leading teams in healthcare

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Leading Teams For Health-Care Providers

Eng. Abdel-Halim MahmoudTeamSTEPPS 2.0 Certified Master TrainerPerformance Excellence Coach Examiner @ the Baldrige Performance Excellence Award, MN, USACEO, Egypt Excellence CenterThe 4th Module of TeamSTEPPS Fundamental Course

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams1

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2 ObjectivesDescribe how leadership affects team processes and outcomes Identify different types of team leaders Describe the activities involved in successfully leading teamsDescribe the tools for leading teams, including briefs, huddles, and debriefsApply the tools for leading teams to specific clinical scenarios

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams

3 TeamStepps Fundamental CouseModule 1 Introduction Module 2 Team Structure Module 3 Communication Module 4 Leading Teams Module 5 Situation Monitoring Module 6 Mutual Support Module 7 Summary

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 4 Material You will Use

http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/index.html

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 5 Team Strategies & Tools to Enhance Teamwork Performance & Patient SafetyBased on more than 30 years of research and evidenceTeam training programs have been shown to improve attitudes, increase knowledge, and improve behavioral skillsSalas, et al. (2008) meta-analysis provided evidence that team training had a moderate, positive effect on team outcomes ( = .38)

What is


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6 Outcomes of Team CompetenciesKnowledgeShared Mental Model

AttitudesMutual TrustTeam Orientation

PerformanceAdaptabilityAccuracyProductivityEfficiencySafety


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7 Leadership ExerciseWhat characteristics, attitudes, or skills made the leaders that you have known effective and successful? If there was room for improvement, what could they have done to be more effective? Do you feel that leadership can be learned or taught, or is it an innate skill? What one characteristic is most important to the success of effective leaders?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 8

LeadershipHolds a teamwork system togetherEnsures a plan is conveyed, reviewed, and updatedFacilitated through communication, continuous monitoring of the situation, and fostering of an environment of mutual support


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Types of Team LeadersDesignated The person assigned to lead and organize a team, establish clear goals, and facilitate open communication and teamwork among team membersSituational Any team member who has the skills to manage the situation at hand


Types of Team LeadersThinking in your work unitWho are the designated team leaders on your unit? Is the role of the designated team leader acknowledged and understood by team members? Can you describe a case in which someone assumed the role of the situational team leader? Can the roles of the designated leader and situational leader be better defined on your unit?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 11 Define, assign, share, monitor, and modify a plan Review the teams performanceEstablish rules of engagement Manage and allocate resources effectively Provide feedback regarding assigned responsibilities and progress toward the goalFacilitate information sharing Encourage team members to assist one anotherFacilitate conflict resolutionModel effective teamwork

Effective Team Leaders

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 12 Defining the PlanWhen developing a plan, team leaders should consider:Time How much time is available to complete all the necessary tasks and activities?People Do the available staff have the necessary knowledge and skills to perform their roles?Equipment Is the necessary equipment available and working?Information Has all of the necessary information been collected and reviewed?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 13 Defining the Plan in your work unitHow do your team leaders communicate a plan of care to the care team? Which strategies have been effective and which have not been effective? How do your team leaders communicate changes to the plan of care to the care team?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading TeamsCase Study DiscussionAfter attending TeamSTEPPS Master Training, a physician and nurse leader in a Level I Trauma Center decide that trauma resuscitations could be more effectively conducted. Currently, when a trauma alert is called to indicate the pending arrival of a severely injured patient, more staff show up to the trauma bay than needed, necessary equipment is sometimes missing or not functioning properly, and the lead trauma physician often shows up just as EMS is bringing the patient into the trauma bay. The newly trained Master Trainers observe that these practices have led to confusion and chaos that put patients at risk and result in valuable time being lost. What changes would you recommend to improve performance in the trauma bay?

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TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 15 Determine the tasks and roles to be assignedDetermine which roles must be filled and allocate tasks appropriatelyCommunicate clear expectations of what team members need to doRequest feedback

Assigning Tasks and Responsibilities


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16 How do team leaders assign tasks in your units, once a plan has been established? What approaches to assigning tasks and responsibilities are effective and what has not been effective? Assigning Tasks and ResponsibilitiesIn your work unit


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17 Sharing the Plan:BriefsA team briefing is an effective strategy for sharing the plan Briefs should help:Form the teamDesignate team roles and responsibilitiesEstablish climate and goalsEngage team in short- and long-term planning

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 18 Discussing the Video

Who is the designated team leader? Did the team develop a comprehensive plan for Mrs. Keys? Did the team address contingencies and was the patient included in those discussions?


