North Shore-LIJ Health System Implements TeamSTEPPS® to Improve Patient Safety

New York's largest health care system, North Shore-LIJ Health System, has used AHRQ's TeamSTEPPS® patient safety training program, along with the Agency's Hospital Survey on Patient Safety Culture, to improve teamwork and patient outcomes in 17 hospitals and three nursing facilities.

North Shore-LIJ's system-wide adoption of TeamSTEPPS, an evidence-based program developed by AHRQ and the Department of Defense to improve communication and teamwork skills among health care professionals, began with a pilot project at its Plainview Hospital facility. Significant improvement was shown at Plainview within three years in all dimensions of patient safety, according to results measured by AHRQ's Hospital Survey on Patient Safety Culture. The survey helps assess staff perspectives on patient safety issues, medical errors, and event reporting.

When North Shore-LIJ expanded the use of AHRQ tools to all its facilities in 2008, eight of the 12 measured dimensions fell below the national average. System leaders believed that using AHRQ’s TeamSTEPPS training framework with their existing Collaborative Care Model—an evidence-based approach where health care providers work together to monitor patients’ progress—could lead to lasting improvements.

"TeamSTEPPS could be used in two different ways," said Lily Thomas, Ph.D., R.N., vice president of system nursing research. "We could create transformational change and build a culture of patient safety. We could also use TeamSTEPPS for continuous improvement and problem solving."

Using TeamSTEPPS curricula along with training templates developed by North Shore-LIJ staff, the organization trained more than 40,000 employees by April 2015. The system embraced hallmarks of TeamSTEPPS communication strategies, including the “Brief, Debrief, Huddle” model, and “I Pass the BATON.”

When the Hospital Survey on Patient Safety Culturewas repeated in 2013, significant improvements were identified in all the measured dimensions, with nine of the 12 rising above the national average. Areas of strength included “organizational learning” and “teamwork within units.”

The organization credits TeamSTEPPS as a major component of its multi-faceted approach for helping to reduce medical malpractice expenses by 2.5 percent. The training also has been instrumental in reducing patient harms, including a 60 percent decrease in central line-associated bloodstream infections and a 50 percent decrease in hospital-acquired pressure ulcers since 2011.

“TeamSTEPPS gave people permission to do the right thing and provided processes in the context of patient safety,” noted Dr. Thomas.