistencies. The Team was surveyed again approximately one year after initiation of this initiative.

The coordinating team worked to identify issues, why the tenants of Team STEPPS was felt to be a good fit to address some identified needs of this department, and the results of this intervention. We will address how the partnership between the Unit Based Council chair, the ED physician lead, and the professional development specialist were integral to the success of this project. This initiative did not immediately demonstrate objective improvements in teamwork. However, after building on the initial program, significant improvements were found both objectively and subjectively.