"TeamSTEPPS communication tools are a critical building block in the medical establishment by framing the cultural environment for medical staff and patients," explains MAJ Angelika Chiri, RN, CMSRN Nurse Staff Officer MEDCOM Primary Care Service Line. As the Army Medical Home moves toward a high reliability organization, these essential tools require leadership and staff members to incorporate the tools into the day-to-day work processes. The tools and skills taught in TeamSTEPPS embraces the "collaborative team" concept which enhances the delivery of care. Often the current staff communication process is assumed to be adequate or without issues. Yet in reality, the communication process encounters poor facilitation and does not fully convey the intended message to the receiver which is reflective in staff dissatisfaction and or our patient dissatisfaction.
Chiri goes on to explain that the initiation of TeamSTEPPS was directed through the MEDCOM Operations Order (OPORD) 11-38 (AMEDD-Wide Implementation of TeamSTEPPS) in May 2011 as a means to enhance team work, thereby, promoting patient safety. This MEDCOM patient safety initiative was set to deliver safer patient care to the beneficiaries and enhance the communication skills amongst medical workers. Areas that focus on enhancement of team performance include the following: understanding team structure, communication tools, leadership, situation monitoring, mutual support, and a guide to evaluate common barriers, tools and strategies from TeamSTEPPS and how to achieve positive outcomes. The interaction between the outcomes and skills is the basis of a team striving to deliver safe quality care and supports the quality improvement process.
The initial training and utilization of TeamSTEPPS is a requirement for all staff members working in or for the Military Treatment Facilities conveying leadership's commitment and support of effective communication and patient safety. On-going sustainment is crucial for the success of TeamSTEPPS program at any facility. It is the responsibility of each section or department to embrace the oversight of the sustainment process for their area. Each section or department should focus on highlighting topics that may require re-evaluation for their specific needs and coordinate these efforts with a TeamSTEPPS Champion or Instructor.
"It is a fact that communication is a two-way process and on-going; therefore, it requires participation from all staff to maintain an open and unbiased culture. The process begins with leadership through empowerment and conveying a transparent vision/mission on how essential each team member is." Chiri shared. All staff members contribute to the success of our medical system's delivery of high quality medical care to not only our beneficiaries but also our co-workers. The same focus is required for the inter-personal communication skills which influences the day-to-day productivity in a work environment. In an essence, the inter-personal communication from staff members facilitates effective and safe patient care. Empowerment equates to the success in this area and is reflected in a high performing team that promotes cohesiveness and synergy, leading to increase in satisfaction from staff and patients alike.
Chiri also clarified that with the current economic state; life stressor's are not limited to an individual's personal life but often crosses over into the work environment. Since there is a human aspect to this, having an awareness of one's current work climate requires engagement from not only leadership but also from all staff members in order for the work environment to sustain a state of wellbeing.
TeamSTEPPS provides tools that enable a staff member to effectively communicate with others as well as enhances the work environment which also transfers to one's personal life. One of the main tools that assist in personal conflicts is the DESC Script. DESC script facilitates a constructive approach that manages and resolves conflicts between individuals. Conflict is one of the greatest challenges that all individuals face and often is not dealt with effectively. Conflict is a friction that creates a difficult environment between all parties involved. If conflict is not addressed promptly nor in a productive manner then the situation will turn in a negative direction and may ultimately create a hostile working environment.
DESC Script can be used as a communication tool to help solve interpersonal conflicts which often create a hostile and or a harassing environment or behaviors. It also is beneficial for informational conflict that develops among professionals that have different information on a subject or understanding from a related communication.
DESC Script is:
D = Describe the specific situation or behavior; provide concrete data.
E = Express how the situation makes you feel/what your concerns are.
S = Suggest other alternatives and seek agreement.
C = Consequences should be stated in terms of impact on established team goals; strive for consensus.
As with all communication the effectiveness is directly related to time, timely discussion. How an individual frames a situation will direct the flow and openness of all involved to resolve the conflict. Conflict results from a misunderstanding or miscommunication therefore articulating ones message in such a way that others who receive the message have a clear and concise understanding is essential.
TeamSTEPPS is a leader's resource guide in managing their team communication and evaluating current team work. As commanders or leaders assume command of a new unit or department one tool, TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ), provides a view of the current team work environment. The tool functions a climate or culture evaluation for the commander or leader depicting their team's current view on the team work culture. The information provides insight to areas of opportunities to improvement the end state focus of patient safety as well as the delivery of high quality health care. The questionnaire supports MEDCOM and Defense Health Agency's initiatives as military medicine transitions to a System for Health.
Medicine is a continuum of evolution striving for excellence. In 2016, TeamSTEPPS forged forward to highlight the ambulatory setting, offering a new course focused on office- based care. The course supports the ambulatory setting environment and utilizes evidence-based practice. The framework of techniques and strategies specific for the ambulatory setting provides leadership as well as team member's avenues to achieve the best outcomes for patients.
"We all are an intricate part of this endeavor, where even the smallest opportunity to excel facilitates a forward movement; thereby, shaping the future footprint of our healthcare system. Army Medical Home is one of the main entry points into our military healthcare system our beneficiaries' access which empowers us to promote innovation as we shape the future of military medicine," conveyed Chiri.
Related Links:
TeamSTEPPS Teamwork Peceptions Questionnaire (T-TPQ)
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