TOPIC Who is on core team?All members understandand agree upon goals?Roles and responsibilitiesunderstood?Plan of care?Staff availability?Workload?Available resources?

Briefing Checklist Tool


Briefing Checklist DiscussionHave you participated in a brief? Did the items on this checklist occur? If not, what was not done? If you were designing a briefing checklist for your unit, what items would you include?When would the briefing occur? Who would be expected to attend?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 21 Break into small groups with others from your unit, work area, or organization.Identify when, why, and where briefings might be conducted. Note who should lead the brief and who should participate.Develop a checklist for guiding the brief.Discuss what outcomes you expect to see as a result of implementing briefs.At the end of the exercise, present and discuss your plans with the group.Briefing & ChecklistExercise in your work unit

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 22 Monitoring & Modifying the Plan: HuddleProblem SolvingHold ad hoc, touch base meetings to regain situation awarenessDiscuss critical issues and emerging eventsAnticipate outcomes and likely contingenciesAssign resourcesExpress concerns

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 23 Huddle Video Discussion

What event necessitated the need for the huddle?

What key information was shared in the huddle?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 24 Reviewing the Teams Performance: DebriefProcess ImprovementBrief, informal information exchange and feedback sessions Occur after an event or shiftDesigned to improve teamwork skillsDesigned to improve outcomesAn accurate recounting of key eventsAnalysis of why the event occurredDiscussion of lessons learned and reinforcement of successes Revised plan to incorporate lessons learned

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 25 TOPIC Communication clear?Roles and responsibilities understood?Situation awarenessmaintained?Workload distribution?Did we ask for or offerassistance?Were errors made or avoided?What went well, what should change, what can improve?

Debrief Checklist


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Debrief Video


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Debrief Video Discussion

What were some of the positive effects from this debrief?

Describe the tone Dr. Upton set for the debrief.


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28 Facilitating Conflict ResolutionEffective leaders:Facilitate conflict resolution to avoid compromising patient safety and quality of careDo not allow interpersonal or irrelevant issues to negatively affect the teamHelp team members master conflict resolution techniques DOD Professional Conduct Toolkit:http://www.health.mil/dodpatientsafety/ProductsandServices/Toolk its.aspx

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 29 Effective leaders cultivate desired team behaviors and skills through:Open sharing of informationRole modeling and effective cueing of team members to use prescribed teamwork behaviors and skillsConstructive and timely feedbackFacilitation of briefs, huddles, debriefs, and conflict resolutionMitigation of conflict within the teamPromoting & Modeling Teamwork

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 30 Team Formation Video

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 31 Video Discussion

What leadership tools and strategies did Dr. Dean use?

How did the nurses demonstrate leadership?

What leadership tools and strategies did Dr. Upton use?

TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 32 Tools & Strategies SummaryTOOLS and STRATEGIESCommunicationSBARCall-OutCheck-BackHandoffLeading TeamsBriefHuddle DebriefOUTCOMESShared Mental ModelAdaptabilityTeam OrientationMutual TrustTeam PerformancePatient Safety!!

BARRIERSInconsistency in Team MembershipLack of TimeLack of Information SharingHierarchyDefensivenessConventional ThinkingComplacencyVarying Communication StylesConflictLack of Coordination and Followup With CoworkersDistractionsFatigueWorkloadMisinterpretation of CuesLack of Role Clarity


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33 Applying TeamSTEPPS ExerciseDoes the team experiencing the issue in your organization have a designated leader? Who is it?Is your teamwork issue related to the teams leadership?If yes, what is the leadership issue?Which of the tools and/or strategies for leading teams might you consider implementing to address the issue?


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34 Applying TeamSTEPPS ExerciseDoes the team experiencing the issue in your organization have a designated leader? Who is it?Is your teamwork issue related to the teams leadership?If yes, what is the leadership issue?Which of the tools and/or strategies for leading teams might you consider implementing to address the issue?


TEAMSTEPPS 05.2Mod 4 2.0 Page #Leading Teams 36 THANK YOUEngineer Abdel- Halim MahmoudPerformance Excellence Coach; Organizations, Projects & TeamsMember, Board of Evaluators 2015, Baldrige-Based Performance Excellence Award. Performance Excellence Network, MN, USACEO, Egypt Excellence Center, Cairo, Egypt

www.EgyptExcellence.com [email protected]: +20.102.5151290


leading teams in healthcare

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