Featured Case Study: AHRQ Training Program Improves Care at Texas Military Hospital

After the San Antonio Military Medical Center implementedAHRQ’sTeamSTEPPS® training program in 2013, patient safety concerns declined by 60 percent in urology services while on-time surgical start rates improved by 21 percent. Read the case study.

AHRQ's TeamSTEPPS® Boosts Patient Safety, Efficiency for Texas Military Hospital's Operating Rooms

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Patient Safety

January 2016

Patient safety problems decreased dramatically and operating room procedures improved significantly after the 425-bed San Antonio Military Medical Center implemented AHRQ's TeamSTEPPS® program in November 2013.

Center officials said patient safety concerns declined by 60 percent in urology services within six months of the program's implementation, while average procedure times and on-time surgery starts also improved. TeamSTEPPS was expanded hospital-wide after its successful introduction in the facility's 28 surgical operating rooms.

"A lot of patient safety issues are related to communication and relaying information," said Thomas E. Novak, M.D., L.T.C., Medical Corps, U.S. Army, and program director of urology at the center. "A big part of TeamSTEPPS is getting all team members and the team captain together at the right time and the right place."

TeamSTEPPS is a patient safety training program developed by AHRQ and the Department of Defense to improve teamwork skills among health care professionals.

As a result of TeamSTEPPS training at the San Antonio facility, preoperative briefings are conducted in operating rooms with all surgical team members required to arrive 30 minutes prior to each scheduled procedure. The briefings typically run five to 10 minutes, covering key aspects of all cases planned for the day in that operating room. Surgical teams also attend a postoperative briefing before leaving the operating room after each procedure; this briefing typically lasts less than five minutes.

While TeamSTEPPS was implemented throughout the surgical unit, officials conducted an evaluation of operating room efficiency and patient safety within urology services as a representative sample. Medical center clinicians studied the impact of TeamSTEPPS on urology-related surgeries in the year following the TeamSTEPPS implementation and compared several quality and efficiency measures in the year before the program was introduced. This included potential or realized patient safety issues, categorized by personnel, instrument/equipment, and support services, as well as average surgical time in minutes, on-time start rates for procedures, and the average time for a surgical case.

In addition to a decline from 16 percent to 6 percent in surgeries that involved potential or actual patient safety issues, the urology surgical team also saw:

Improved operating room efficiency, with a 10.1 percent reduction in average case time.
Improved on-time start rates by 20.9 percent.

"I think everyone has bought into TeamSTEPPS," Dr. Novak observed. "They see better, safer patient care. It has made an impact on the institution."

A study about San Antonio Medical Center's use of TeamSTEPPS appeared in the April 17, 2015, issue of the American Journal of Medical Quality. Select to read the abstract.

The view(s) expressed herein are those of the author(s) and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, the Department of Defense, or the U.S. Government.

Impact Case Study Identifier:

2015-37

AHRQ Product(s): TeamSTEPPS®

Topics(s): Cost, Patient Safety, Quality

Geographic Location: Texas

Implementer: San Antonio Military Medical Center

Date: 01/21/2016

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Page last reviewed January 2016

Internet Citation: AHRQ's TeamSTEPPS® Boosts Patient Safety, Efficiency for Texas Military Hospital's Operating Rooms. January 2016. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/policymakers/case-studies/201537.html