for Office-Based Care Introduction Office-Based Care Collaboration of:

for Office-Based Care Introduction Office-Based Care  Collaboration of:

for Office-Based Care Introduction Office-Based Care Collaboration of: Agency for Healthcare Research and Quality (AHRQ) Department of Defense Team Strategies & Tools to Enhance Performance & Patient Safety Focuses on strengthening the specific knowledge, skills, and attitudes of teamwork Can be tailored to meet the needs of any team in any

setting Mod Page1 205.2 Page 2 Office-based care TeamSTEPPS tailors to the office-based setting TEAMSTEPPS 05.2 Office-Based Care More than 40 years of research and evidence from high-risk fields Provides specific tools and strategies for: Improving communication in teamwork Reducing chance of error

Enhancing patient safety Outcomes of a high-performing team are adaptability, accuracy, productivity, efficiency, and safety Mod Page1 305.2 Page 3 TEAMSTEPPS 05.2 Office-Based Care TeamSTEPPS Skills Mod Page1 405.2 Page 4 TEAMSTEPPS 05.2 Office-Based Care Does TeamSTEPPS Work?

Research has found that teamwork plays a critical role in providing quality health care Clinical outcomes include: Mod Page1 505.2 Page 5 50% reduction in the Weighted Adverse Outcome Score, which describes the adverse event score per delivery 50% decrease in the Severity Index, which measures the average severity of each delivery with an adverse event (Mann, et al., 2006) Reduced rate of adverse drug events Improved medication reconciliation at patient admission

(Haig, et al., 2006) TEAMSTEPPS 05.2 Office-Based Care Does TeamSTEPPS Work? Teamwork outcomes include: Mod Page1 605.2 Page 6 Significant improvement in communication and supportive behavior Significant increase in perceptions of teamwork after training (Weaver, et al., 2010) Reductions in turnover rate

Increases in employee satisfaction (Leonard, et al., 2004) TEAMSTEPPS 05.2 Office-Based Care Office Environment Do your patients have any idea how chaotic the office really is? How would they know? What would they hear or see? If you could describe the office in one word, what would it be? If your patients could describe

the office in one word, what would it be? If someone asked you to explain a typical day, what would you say? If patients described a typical visit, what would they say? Mod Page1 705.2 Page 7 TEAMSTEPPS 05.2 Office-Based Care Office Environment On the surface, the office environment can and should appear calm and orderly to patients Like a duck calm appearing above the water while chaos churns below Office

Mod Page1 805.2 Page 8 Does not conform to a pattern of work Has many components working together on multiple tasks simultaneously Treats numerous patients simultaneously TEAMSTEPPS 05.2 Office-Based Care Team-Building Exercise: Paper Chains Mod

Page1 905.2 Page 9 TEAMSTEPPS 05.2 Office-Based Care Why Does Teamwork Matter in Office-Based Care? Better continuity of care, access to care, and patient satisfaction (Stevenson, et al., 2001) Higher patient-perceived quality of care (Campbell, et al., 2001) Superior care for diabetes patients (Bower, et al., 2003) Mod Page1 10 05.2 Page 10 TEAMSTEPPS 05.2

Office-Based Care References Bower P, Campbell S, Bojke C, et al. Team structure, team climate, and the quality of care in primary care: An observational study. QSHC 2003;12:273-9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1743743/ Campbell SM, Hann M, Hacker J, et al. Identifying predictors of high quality care in English general practice: observational study. BMJ 2001;323:1-6. http://www.bmj.com/content/323/7316/784 Haig K, Sutton S, Whittington J. SBAR: a shared mental model for improving communication between clinicians. Jt Comm J Qual Patient Saf 2006;32(3):167-75. Leonard M, Graham S, Bonacum D. The human factor: The critical importance of effective teamwork and communication in providing safe care. Qual Saf Health Care 2004;13 Suppl 1:8590. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1765783/

Mann S, Marcus R, Sachs B. Lessons from the cockpit: how team training can reduce errors on L&D. (Grand Rounds) Contemp OB/GYN 2006 Jan;51:34-45. http:// www.npic.org/Projects/Lessons_From_The_Cockpit.pdf Stevenson K, Baker R, Farooqi A, et al. Features of primary health care teams associated with successful quality improvement of diabetes care. Fam Pract 2001;18:21-26. http:// www.ncbi.nlm.nih.gov/pubmed/11145623 Weaver SJ, Rosen MA, DiazGranados D, et al. Does teamwork improve performance in the operating room? A multi-level evaluation. Jt Comm J Qual Patient Saf. 2010;36(3):133-42. http:// psnet.ahrq.gov/public/Weaver-JCJQPS-2010-ID-17607.pdf Mod Page1 11 05.2 Page 11 TEAMSTEPPS 05.2

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