Aurora Health Care, Milwaukee, WI
Team Competency: A Key Element for Excellence in the Patient Experience

Abstract

Background: Quality metrics and patient experience data (CGCAHPS) in our resident clinics lag behind those of ambulatory clinics elsewhere in the Aurora Health Care (AHC) system. Team functioning is a critical factor in patient experience scores, but we have no initiatives to date that explicitly address the competencies required to be a member of an effective team. By implementing TeamSTEPPS (healthcare teamwork training), we will see improved patient experience metrics and caregiver satisfaction.

Methods: All providers, including faculty, residents, and staff, at 2 Family Medicine residency sites completed a 4-hour, 3-module TeamSTEPPS training. The modules included background, team structure, and mutual support and were adapted to ambulatory care settings. A 2-month follow-up obtained data on caregiver commitment to change and team assessments. AHC also compared patient experience metrics at baseline and posttraining.

Results: With a response rate of 69% (55 of 80), participants showed no change or slight increase in teamwork assessments in 13 of 15 categories on a scale of 1 (strongly disagree) to 5 (strongly agree). Respondents had a slight decrease in perceived support from their boss/supervisor (4.0 post/4.1 pre) and in confidence in team harmony (3.3 post/3.4 pre). Participants reported an increase in all commitment-to-change categories. Merged patient experience metrics revealed an increase in all service impact domains postintervention. All sites have committed to and are engaged in performing better as a team. We identified tensions between balancing immediate clinical care needs with cultural change training and also the difficulty of creating a process for both local and systemwide implementation.

Conclusions: Team competency may be the critical process element enabling AHC to achieve clinical and system strategic targets. TeamSTEPPS is an excellent and comprehensive yet flexible tool to teach team competency. Leadership support from conception through test phase is critical for initiating and disseminating team training.