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STEPPS: Producing Effective Medical Teams to Achieve Optimal Patient Outcomes

Slide presentation from the AHRQ 2008 conference showcasing Agency research and projects.

Slide Presentation from the AHRQ 2008 Annual Conference

On September 10, 2008, Andy Kosseff, made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (355 KB; Plugin Software Help).

Slide 1

STEPPS [Strategies and Tools to Enhance Performance and Patient Safety]: Producing Effective Medical Teams to Achieve Optimal Patient Outcomes

AHRQ Annual Conference Sept. 10, 2008
Andy Kosseff, MD
SSM Health Care Medical Director.

Slide 2

Why is STEPPS So Important Now

  • Fragmentation of care.
  • Multiple initiatives—are patients safer.
  • Electronic health records.
  • Care giving doctors and nurses are the heart of a safety culture.

Slide 3

SSM's Progress

  • Started TeamSTEPPS™ training in Oct., 2007.
  • Have trained 400 clinicians on 3 pilot units.
  • Established outcomes measurement plan for each unit trained.
  • Will train another 300 clinicians in 2008.

Slide 4

STEPPS Outcome Measures

  • Number of serious and sentinel events.
  • Adverse Outcome Index (OB)/Trigger tool.
  • AHRQ Patient Safety Culture Survey.
  • Patient, physician, and nurse satisfaction surveys.
  • Nurse turnover rate

Slide 5

Additional Aspects of STEPPS Training

  • It is acceptable communication training.
  • It sets a standard for performance on clinical units—agreed upon by bedside clinicians.

Slide 6

Operationalizing STEPPS

  • Prework
    • Introduction to Administrative Council.
    • Introduction to doctors and nurses on unit to be trained.
    • Measurement.
    • Start training.
  • Implementation
    • Coaches to sustain implementation.
    • Monthly STEPPS Steering Team meeting.
    • Sequential tools and concepts implementation.
    • Outcome data feedback.
    • Train new doctors and nurses.

Slide 7

SSM Customization

  • Focus on core teams.
  • Use clinical cases from units being trained.
  • Make initial Fundamentals training 4 hours.
  • Use as a foundation of safety and care.

Slide 8

What We Should Have Known

  • Doctors and nurses on both sides of the podium.
  • Training is the easy part.
  • Not all STEPPS trainers are trainers.
  • Understand advocacy and assertion clearly.
  • Separate teamwork training from Electronic Health Record (EHR) implementation.

Slide 9


  • Intensive support for all trained units.
  • Train our own trainers.
  • Simulation training.
  • Broad use of STEPPS on all clinical units.

Slide 10

The End

  • Please contact Andy Kosseff for further information or discussion.
Current as of February 2009
Internet Citation: STEPPS: Producing Effective Medical Teams to Achieve Optimal Patient Outcomes. February 2009. Agency for Healthcare Research and Quality, Rockville, MD.


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