TeamSTEPPS for Office-Based Care Measurement Office-Based Care Objectives
TeamSTEPPS for Office-Based Care Measurement Office-Based Care Objectives Describe the importance of measurement Describe the Kirkpatrick model of training evaluation Identify measures that can be used to assess the impact of TeamSTEPPS for Office-Based Care Describe the AHRQ Medical Office Survey on Patient Safety Culture Prepare a plan for determining if TeamSTEPPS worked Mod Page1 205.2 Page 2 TEAMSTEPPS 05.2 Office-Based Care
TeamSTEPPS Phases Requires Measurement Mod Page1 305.2 Page 3 TEAMSTEPPS 05.2 Office-Based Care How To Measure - Kirkpatrick Level IV Results Level III Behavior Level II Learning Level I Reactions Mod Page1 405.2 Page 4 M
U L T I L E V E L A P P R O A C H TEAMSTEPPS 05.2 (Organizational results) (Transfer to the job) (Think, Do, Feel) (Like it and useful)
Office-Based Care Available Measures Reactions TeamSTEPPS for Office-Based Care Course Evaluation Form Learning TeamSTEPPS Teamwork Attitudes Questionnaire (TTAQ) for Office-Based Care TeamSTEPPS for Office-Based Care Knowledge Test Team Performance Observation Tool for OfficeBased Care TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care Mod Page1 505.2 Page 5 TEAMSTEPPS 05.2 Behavior Team Performance Observation Tool for OfficeBased Care
TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care AHRQ Medical Office Survey on Patient Safety Culture Results Patient outcome and clinical process measures AHRQ Medical Office Survey on Patient Safety Culture Consumer Assessment of Healthcare Providers and Systems for Patient-Centered Medical Homes Office-Based Care TeamSTEPPS for Office-Based Care Course Evaluation Form Level I - Reactions Includes evaluation questions for all components of the TeamSTEPPS for Office-Based Care course Customizable Provides information about what trainees thought
about the training Mod Page1 605.2 Page 6 TEAMSTEPPS 05.2 Office-Based Care TeamSTEPPS Teamwork Attitudes Questionnaire (T-TAQ) for Office-Based Care Level II - Learning 30-item self-report tool Respondents rate their agreement with items on a 5-point Likert scale Measures attitudes toward: Mod Page1 705.2 Page 7
Team Structure Leadership Situation Monitoring Mutual Support Communication TEAMSTEPPS 05.2 Office-Based Care TeamSTEPPS for Office-Based
Care Knowledge Test Level II - Learning Multiple-choice test Uses: To assess knowledge of teamwork To measure changes in knowledge Caution Mod Page1 805.2 Page 8 Items tend to be too easy TEAMSTEPPS 05.2 Office-Based Care Team Performance Observation Tool
for Office-Based Care Level II - Learning and Level III - Behavior Tool for observing team performance Site assessment Measure of training effectiveness Observers should practice using the tool Can be adapted to a particular practice type Mod Page1 905.2 Page 9 TEAMSTEPPS 05.2 Office-Based Care TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care Level II - Learning and Level III - Behavior
35-item self-report tool Respondents rate their agreement with items on a 5-point Likert scale Measures staff perceptions of: Mod Page1 10 05.2 Page 10 Team Structure Leadership Situation Monitoring Mutual Support
Communication TEAMSTEPPS 05.2 Office-Based Care Behavior Measure whether the information learned during training is transferred to the job Two important factors in transfer are: Whether there is an opportunity to use the new TeamSTEPPS tools or strategies on the job Whether use of the TeamSTEPPS tools and strategies is valued and reinforced Mod Page1 11 05.2 Page 11 TEAMSTEPPS 05.2
Office-Based Care Behavior: An Example As part of a pediatric practices efforts to improve teamwork, all nurses are trained on the use of SBAR for presenting patient information to physicians. However, while the physicians attended training, it is obvious that they did not buy in to SBAR. Shortly after implementing the SBAR strategy, a nurse calls the on-call physician with concerns about a patient who needs to be seen and may need to be admitted to the hospital. The nurse begins to present the patients situation and background, but before she can complete her SBAR report, the physician jumps in and says, Forget that SBAR stuff; just tell me what I need to know! Mod Page1 12 05.2 Page 12 TEAMSTEPPS 05.2 Office-Based Care
Behavior: Measures Team Performance Observation Tool for Office-Based Care Teamwork Perceptions Questionnaire (T-TPQ) for Office-Based Care AHRQ Medical Office Survey on Patient Safety Culture Mod Page1 13 05.2 Page 13 TEAMSTEPPS 05.2 Office-Based Care Results: Measures Patient outcome measures Examples: Complication rates, infection rates, measurable medication errors, patient experience measures
Clinical process measures Mod Page1 14 05.2 Page 14 Examples: Length of patient wait time, number of required patient appointments made and completed, percentage of lab results communicated to patients, staff perceptions of safety TEAMSTEPPS 05.2 Office-Based Care Medical Office Survey on Patient Safety Culture Designed specifically for outpatient medical office providers and staff Designed for medical offices with at least three providers Not recommended for use in solo practitioner or twoprovider offices, to protect confidentiality
Can be used to facilitate dialogue about patient safety and quality in small offices Online at http://www.ahrq.gov/professionals/ quality-patient-safety/patientsafetyculture/ medical-office/index.html Mod Page1 15 05.2 Page 15 TEAMSTEPPS 05.2 Office-Based Care Medical Office Survey on Patient Safety Culture Uses Raise awareness about patient safety issues Assess patient safety culture Track changes in patient safety culture over time Evaluate the impact of patient safety interventions (e.g., TeamSTEPPS) Mod Page1 16
05.2 Page 16 TEAMSTEPPS 05.2 Office-Based Care Survey Measures: 12 Dimensions and 2 Overall Items Survey Dimensions Communication about error Communication openness Information exchange with other settings Office processes and standardization Organizational learning Overall perceptions of patient safety and quality
Owner/managing partner/leadership support for patient safety Patient care tracking/followup Patient safety and quality issues Staff training Teamwork Work pressure and pace Overall Items Mod Page1 17 05.2 Page 17 How they would rate this medical office on five different areas of health care quality (i.e., patient centered, effective, timely, efficient, and
equitable) How they would rate this medical office on patient safety TEAMSTEPPS 05.2 Office-Based Care What Support Is Available? Survey Toolkit Survey forms Survey items and dimensions Survey Users Guide Comparative Database and Reports Data Entry and Analysis Tool E-mail questions to: [email protected] or [email protected] Mod Page1 18
05.2 Page 18 TEAMSTEPPS 05.2 Office-Based Care Evaluating TeamSTEPPS for Office-Based Care Exercise Break into small groups and identify: 1. One or two measures you can use to assess whether briefings transfer to the office setting 2. One or two measures to determine if briefings affect the offices patient safety outcomes Mod Page1 19 05.2 Page 19 TEAMSTEPPS 05.2
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