Use TeamSTEPPS to Communicate Effectively Attend ASCA 2018 to find out more BY WILLIAM BERRY, MD

Team Strategies and Tools to Enhance Performance and Patient Safety (Team- STEPPS) is an evidence- based set of teamwork tools

aimed at optimizing patient outcomes by improving communication and teamwork skills among health care professionals. The Agency for Health- care Research and Quality (AHRQ) of the US Department of Health & Human Services (HHS) developed TeamSTEPPS. During my presenta- tion at ASCA 2018, April 11–14, in Boston, Massachusetts, I will discuss how ASCs can use TeamSTEPPS to improve their performance.

I am a former cardiothoracic sur- geon who believes deeply that effective teamwork in the operating room (OR) is critical to great patient outcomes. I was on the team that helped build the World Health Organization’s (WHO) Surgical Safety checklist in 2007 and have been an enthusiastic advocate of the checklist ever since.

In the years after the checklist was released, it began to spread widely in the ORs of hospitals around the world. Several years ago, the use of the check- list was incorporated into the regula- tions governing certification of ASCs released by the Centers for Medicare & Medicaid Services (CMS). At about that time, AHRQ began to shift its atten- tion from the inpatient hospital setting to ambulatory care, including ASCs. AHRQ sponsored a large multi- year project aimed at improving the safety and quality of care in the ASC setting using the surgical safety checklist and improved teamwork and communication through the TeamSTEPPS program. ASCA was one of the stakeholders of the proj- ect along with the American Hospital Association’s research and education arm the Health Research and Edu-


TeamSTEPPS aims to improve team performance with tools, such as check lists, to help people speak up.”

—William Berry, MD, Ariadne Labs

cational Trust (HRET). About 600 ASCs were involved in the project, which wrapped up about a year ago. A major part of the project involved taking

the TeamSTEPPS program

from the hospital setting and translat- ing it to the ASC setting. We worked together and came up with a program that ASCs could take and use with all their staff and, particularly, staff who worked in the OR. TeamSTEPPS aims to improve team performance with tools, such as check- lists, to help people speak up. Twenty percent of the people in the AHRQ proj- ect said they were so afraid of being yelled at if they spoke up that they


wouldn’t speak up even if there was a patient safety issue. In one case, the staff knew that an ophthalmologist was about to put in wrong lenses but did not point it out because the surgeon was unap- proachable. In other cases, a surgeon might not have shared with his team spe- cifics about a patient’s medical issues or what the team needed to have ready for the surgeon to use during the procedure. The lack of good communication made a big disconnect between what the sur- geon thought the team would have ready and what his team members thought they needed to get ready. This is not the saf- est or most efficient way to do surgery. Surgeons need to share necessary infor-

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