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Evaluation of TeamSTEPPS Implementation for Community Hospital Patient Safety

TeamSTEPPS 社区医院患者安全实施评估

基本信息

批准号：
8712417
负责人：
MARCIA M WARD
金额：
$ 49.62万
依托单位：
UNIVERSITY OF IOWA
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-09-30 至 2016-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8712417
关键词：
Evaluation TeamSTEPPS Implementation Community Hospital

项目摘要

PROJECT SUMMARY The risk of patient harm is increasing as the healthcare system becomes more complex. Despite a decade of intense scrutiny and many attempts to impact these refractory challenges, there remains a need to refine and explore strategies to "hard-wire" a culture of patient safety among front-line healthcare workers. A recently disseminated strategy is Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPSTM). TeamSTEPPS was developed through a partnership of AHRQ and the Department of Defense to improve healthcare team performance through flexible training designed to enhance team knowledge, skills, and attitudes. TeamSTEPPS involves a comprehensive curriculum that spells out key actions for a culture change of teamwork including: team leadership, mutual performance monitoring, back-up behaviors, adaptability, team/collective orientation, shared mental models, mutual trust, and closed-loop communication. AHRQ is actively disseminating TeamSTEPPS through national training centers. Although firmly based in research findings on the operations and effectiveness of teamwork, many aspects of the TeamSTEPPS approach have not yet been evaluated. There remains a need to ground team performance within organizational science to facilitate the exploration and testing of relationships among the TeamSTEPPS elements and organizational performance. Thus, the purpose of this study is to examine the relationship between key TeamSTEPPS elements and outcomes through considering both retrospective and prospective implementations in hospitals chosen to represent a cross-section of complexity (Critical Access Hospital vs. nonCAH) and affiliation (independent vs. owned/managed by a system). Multi-method approaches will be used to monitor the TeamSTEPPS application to the Complex Adaptive Systems (CAS) of microsystems in a variety of hospital units. The specific aims are to: 1) Explicate organizational elements that have facilitated or precluded full integration of the TeamSTEPPS model in 10 hospital units that have previously adopted the model; 2) Prospectively examine the process and outcomes of implementing TeamSTEPPS in 12 hospitals chosen to represent a cross-section of complexity (Critical Access Hospital vs. nonCAH) and affiliation (independent vs. owned/managed by a system); 3) Test the relationship between TeamSTEPPS measures (patient safety culture, teamwork attitudes and performance, initiative fidelity, and observed knowledge-skills- attitude (KSA) behaviors) and outcomes over time; and 4) Identify the TeamSTEPPS strategies that are most successful in terms of positive outcomes and the characteristics of a high reliability organization and then determine the burden and cost of implementing these successful strategies.

项目摘要随着医疗保健系统变得越来越复杂，患者伤害的风险也在增加。尽管经历了十年的尽管进行了严格的审查和许多尝试来应对这些难以克服的挑战，但仍然需要改进和探讨策略，在前线医护人员中建立病人安全的文化。一个最近传播的战略是团队战略和工具，以提高绩效和患者安全（TeamSTEPPSTM）. TeamSTEPPS是通过AHRQ和教育部的伙伴关系开发的。通过灵活的培训来提高医疗团队的表现，知识、技能和态度。TeamSTEPPS涉及一个全面的课程，阐明了关键改变团队合作文化的行动，包括：团队领导、相互业绩监测、支持行为、适应性、团队/集体导向、共享心智模型、相互信任和闭环通信AHRQ正在通过国家培训中心积极传播TeamSTEPPS。虽然基于对团队合作的运作和有效性的研究结果， TeamSTEPPS方法尚未进行评价。仍然需要巩固团队绩效在组织科学中，以促进探索和测试TeamSTEPPS之间的关系要素和组织绩效。因此，本研究的目的是考察这种关系通过考虑回顾性和前瞻性，在关键TeamSTEPPS要素和结果之间进行平衡医院中的实施，选择代表复杂性的横截面（关键访问医院与非CAH）和从属关系（独立与由系统拥有/管理）。将采用多种方法监控TeamSTEPPS在各种微系统的复杂适应系统（CAS）中的应用医院单位。具体目标是：（1）阐明促进或排除了TeamSTEPPS模式在10个以前采用模型; 2）Professional检查TeamSTEPPS在12家医院的实施过程和结果选择代表复杂性的横截面（关键访问医院与非CAH）和从属关系（独立与由系统拥有/管理）; 3）测试TeamSTEPPS度量之间的关系（患者安全文化、团队合作态度和表现、主动忠诚度和观察到的知识-技能- 态度（KSA）行为）和随着时间的推移的结果;以及4）确定最重要的TeamSTEPPS策略在积极成果和高可靠性组织的特征方面取得成功，然后确定实施这些成功战略的负担和成本。