Teamstepps

TeamSTEPPS Framework

• A framework that demonstrates the skills central to safe, effective, and patient-centered care.

TeamSTEPPS Skills

• Mutual Support is one of the four TeamSTEPPS skills that are key to safe, effective, and patient-centered care.

Mutual Support

• "Backup behavior" includes team members assisting each Other.
• Providing and receiving performance feedback.
• Assertive and advocacy behaviors are exerted when patient safety is threatened.
• Utilization of the two-challenge rule and CUS signal phrases is imporatnt when patient safety is threatened.
• Hospitals can adjust patient loads to support those needing more care.
• In an outpatient practice, one can volunteer to stay later to help a colleague caring for a sick child.
• Diagnostic accuracy entails cross-training staff and monitoring workload to mitigate overloads.
• Patient/family mutual support involves repeating expressions of concern to other team members regarding a patient's unusual behaviors.
• Virtual teams use cameras to interpret nonverbal cues and ensure team member engagement.
• Virtual assistance can support onsite staff with tasks like paperwork or diagnoses.
• Task Assistance
• Formative Feedback
• Advocacy and Assertion
• Two-Challenge Rule
• CUS

Task Assistance

• Helps build a strong, trusting team.
• Fosters psychological safety and protects against work overload.
• Offers and requests for assistance should be within the context of patient safety.
• Seeking and providing assistance to patients and their families and caregivers is important.
• Team resilience is strengthened by asking "I have 10 minutes. How can I help?"

Formative Feedback

• Shared to improve team performance, either intentionally or unintentionally.
• Showing gratitude for team members' positive actions is important.
• Feedback should be timely, given after the behavior occurs.
• It should be respectful, focusing on behaviors rather than personal attributes.
• Feedback should be specific to the task or behavior needing change, improvement, or support.
• Direct feedback toward improvement and deliver negative information with consideration and respect.
• The impact of team behaviors on the patient's well-being should be addressed.

Advocacy and Assertion

• Advocating for the patient is essential when team members' viewpoints differ from the decision-maker's, especially when patient safety is at risk.
• Assert a corrective action in a firm and respectful manner.
• Steps to assert a corrective action:
  • Open the conversation
  • State the concern
  • Describe the Problem
  • Offer a Solution
  • Set the next steps

Two-Challenge Rule

• Empowers team members to "stop the line" if they sense a safety breach.
• This action requires immediate cessation and resolution of the safety issue.
• If ignored, assertively restate the concern.
• The challenged team member must acknowledge understanding the concern.
• Rephrase the anticipated danger if the response fails to clarify and alleviate concern.
• If the safety issue persists, take stronger action, engage the other team members, and use supervisor or chain of command, if needed.

CUS

• An acronym for three assertive statements:
  • Concerned
  • Uncomfortable
  • Safety issue