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TEAMLast week, I attended the second and last part of the TeamStepps workshop. In another post (“Was I Dreaming?”) I described the first workshop and my surprise at how the doctors willingly and enthusiastically participated in the dialogue and group activities. What would I find this time around?

TeamStepps is a program that promotes teamwork and teaches “team strategies and tools to enhance performance and patient safety.” The audience was a group of professionals who worked in the surgical area of a large teaching hospital. I volunteer at the hospital and attended as an observer, although I did participate in some of the exercises.

The first thing I noticed when I entered the room was the empty chairs at each of the four tables. After we finished with introductions, it was clear most of the absentees were doctors/surgeons. I felt disappointed. Was their eager involvement at the last meeting just a charade?

This seminar was pivotal for implementing TeamStepps. The group in attendance—nurses, OR techs, surgeons, anesthesiologists—were to be the “coaches” who would model effective team work and help “change the culture” of the hospital. The leaders of the workshop, two doctors and four nurses, were poised to teach how to be an effective coach. Furthermore, there had been homework. Each table had been given a “discussion question” at the end of the last meeting with the expectation that the group would present a three to five minute demonstration. The occupants at my table included two nurses, one OR tech and an orthopedic surgeon who was preoccupied with the open laptop in front of him. I had already excused myself from participating in the skit.

When time came for the demonstrations to begin, those at my table seemed to be looking at the question for the first time. The other three groups appeared to be scrambling also. In the meantime, some doctors had slowly been slipping into their seats. Two appeared at our table and joined the activity. The surgeon at the end of the table had closed his laptop. Unbelievably, to me, each group, in turn, stood in front of the room and showed, as instructed, the right and wrong way to address their question.

(Our table was to communicate how the team would handle a situation when a necessary piece of surgical equipment fell to the floor and was contaminated).

In the skits, the surgeons played nurses, the nurses played doctors, OR techs were the anesthesiologists. The shows prompted much laughter and recognition of obnoxious and unprofessional behavior in the “wrong way” skit and applause for “right way” team interaction.

For the remainder of the meeting the leaders introduced peer-to-peer feedback, not easily understood by some of the surgeons who saw themselves as designated leaders and superiors and staff as subordinates. The coordinators, especially the nursing coordinators, gently suggested that the team was made up of peers regardless of occupational titles.

Like the first TeamStepps session, I was impressed with the positive vibes and enthusiasm from the audience. My world of hierarchical structure and deference paid to the medical staff was changing. I believe that this change in culture will bring a safer patient environment.

On the last page of the handout this statement stood out:

Important that staff realize this is not a passing phase—it is our model for patient safety moving forward.

 I think this model will indeed move forward at this hospital even though the ride may be a bit bumpy.