Section 1: Overview of Key Communication Concepts and Tools
This section provides an overview of the key concepts and tools in the Team Leadership Module. More explanations and illustrations are provided in section 2 of this module; section 3 includes methods for teaching the concepts and tools for this module. The last section has information about implementing the module's tools, including knowing whether an organization is ready for implementation.
Key Concepts
Teams
Teams are sets of people communicating, coordinating, and collaborating—in this case, to provide optimal care to patients. Some teams are formally defined and permanent. Other teams are rapidly created to respond to an emerging need. They include clinicians (e.g., physicians, nurses) and nonclinicians. Patients and family caregivers are always a part of the team, although some patients may be more active team members than others.
Team leadership is one of the four TeamSTEPPS skills that are central to safe, effective, and patient-centered care.
Multi-Team System for Patient Care
Safe and efficient care involves the coordinated activities of a multi-team system (MTS).
MTSs in other care settings are often more complex than the ones in hospitals. Whether inside or outside the hospital, medically complex patients may have multiple core teams with multiple leaders coordinating to improve or maintain various aspects of the patient's health and well-being. Some of these teams may be entirely virtual and/or include providers from multiple organizations or care systems.
Team Leadership
The following are responsibilities of team leaders:
- Organize the team.
- Identify and articulate clear goals.
- Assign tasks and responsibilities.
- Monitor and modify the plan; communicate changes.
- Review the team’s performance, provide formative feedback and critique when needed.
- Manage and allocate resources.
- Facilitate information sharing.
- Encourage team members to assist one another.
- Foster a learning and psychologically safe environment.
- Keep conflict healthy through use of tools such as DESC: Describe, Express, Suggest, Consequences (see Module 4, Mutual Support).
- Reinforce patient-centeredness of all team members and actions.
- Model effective teamwork.
Ensuring Coordinated Team Activities
Effective team leaders establish and maintain shared mental models needed to ensure optimal patient care. Regularly reviewing information in team meetings such as the brief, the huddle, and the debrief, as well as having informal conversations with team members, helps maintain shared mental models and foster effective teamwork.
Sharing the Patient Care Plan
- Brief—Short session prior to start to share the plan, discuss team formation, assign roles and responsibilities, establish expectations and climate, and anticipate outcomes and likely contingencies. The brief readies the team to care optimally for new or existing patients.
Monitoring and Modifying the Plan
- Huddle—Ad hoc meeting to ensure continual progression of care to the goal; to re-establish or affirm situational awareness, reinforce the plan in place, or assess the need to augment or adjust to optimize outcomes.
Reviewing the Team's Performance
- Debrief—A structured, intentional yet informal, quick information exchange session designed to improve team performance and effectiveness through lessons learned and reinforcement of positive behaviors. Teams reflect on and analyze their performance against the plan, extracting the lessons from that experience. They collaborate and gain consensus on methods that will improve performance and safety. Teams that consistently debrief perform 15 percent better than those that do not. The debrief is how teams learn from the treatment of one patient to improve and optimally care for future patients with similar needs.
Team Leadership Tools
Team leadership tools include the Brief Checklist and the Debrief Checklist.
