Building Your SUSP Team Part I

Armstrong Institute for Patient Safety and Quality

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Learning Objectives

• Describe the importance of your SUSP team• Develop a strategy to build a successful team• Define roles and responsibilities of team

members• Identify characteristics of successful teams

and barriers to team performance

An overview of the SUSP team

The Armstrong Institute Model to Improve Care

Surgical Unit based Safety Program

(SUSP)

1. Educate staff on science of safety

2. Identify defects

3. Recruit executive to adopt unit

4. Learn from one defect per quarter

5. Implement teamwork tools

Translating Evidence Into

Practice(TRiP)

1. Summarize the evidence

2. Identify local barriers to implementation

3. Measure performance

4. Ensure all patients get the evidence

• Engage• Educate• Execute• Evaluate

Reducing Surgical Site Infections

• Emerging Evidence

• Local Opportunities to Improve

• Collaborative learning

http://www.hopkinsmedicine.org/armstrong_institute Technical Work Adaptive Work

The Peri-operative SUSP Team

• Understands that patient safety culture is local• Composed of engaged frontline providers from pre-,

intra-, and post-operative care areas who take ownership of patient safety

• Includes staff members who have different levels of experience and perspectives

• Meets regularly (weekly or at least monthly)• Has adequate resources including protected time

– 2 to 4 hours per week for a team leader, surgeon, anesthesia, nurse, and infection preventionist

Team Performance

Outputs

• Performance

• Attitudes

• Behaviors

Inputs

• Environment

• Hospital &

Unit Context

• Team Composition

• Task Design

Processes

• Inside Team

• Outside Team

• Team Traits

SUSP Team Members

• Surgeons• Anesthesiologists• CRNAs• Circulating nurses• Scrub nurses / OR

techs• Perioperative nurses• Executive partner• Nurse leaders

• Physician assistants• Nurse educators• Anesthesia assistants• Infection

preventionists• OR directors• Patient safety officers• Chief quality officers• Ancillary staff

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Team Composition

• A team leader

• Champions (nurse and physician)

• Local “opinion leaders”

• People with diverse opinions

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Team Composition

• Someone outgoing

• Someone who sees the big picture

• Someone detail-oriented

• Everyone dedicated

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Successful teams have…

• Reliable Processes

– Education and engagement activities

– Communication

– Leadership support/buy-in

– Conflict (and conflict resolution)

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Successful teams have…(cont.)

• Norms

– Valuing individual contributions

– Cohesion (team unity)

– Goal agreement

– Self-assessment of knowledge /skills

– Participation of team members

• Role clarity

Forming your SUSP team

Engage Core SUSP Team Members

• Surgeons• Anesthesiologists• CRNAs• Circulating nurses• Scrub nurses / OR techs• Perioperative nurses• Executive partner• Nurse leaders

Kevin Driscoll CRNACRNA Lead

Deb Hobson RN“Coach”

Tracie Cometa RNLead RN

Mary Grace Hensel RNManager OR

Sean Berenholtz MDAnesthesia Lead

Lucy Mitchell RNNSQIP SCR

Elizabeth Wick MDSurgery Lead

Renee Demski MBASenior Director QualityJohns Hopkins Medicine

Executive

CoachNSQIPOutcomes

Steph Mullens CSTLead Tech

Tips for Engaging Physicians on the SUSP Team

1. Identify physician leaders

2. Create a forum for this role

3. Listen to physician concerns

4. Develop plans to address concerns

5. Reward physician leaders

6. Create a vehicle for communication

7. Develop a plan for communications

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Physician Engagement Strategies

• Create a Compact (an Agreement) with management– Clearly define what is expected of physicians– Review performance regularly

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Example Physician Champion Compact

• Hospital will provide support for percent of physicians’ time

• In return, physician will do the following:– Monitor and improve quality

• Implement CUSP and SSI interventions• Hold regular meetings with team• Involve other members of Medical staff in

quality• Report SSI rates and learning from defects

results to senior leaders and board

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Example Physician Champion Compact

• Further, physician will do the following:

– Work with hospital to clarify what will be measured, who will measure it, and who will produce reports

• Meet quarterly to discuss progress

Tips for Scheduling Your Meetings

• Incorporate SUSP meetings into ongoing educational activities to ease scheduling challenges– Regularly scheduled nurse training– Grand rounds for physicians– Invite RNs to joint grand rounds

• Create incentives for participating– Educational credit for participation

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Establishing clear roles and responsibilities on your SUSP team

Armstrong Institute, 2012

Action Items

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

• Complete the SUSP Team Membership Form

• Plan to attend Part II of Building your SUSP Team