Sixteen members of Kimbrough Ambulatory Center's surgical team underwent three days of extensive training in patient safety from May 1 to 3.
The medical personnel were trained in Team Strategies and Tools to Enhance Performance and Patient Safety, an evidence-based teamwork system designed for health care professionals to enhance communication and teamwork skills.
The program was developed by the DoD's Patient Safety Program in collaboration with the Agency for Healthcare Research and Quality, according to the TeamSTEPPS website.
Kimbrough, which was accredited by the Joint Commission in April, volunteered to undergo the training and was selected as one of the first Army medical facilities in the U.S. Army Northern Regional Medical Command to do so.
Phyllis Toor, the TeamSTEPPS program manager and a nurse consultant with MEDCOM, said Kimbrough was selected because of the medical facility's exemplary patient safety program.
Toor, along with three TeamSTEPP master trainers from Fort Sill, Okla., led the three-day training that emphasized techniques to enhance patient safety in the operating room.
The goal of TeamSTEPPS is to develop "team strategies and tools to enhance performance and patient safety and develop high-performing Army medical facilities," Toor said.
Navy Cmdr. Dr. George Nanos, chief of surgery and a hand surgeon, and Lt. Col. Rebecca Preza, chief of perioperative services, as well as nurses, anesthesiologists and operating room technicians received the training. The staff members are now certified master trainers for TeamSTEPPS and can teach colleagues the principles of the program.
Loma Lohn, MEDDAC patient safety manager and a master TeamSTEPPS trainer, has trained about 90 percent of Kimbrough's staff in the TS curriculum.
Lohn said Kimbrough volunteered for the Surgical Services Simulation Training partly because the facility's operating room staff required training in order to implement the TS specialized electronic debriefing tool, which is new to their area of expertise. This tool was developed in order for staff to quickly identify issues that need attention as well as identifying trends over time. The tool is just one aspect of TS that facilitates communication across the team by allowing each team member to provide input.
The TeamSTEPPS curriculum is made up of four teachable skills: leadership, situation monitoring, mutual support and communication.
According to the program's website, TeamSTEPPS aims to produce effective medical teams by teaching health care professionals how to use information, people and resources to achieve the best clinical outcomes for patients; how to increase team awareness and clarify team roles and responsibilities; how to resolve conflicts and improve information sharing; and how to eliminate barriers to quality and safety.
The curriculum is made of modules that are taught through lectures and workplace scenarios that enable medical personnel to practice skills they have learned in the classroom.
On the third day of training, the newly trained team members coach other colleagues in real-life situations at the medical facility.
For example, one leadership module teaches the leaders of a medical team to conduct a briefing with the staff at the beginning of the workday to discuss the team's formation, assign essential roles, establish expectations and anticipate outcomes.
If there are problems, the team conducts a huddle to assess the situation, reinforce plans that are in place or assess the need to adjust plans.
At the end of the day, a debriefing is held to exchange information on how to improve the team's effectiveness and performance for the next day.
To enhance situation monitoring, team members learn to assess and monitor the actions of their colleagues to provide a safety net within the team. This enables them to ensure that mistakes or oversights are quickly caught.
Team members also learn to watch each other's back. An example would be to ensure all staff members receive a break when necessary in an effort to take care of team members as well as the patient.
Team members also are encouraged to advocate for the patient by speaking up when senior staff members make a mistake or need to consider additional information about a patient.
Col. Danny B.N. Jaghab, commander, U.S. Army Medical Department, Fort Meade, and with Kimbrough, observed the second day of training when the medical teams were acting out scenarios in the operating room.
"I wanted to see how receptive the staff would be to the training," he said, "and I was most pleased to see their total engagement and responsiveness to the processes."
Jaghad said that overall, the three-day training was "very practical and valuable with a primary focus on better communication for optimal patient safety."
Nanos said the training was excellent.
"It brought the team concept to the forefront to deliver good quality and safe patient care," he said. "We also learned to monitor and improve what we're doing. We are even more prepared for everyone's surgery."
Preza said the team gained better communication skills and how to interact more efficiently as a collective.
"As we were working the scenarios, we were identifying areas to make changes and improvements," she said. "It was almost an immediate use of tools and assessments. We took ownership of the process."
The next step, said Toor, is for the surgical team to create an implementation and sustainability plan for TeamSTEPP, which will outline how the training will be utilized over the next six months to a year.
The plan will be presented to Jaghab for his review and approval.
"I would like to see [TeamSTEPPS] implemented throughout our other medical treatment facilities within the MEDDAC with team champions who meet regularly to discuss the progress of the implementation," Jaghab said. "I would also like patients through our Patient Family Advisory Committee to engage in the process to improve communication between providers and patients."
The PFAC has already received training by Lohn, who is planning to develop a TS program for patients.
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