© 2009 on the cusp: stop bsi building a team. © 2009 learning objectives to understand the central...

© 2009

On the CUSP: STOP BSIOn the CUSP: STOP BSIBuilding a TeamBuilding a Team

© 2009

Learning ObjectivesLearning Objectives

• To understand the central importance of your ICU quality improvement team

• To develop a strategy for building a successful team

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The Quality Improvement TeamThe Quality Improvement Team

• The core team working on the CUSP/ CLABSI project

• The small group that spreads the intervention to the rest of the ICU

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Importance of the Quality Importance of the Quality Improvement TeamImprovement Team

• Why do you think the team would matter to outcomes?– “Absolute Power” over local implementation

• What do you think makes a good team?– The Who– The How

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Team PerformanceTeam Performance

Outputs• Performance

• Attitudes

• Behaviors

Inputs• Environment

• Hospital & Unit Context

• Team Composition

• Task Design

Processes• Inside Team

• Outside Team

• Team Traits

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Team CompositionTeam Composition

• Size (not too small, not too large)

• Multidisciplinary representation– ICU Nurses– ICU Physicians– Infection Control– ICU Medical Director– Nurse Educator– ICU Nurse Manager– Executive Partner (VP or above) – Pharmacist– Hospital Patient Safety Officer or Chief Quality

Officer– Staff from Safety, Quality or Risk Mgmt Office– Respiratory Therapist

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Team CompositionTeam Composition

• A team leader

• Champions (nurse and physician)

• Local “opinion leaders”

• People with diverse opinions

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Team CompositionTeam Composition

• Someone gregarious

• Someone who sees the big picture

• Someone detail-oriented

• Everyone dedicated

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Successful teams have…Successful teams have…

• Reliable Processes

– Education and engagement activities

– Communication

– Leadership support/buy-in

– Conflict (and conflict resolution)

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Successful teams haveSuccessful teams have…(cont.)…(cont.)

• Norms

– Valuing individual contributions

– Cohesion (team unity)

– Goal agreement

– Self-assessment of knowledge /skills

– Participation of team members

• Role clarity

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Action ItemsAction Items

• Form your team with an appreciation of the importance of WHO is on the team

• Carefully plan HOW you will act as a unified group

• Do a “pre-mortem” assessment—if this project were to fail, why would it? What could the QI team have done to prevent failure?

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Reference ListReference List

• Marsteller, Jill A., Stephen Shortell, Michael Lin, Elizabeth Dell, Stephanie Wang, et al. “How Do Teams in Quality Improvement Collaboratives Interact?” Joint Commission Journal of Quality and Patient Safety, 2007 May; 33(5):267-76.

• Shortell, Stephen, Jill A. Marsteller, Michael Lin, Marjorie Pearson, Shinyi Wu, Peter Mendel, Shan Cretin, and Mayde Rosen. “The Role of Team Effectiveness in Improving Chronic Illness Care,” Medical Care, November 2004.