AHRQ Safety Program for Long-Term Care: HAIs/CAUTI
This template provides suggestions about roles, characteristics, and responsibilities for members of your improvement team. Develop your team and document influential and respected leaders, clinicians, frontline staff, and residents and families who will provide primary and backup support for each core team member's role.
Create a Team | ||
Objective: | To assemble a core team of influential leaders and staff members necessary to drive successful implementation of the AHRQ Safety Program for Long-Term Care: Preventing Catheter-Associated Urinary Tract Infections (CAUTI) and other healthcare-associated infections (HAIs) at your facility. | |
Instructions: | Review key characteristics of each core team member role and suggested responsibilities to determine who should be on the team. We recommend that you include backup (alternate or deputy) team members to support each suggested core team member's role and responsibilities. On the next page, use the matrix to build consensus and determine each role's responsibilities. |
Name(s) | Team Member Role | Key Characteristics | Suggested Responsibilities |
---|---|---|---|
1.
2. |
Team Leader | Ability to engage staff through persistence, commitment, continuity, style, and collaboration Energized; positive attitude Data driven |
|
1.
2. |
Administrative Champion | Senior policy and delivery support Energized; positive attitude |
|
1.
2. |
Infection Preventionist | Data driven Collaborative Problem solver Advocate |
|
1.
2. |
Physician Champion | Resourceful Problem solver Influencer Data driven |
|
1.
2. |
Nurse Champion | Energized; positive attitude Collaborative Influencer Advocate |
|
1.
2. |
Frontline Champion | Resourceful Problem solver |
|
Bibliography
1. Action Planning Worksheets. TeamSTEPPS Implementation Guide. Rockville, MD: Agency for Healthcare Research and Quality; October 2014.
2. Appendix A. Checklists for Assessing Executive and Physician Champion Potential. Toolkit for Reducing Catheter-Associated Urinary Tract Infections in Hospital Units: Implementation Guide. Rockville, MD: Agency for Healthcare Research and Quality; October 2015.
Instructions: Review the suggested responsibilities for each core team member role listed on the team roster and use this matrix to build consensus among staff and determine each role's responsibilities. Alternatively, you can use this tool to begin planning suggested responsibilities of each role to discuss with the team. Check each box when responsibilities are agreed upon for each role.
Team Responsibilities | Team Leader | Administrative Champion | Physician Champion | Nurse Champion | Frontline Champion | Infection Preventionist |
---|---|---|---|---|---|---|
Advocate for project goals with peers | ||||||
Represent team to leadership and committees | ||||||
Prioritize safety defects | ||||||
Meet regularly to review progress | ||||||
Educate peers about HAIs/CAUTI and infection prevention practices | ||||||
Identify and implement strategies to overcome barriers | ||||||
Empower nurses and other staff to stop procedures if protocols are not followed | ||||||
Collect and review data | ||||||
Support implementation of recommendations |