Northern Illinois University (NIU), School of Nursing (SON) has the ability to impact patient safety by integrating teamwork and communication into the curriculum as well as by faculty role modeling the behaviors. The first step is to develop skills in the faculty related to creating high functioning teams, interprofessional collaboration and innovation. Faculty, students, administrators, department leaders and frontline providers increasingly manage and work not only in teams, but as part of teams-of-teams, or multi-team systems. Weaver et al (2010) looked at the “team” involved in team training and found that most team training was focused on the core clinical team with less than 40% of team training involving individuals responsible for establishing and communicating vision, developing expectations related to teamwork and redesigning processes.
As the NIU SON undergoes a transition from seasoned faculty to younger faculty, it became evident to the interim chair that the nursing faculty/staff could benefit from team training as a precursor to strategic planning and other curricular changes. Coincidentally, this came at a time when a person with experience in team training and development, at the hospital and national level, joined the faculty. Capitalizing on this unique situation, we saw the opportunity to take a well-known team training program, adapt it for the academic population and evaluate its effectiveness as this has been identified as a gap in the healthcare team training literature.
As the initiative unfolded, some faculty were resistant as they were concerned with too much work on part of the new faculty member. To mitigate the concerns, a team was convened to develop and lead the initiative with representation from the faculty (DNP and PhD), leadership and staff of the SON. Initially, we saw this as a faculty development opportunity but quickly realized that this was an opportunity to adapt an evidence-based team training program beyond the clinical setting to those who prepare clinicians.
Developed by the Department of Defense and the Agency for Healthcare Research and Quality (AHRQ), Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidenced based teamwork system that improves communication and teamwork skills among healthcare professionals (AHRQ, 2017a). It is grounded in more than 20 years of research and has been applied across the spectrum of healthcare. The key competencies include optimizing the use of information, people, and resources to achieve the best outcomes, increasing team awareness, clarifying team roles and responsibilities, resolving conflicts, improving information sharing and eliminating barriers (AHRQ, 2017a).
Since the inception, TeamSTEPPS has been implemented across many disciplines and has been found to improve teamwork, communication and collaboration through the use of the TeamSTEPPS training and the tools such as SBAR, briefings, checklists and huddles. This allows for a common language among healthcare providers and across practice settings (Gillespie, B., Chaboyer & Murray, 2010). There is limited literature related to TeamSTEPPS training for nursing faculty so embarking on this may provide insight and further facilitate that “common language” among those who prepare future nurses.
This translational research project began in October 2017 and will continue through May 2018. It is structured using the quality improvement framework, Plan, Do, Study, Act (PDSA). Phase 1 – PLAN (Oct 2017-Jan 2018)
In the planning phase, the committee administered and analyzed the perceptions of the SON faculty/staff related to teamwork using the TeamSTEPPS Team Perceptions Questionnaire (T-TPQ) (AHRQ, 2017b), assessed the strengths of the individuals using the Clifton Strengths Finders assessment (Rath, 2007), reviewed related literature, determined measurement criteria, designed the educational program and defined the coaching role.
Phase 2 - DO (Jan - April 2018)
As part of the ‘Do’ phase, all NIU SON faculty and staff will attend a 6-hour training session on the topic areas of team structure, leading teams, communication, situation monitoring, and mutual support. Additionally, a debrief on the how to maximize individual strengths will be shared with the participants. After the training each attendee will be required to operationalize a concept through a “small test of change” and will be supported by a faculty coach during that process. The T-TPQ will be administered again in February and April 2018.
Phase 3 – STUDY (Apr – May 2018)
In the “study” phase, the results of the “small test of change” as well as the T-TPQ and course evaluation will be reviewed to determine if performance improved and to evaluate lessons learned during the “small test of change”.
Phase 4 – ACT (Aug 2018-ongoing)
During this phase, decisions will be made as to what actions should be taken based on results. These actions may include planning for the next PDSA cycle, developing a strategy for monitoring the improved processes at predefined intervals to ensure they are sustained and/or measuring for sustainment of project gains on an ongoing basis.
Outcome
The outcomes that we hope to achieve are a more cohesive faculty, improved perception of teamwork, retention of staff and practice changes that will improve processes and/or efficiency.
Conclusion
Over the last several years, many studies have been conducted on the relationship of teamwork to performance and there is evidence to show that there is positive correlation between the two variables (Schmutz & Manser, 2013). Salas et al (2008) suggest that team training interventions enhance a variety of team outcomes including cognitive outcomes, affective outcomes, teamwork processes, and performance outcomes. The result is individuals who are prepared to deal with the complexities of academia, healthcare and interprofessional dynamics.
Key Tips
- Team training has been shown to improve communication, employee satisfaction and reduce turnover
- Maximizing individual strengths can create a more productive team
- Since there is limited literature related to team training for nursing faculty, this initiative may provide insight and further facilitate a “common language” among those who prepare future nurses
Agency for Healthcare Research and Quality. (2017a). About TeamSTEPPS®. Retrieved from http://www.ahrq.gov/teamstepps/about-teamstepps/index.html
Agency for Healthcare Research and Quality. (2017b). Teamwork Perceptions Questionnaire (T-TPQ). Retrieved from: http://www.ahrq.gov/teamstepps/instructor/reference/teampercept.html
Gillespie, B., Chaboyer, M. & Murray, P. (2010). Enhancing communication in surgery through team training interventions: a systematic literature review. AORN Journal, 92(6), p. 642-657.
Rath, T. (2007). Strengths finder 2.0. New York: Gallup Press.
Salas, E., DiazGranados, D., Klein, C., Burke, C.S., Stagl, K.C., Goodwin, G.F & Halpin, S. (2008). Does team training improve team performance? A meta-analysis. Human Factors, 50(6). p. 903-933.
Schmutz, J., & Manser, T. (2013). Do team processes really have an effect on clinical performance? A systematic literature review. British Journal of Anaesthesia, 110(4), p. 529-544.
Weaver, S., Dy, S., & Rosen, M. (2014). Team-training in healthcare: a narrative synthesis of the literature. BMJ Quality & Safety, 23(5), p. 359-372.