Table 1.

Overview of team training and implemented TeamSTEPPS tools and strategies—and their related key principles

Year Month	Tools and strategies Team competencies	Explanations of the team training and the tools and strategies implemented	Profession group Implementation
2016 May	Patient safety and TeamSTEPPS five key principles	Six hours of compulsory team training: didactics, discussions, role-play and high-fidelity simulation training	All healthcare personnel
2016 May	Closed-loop Communication	To ensure that information conveyed by the sender is understood by the receiver as intended. The sender has to ensure verification from the receiver	All healthcare personnel Critical information—especially regarding orally medicating orders
2016 June	SBAR Communication	A technique for communicating critical information that requires immediate attention and action concerning a patient’s condition. SBAR: S = Situation B = Background A = Assessment R = Request/Recommendation	All healthcare personnel For example, by a deteriorating patient
2016 August	Briefs Leadership	Sharing the plan: Short session prior to start? To share the plan, discuss team formation, assign roles and responsibilities, establish expectations and climate, anticipate outcomes and likely contingencies	Nursing staff Start of every shift
2016 September	Huddles Leadership	Monitoring and modifying the plan: Ad hoc meeting to reestablish situational awareness, reinforce plans already in place and assess the need to adjust the plan	All healthcare personnel Daily after rounding by the patient whiteboard—the rounding physician and nursing staff—lead by a registered nurse
2016 October	Cross monitoring Situation monitoring	A harm error reduction strategy that involves: (1) Monitoring actions of other team members; (2) Providing a safety net within the team; (3) Ensuring that mistakes or oversights are caught quickly and easily, and (4) “Watching each other’s back”	Registered nurses Mandatory control by two registered nurses with intravenous I.V. medication administration
2016 November	TeamSTEPPS 4 team competencies	TeamSTEPPS refresher training; classroom team training	Nursing staff (75 min) and physicians (20 min)
2017 January	Debriefs Leadership	Reviewing the Team’s Performance. Informal information exchange session designed to improve team performance and effectiveness through lessons learned and reinforcement of positive behaviors	Nursing staff Once a week with Unit Nurse Manager
2017 January	Task assistance Mutual support	Helping others with tasks builds a strong team. Key strategies include: (1) Team members protect each other from work overload, (2) Effective teams place all offers and requests for assistance in the context of patient safety, and (3) Team members foster a climate where it is expected that assistance will be actively sought and offered	Nursing staff Distribution of workload, number of patients
2017 February	STEP Situation Monitoring	A tool for monitoring situations in the delivery of healthcare. Status of the patient (S), Team members (T), Environment (E), Progress toward the goal (P)	Nursing staff Updated electronic care plan
2017 March	Two challenge rule Mutual support	Empowers all team members to “stop the line” if they sense or discover an essential safety breach. When an initial assertive statement is ignored: (1) It is the team members’ responsibility to assertively voice concern at least two times to ensure that it has been heard, (2) The team member being challenged must acknowledge that concern has been heard, and (3) If the safety issue still hasn’t been addressed, the team member has to take a stronger course of action and utilize supervisor or chain of command	All healthcare personnel Anyone: Speak-up until heard when seeing a situation that may threaten patient safety
2017 May	TeamSTEPPS 4 team competencies	TeamSTEPPS refresher training; classroom team training	Nursing staff (75 min)
2017 May	I-PASS Communication	The transfer of information (along with authority and responsibility) during transitions in care across the continuum. It includes an opportunity to ask questions, clarify, and confirm. I = Illness severity, P = Patient summary, A = Action list, S = Situation awareness and contingency planning, S = Synthesis by receiver	Nursing staff Handoffs with focus on patient safety risks