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© 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
© 2009
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
© 2009
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
© 2009
Team PerformanceTeam Performance
Outputs• Performance
• Attitudes
• Behaviors
Inputs• Environment
• Hospital & Unit Context
• Team Composition
• Task Design
Processes• Inside Team
• Outside Team
• Team Traits
© 2009
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
© 2009
Team CompositionTeam Composition
• A team leader
• Champions (nurse and physician)
• Local “opinion leaders”
• People with diverse opinions
© 2009
Team CompositionTeam Composition
• Someone gregarious
• Someone who sees the big picture
• Someone detail-oriented
• Everyone dedicated
© 2009
Successful teams have…Successful teams have…
• Reliable Processes
– Education and engagement activities
– Communication
– Leadership support/buy-in
– Conflict (and conflict resolution)
© 2009
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
© 2009
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?
© 2009
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.