The 4th Module of TeamSTEPPS 2.0 Fundamental Training Course. It teaches skills, strategies and tools for successful leading teams on specific clinical scenarios.

1. Leading Teams For
Health-Care Providers
Eng. Abdel-Halim Mahmoud
TeamSTEPPS 2.0 Certified Master Trainer
Performance Excellence Coach
Examiner @ the Baldrige Performance Excellence
Award, MN, USA
CEO, Egypt Excellence Center
The 4th Module of
TeamSTEPPS Fundamental Course

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Objectives
 Describe how leadership affects team
processes and outcomes
 Identify different types of team leaders
 Describe the activities involved in successfully
leading teams
 Describe the tools for leading teams, including
briefs, huddles, and debriefs
 Apply the tools for leading teams to specific
clinical scenarios

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TeamStepps Fundamental Couse
 Module 1 – Introduction
 Module 2 – Team Structure
 Module 3 – Communication
 Module 4 – Leading Teams
 Module 5 – Situation Monitoring
 Module 6 – Mutual Support
 Module 7 – Summary

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Material You will Use
http://www.ahrq.gov/professionals/education/curriculum-
tools/teamstepps/instructor/fundamentals/index.html

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Team Strategies & Tools to Enhance
Teamwork Performance
& Patient Safety
 Based on more than 30 years of research and evidence
 Team training programs have been shown to improve attitudes,
increase knowledge, and improve behavioral skills
 Salas, et al. (2008) meta-analysis provided evidence that team
training had a moderate, positive effect on team outcomes
(ρ = .38)
What is

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Outcomes of Team Competencies
 Knowledge
 Shared Mental Model
 Attitudes
 Mutual Trust
 Team Orientation
 Performance
 Adaptability
 Accuracy
 Productivity
 Efficiency
 Safety

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Leadership Exercise
1. What characteristics, attitudes, or skills made the
leaders that you have known effective and
successful?
2. If there was room for improvement, what could they
have done to be more effective?
3. Do you feel that leadership can be learned or
taught, or is it an innate skill?
4. What one characteristic is most important to the
success of effective leaders?

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Leadership
 Holds a teamwork
system together
 Ensures a plan is
conveyed,
reviewed, and
updated
 Facilitated through
communication,
continuous
monitoring of the
situation, and
fostering of an
environment of
mutual support

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Types of Team Leaders
 Designated – The person assigned to lead
and organize a team, establish clear goals,
and facilitate open communication and
teamwork among team members
 Situational – Any team member who has the
skills to manage the situation at hand

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Types of Team Leaders
Thinking in your work unit
 Who are the designated team leaders on your unit?
 Is the role of the designated team leader
acknowledged and understood by team members?
 Can you describe a case in which someone
assumed the role of the situational team leader?
 Can the roles of the designated leader and
situational leader be better defined on your unit?

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 Define, assign, share, monitor, and modify a plan
 Review the team’s performance
 Establish “rules of engagement”
 Manage and allocate resources effectively
 Provide feedback regarding assigned responsibilities
and progress toward the goal
 Facilitate information sharing
 Encourage team members to assist one another
 Facilitate conflict resolution
 Model effective teamwork
Effective Team Leaders

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Defining the Plan
 When developing a plan, team leaders should
consider:
 Time – How much time is available to complete all the
necessary tasks and activities?
 People – Do the available staff have the necessary
knowledge and skills to perform their roles?
 Equipment – Is the necessary equipment available and
working?
 Information – Has all of the necessary information been
collected and reviewed?

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Defining the Plan
in your work unit
 How do your team leaders communicate a plan
of care to the care team?
 Which strategies have been effective and which
have not been effective?
 How do your team leaders communicate
changes to the plan of care to the care team?

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Case Study Discussion
After attending TeamSTEPPS Master Training, a physician and
nurse leader in a Level I Trauma Center decide that trauma
resuscitations could be more effectively conducted. Currently,
when a trauma alert is called to indicate the pending arrival of a
severely injured patient, more staff show up to the trauma bay
than needed, necessary equipment is sometimes missing or not
functioning properly, and the lead trauma physician often shows
up just as EMS is bringing the patient into the trauma bay. The
newly trained Master Trainers observe that these practices have
led to confusion and chaos that put patients at risk and result in
valuable time being lost.
What changes would you recommend to improve performance in
the trauma bay?
14

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 Determine the tasks and
roles to be assigned
 Determine which roles
must be filled and allocate
tasks appropriately
 Communicate clear
expectations of what team
members need to do
 Request feedback
Assigning Tasks and
Responsibilities

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 How do team leaders
assign tasks in your
units, once a plan has
been established?
 What approaches to
assigning tasks and
responsibilities are
effective and what
has not been
effective?
Assigning Tasks and
Responsibilities
In your work unit

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Sharing the Plan:
Briefs
 A team briefing is an
effective strategy for
sharing the plan
 Briefs should help:
 Form the team
 Designate team roles and
responsibilities
 Establish climate and
goals
 Engage team in short-
and long-term planning

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Discussing the Video
 Who is the designated
team leader?
 Did the team develop a
comprehensive plan for
Mrs. Keys?
 Did the team address
contingencies and was
the patient included in
those discussions?

