TeamSTEPPS Adoption in Action

In 2009, UNC Health Care, in partnership with Research Triangle Institute, completed an AHRQ-funded 2-year project to implement and measure the effectiveness of TeamSTEPPS™: Strategies and Tools to Enhance Performance and Patient Safety. The TeamSTEPPS Adoption in Action project objectives for the Pediatric and Surgical Intensive Care Units included improvements in all components in teamwork as measured by a direct observation of team interactions during specific events (multidisciplinary rounds, Extra Corporeal Membrane Oxygenation cannulation procedures, transfers to units, and adult and pediatric rapid response team activations).


After an initial planning phase and project team training through TeamSTEPPS Master Training sessions, all medical nursing, respiratory, unit support, and physician staff were trained over a six-month period in the target units. Training sessions consisted of a 1-hour online module with videos and a 1-hour in-person team training session with Master Trainers. Baseline and post-implementation direct observations were completed to assess teamwork skills during predetermined high-risk events in both units. The direct observations used the Teamwork Evaluation of Non-Technical Skills (TENTS) observation tool (Hohenhaus et al. 2008).


The initial project led to 20 physicians, nurses, respiratory therapists, and project staffed trained as Master Trainers and participants in the Leadership Change Team. A statistically significant (p < 0.05) improvement in all observed components of teamwork (see figure below) were attained in the year after full implementation (T3 5/09) compared to pre-implementation baseline in 2008 (Pre 4/08). The project units included TeamSTEPPS training in the Pediatric Intensive Care Unit (PICU) and Surgical Intensive Care Unit (SICU) at our institution and surpassed the goals of the project by spreading throughout 15 total clinical units in the healthcare system by the end of 2009.

TS improvement chart


Mayer CM, Cluff L, Lin W, Willis TS, Stafford RE, Williams C, Saunders R, Short KA, Lenfestey N, Kane HL, Amoozegar JB. Evaluating Efforts to Optimize TeamSTEPPS Implementation in Surgical and Pediatric Intensive Care Units. Jt Comm J Qual Patient Saf. 2011 Aug; 37(8):376-74.


UNC Health Care now has more than 90 clinical and performance improvement TeamSTEPPS™ master trainers covering 17 clinical areas.  Click here to view more information about TeamSTEPPS at UNC Health Care.