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TeamSTEPPS in Long-Term Care

TeamSTEPPS in Long-Term Care. Why Long-Term Care?. Long-term care environment is unique “Patients” are called Residents Care Teams: multi-disciplinary, include non-clinical staff Approximately 16,000 nursing homes and 1.6M nursing home residents across the country.

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TeamSTEPPS in Long-Term Care

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  1. TeamSTEPPS in Long-Term Care

  2. Why Long-Term Care? • Long-term care environment is unique • “Patients” are called Residents • Care Teams: multi-disciplinary, include non-clinical staff • Approximately 16,000 nursing homes and 1.6M nursing home residents across the country

  3. Focus of Long-Term Care Version Text and associated training materials made relevant to the long-term care environment • Language meaningful to long-term care • Exercises, scenarios, tests and videos center around chronic medical or rehabilitation circumstances • Graphics and pictures reflect nursing home staff, care and environment

  4. Long-Term Care Team

  5. Therapeutic Recreation/Activity Staff Social Worker Chef Nurse Rosie the Housekeeper Nurse Assistant Administrator

  6. Implementation • Evidence tested with long-term care leadership and staff • Adjust for audience, including education level and English proficiency • Share experiences and stories • Supplement lectures with exercises • Hold brief yet frequent learning sessions • Focus on communication skills

  7. Long-Term Care Videos • Two videos created • Long-term care – subtle decline in a resident over a 24 hour period • Sub-acute care –possible Myocardial Infarction/Pulmonary Embolism in a resident receiving physical therapy • 14 of 15 TeamSTEPPS skills were highlighted • Time-Out is not a skill deemed necessary for most nursing homes

  8. Conflict Resolution & Patient Safety • Conflict between an Activities Staff and a Nurses Aide • TeamSTEPPS Skills Used: • Two-Challenge Rule • DESC Script

  9. Two-Challenge Rule • Invoked when an initial assertion is ignored… • It is your responsibility to assertively voice your concern at least two times to ensure that it has been heard • The member being challenged must acknowledge • If the outcome is still not acceptable • Take a stronger course of action • Use supervisor or chain of command

  10. Two-Challenge Rule in Action

  11. Conflict Resolution: DESC Script • A constructive approach for managing and resolving conflict • D—Describe the specific situation • E—Express your concerns about the action • S—Suggest other alternatives • C—Consequences should be stated • Ultimately, consensus shall be reached.

  12. Let’s “DESC-It!” • Have timely discussion • Frame problem in terms of your own experience • Use “I” statements to minimize defensiveness • Avoid blaming statements • Critique is not criticism • Focus on what is right, not who is right

  13. DESC Script in Action

  14. New in Long-Term Care Version • Videos and Discussions • Discussion questions about videos and use of skills • Exercises, Scenarios • Care planning group exercise • Multi-disciplinary scenarios • Non-clinical examples and scenarios • Non-clinical application of TeamSTEPPS skills and techniques

  15. Contact Information • Qualidigm: • Michelle Pandolfi • mpandolfi@qualidigm.org • 860-632-3735 • Ann Spenard • aspenard@qualidigm.org • Abt Associates: • Donna Hurd • donna_hurd@abtassoc.com

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