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TOPIC
Who is on core team?
All members understand
and agree upon goals?
Roles and responsibilities
understood?
Plan of care?
Staff availability?
Workload?
Available resources?
Briefing Checklist Tool

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Briefing Checklist Discussion
 Have you participated in a brief?
Did the items on this checklist
occur? If not, what was not
done?
 If you were designing a briefing
checklist for your unit, what items
would you include?
 When would the briefing occur?
 Who would be expected to
attend?

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1. Break into small groups with others from your
unit, work area, or organization.
2. Identify when, why, and where briefings might
be conducted. Note who should lead the brief
and who should participate.
3. Develop a checklist for guiding the brief.
4. Discuss what outcomes you expect to see as
a result of implementing briefs.
5. At the end of the exercise, present and
discuss your plans with the group.
Briefing & Checklist
Exercise in your work unit

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Monitoring & Modifying the Plan:
Huddle
Problem Solving
 Hold ad hoc, “touch base”
meetings to regain
situation awareness
 Discuss critical issues
and emerging events
 Anticipate outcomes
and likely contingencies
 Assign resources
 Express concerns

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Huddle Video Discussion
 What event necessitated
the need for the huddle?
 What key information was
shared in the huddle?

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Reviewing the Team’s Performance:
Debrief
Process Improvement
 Brief, informal information exchange and feedback
sessions
 Occur after an event or shift
 Designed to improve teamwork skills
 Designed to improve outcomes
 An accurate recounting of key events
 Analysis of why the event occurred
 Discussion of lessons learned and reinforcement of
successes
 Revised plan to incorporate lessons learned

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TOPIC
Communication clear?
Roles and responsibilities
understood?
Situation awareness
maintained?
Workload distribution?
Did we ask for or offer
assistance?
Were errors made or
avoided?
What went well, what
should change, what
can improve?
Debrief Checklist

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Debrief Video

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Debrief Video Discussion
• What were some of the
positive effects from this
debrief?
• Describe the tone Dr.
Upton set for the debrief.

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Facilitating Conflict Resolution
 Effective leaders:
 Facilitate conflict resolution to avoid compromising
patient safety and quality of care
 Do not allow interpersonal or irrelevant issues to
negatively affect the team
 Help team members master conflict resolution
techniques
 DOD Professional Conduct Toolkit:
http://www.health.mil/dodpatientsafety/ProductsandServices/Toolk its.aspx

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Effective leaders cultivate desired team
behaviors and skills through:
 Open sharing of information
 Role modeling and effective cueing of team
members to use prescribed teamwork behaviors
and skills
 Constructive and timely feedback
 Facilitation of briefs, huddles, debriefs, and
conflict resolution
 Mitigation of conflict within the team
Promoting & Modeling Teamwork

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Team Formation Video

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Video Discussion
• What leadership tools and
strategies did Dr. Dean use?
• How did the nurses
demonstrate leadership?
• What leadership tools and
strategies did Dr. Upton use?

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Tools & Strategies Summary
TOOLS and
STRATEGIES
Communication
• SBAR
• Call-Out
• Check-Back
• Handoff
Leading Teams
• Brief
• Huddle
• Debrief
OUTCOMES
 Shared Mental Model
 Adaptability
 Team Orientation
 Mutual Trust
 Team Performance
 Patient Safety!!
BARRIERS
 Inconsistency in Team
Membership
 Lack of Time
 Lack of Information Sharing
 Hierarchy
 Defensiveness
 Conventional Thinking
 Complacency
 Varying Communication Styles
 Conflict
 Lack of Coordination and
Followup With Coworkers
 Distractions
 Fatigue
 Workload
 Misinterpretation of Cues
 Lack of Role Clarity

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Applying TeamSTEPPS Exercise
1. Does the team experiencing the issue in your
organization have a designated leader? Who is it?
2. Is your teamwork issue related to the team’s
leadership?
3. If yes, what is the leadership issue?
4. Which of the tools and/or strategies for leading
teams might you consider implementing to address
the issue?

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Applying TeamSTEPPS Exercise
1. Does the team experiencing the issue in
your organization have a designated
leader? Who is it?
2. Is your teamwork issue related to the
team’s leadership?
3. If yes, what is the leadership issue?
4. Which of the tools and/or strategies for
leading teams might you consider
implementing to address the issue?

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THANK YOU
Engineer Abdel- Halim Mahmoud
 Performance Excellence Coach; Organizations, Projects & Teams
 Member, Board of Evaluators 2015, Baldrige-Based Performance
Excellence Award. Performance Excellence Network, MN, USA
 CEO, Egypt Excellence Center, Cairo, Egypt
www.EgyptExcellence.com
ceo@EgyptExcellence.com
Mobile: +20.102.5151290