Integrated Multidisciplinary Training and Practiced Coaching of Teamstepps Improves Reporting of Teamwork in Code Blue and Rapid Response Performance

Background:

Practiced teamwork with good communication is a necessary component of safe, quality health care. Communication failures are the leading root cause of harm in hospitalized patients; poor teamwork is associated with worse health care outcomes. The Institute of Medicine and the Joint Commission have made communication and interdisciplinary team training national patient safety goals. Designed by the Department of Defense in collaboration with the Agency for Healthcare Research and Quality, Team STEPPS is an evidenced‐based curriculum to improve teamwork in health care centered on communication tools. We implemented an integrated multidisciplinary Team‐STEPPS curriculum to improve teamwork and communication in code blue and rapid response activations.

Methods:

Members of our hospital's rapid response and code blue teams executed a survey designed to elicit impressions of teamwork effectiveness during rapid responses and code blue activations. Teammates surveyed included internal medicine residents, critical care nurses, medical/surgical ward nurses, and respiratory therapists. Participants then selected 1 of 6 training sessions. Each session included a mix of physicians, nurses, and respiratory therapist designed to reproduce the true composition of our hospital's rapid response and code blue teams. Each training session included a TeamSTEPPS didactic period followed by coached practice of TeamSTEPPS tools during simulated rapid response and code blue scenarios at our simulation center. Three months after all sessions were completed, participants were again surveyed to assess their impressions of teamwork in code blue and rapid response activations.

Results:

A total of 79 teammates participated in the training sessions: 39 nurses, 6 respiratory therapists, and 34 internal medicine residents. Survey data revealed improved teamwork and communication from an average of 46.8% positive responses prior to training to an average of 72.9% positive responses after training. The most significant improvements from before the intervention to after the intervention were: “I feel comfortable expressing my ideas during rapid response and code blue activations” (56.9% affirmative responses before, 97.2% affirmative responses after), “Information is consistently conveyed in SBAR format” (14% affirmative responses before, 54% affirmative responses after), and “Team members repeat orders and requests to the team leader” (37% affirmative responses before, 66% affirmative responses after). Data obtained after actual patient code blue and rapid responses are currently being collected.

Conclusions:

Integrated multidisciplinary training and coached practice of Team‐STEPPS concepts in hospital providers improves reporting of teamwork and communication in code blue and rapid response activations.

Disclosures:

M. Guidry ‐ none; W. Rothwell ‐ none; B. Conkerton ‐ none