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How to foster team training

Accreditation Connection, June 4, 2004

Departments can no longer function independently of each other now that the JCAHO expects hospitals to foster a team approach to healthcare.

Standard HR.2.30 states that facilities need to provide regular training and education for staff, students, and volunteers. Specifically, the standard rquires that a hospital's educational programs include team training.

One way to comply with this requirement is to follow the lead of Saint Clare's Health System in Denville, NJ, which has incorporated team training in orientation and inservice educational programs. During training sessions, leaders emphasize the importance of respecting all employees' advice and suggestions, says Jill McCaffrey, director of administrative services.

"We encourage employees on all levels-from the medical staff, to housekeepers, to leadership-to respect everyone on the team," says McCaffrey. "Whether staff are in a performance improvement meeting or caring for a patient, everyone should feel comfortable to contribute."

During training sessions, the human resources department uses the example of the chief executive officer (CEO) talking to a maintenance-staff employee in the cafeteria. A CEO that supports a team culture won't dismiss the maintenance worker's concern that he or she smells something burning. The CEO could respond that "Although it is probably the toaster, we should check it out in case it is a fire." A CEO that doesn't support this kind of team environment might brush off the maintenance worker's concerns by saying it is just the toaster, says McCaffrey.

To help encourage a team approach, Saint Clare's has focused on creating a "just culture," which means that it will investigate reported errors in a nonpunitive manner, says McCaffrey. However, a blameless culture doesn't mean that staff would never face disciplinary action if an investigation found that they were not fulfilling their job requirements.

The administration at Saint Clare's encourages staff to report medical errors, as well as corporate compliance or safety issues. Staff can report errors to their supervisors, contact the risk management department, or make anonymous calls to the safety and compliance hotlines, says McCaffrey.

During annual performance reviews, leaders at Saint Clare's evaluate how well staff participate in caregiving teams and how well they work with their colleagues.

For example, a leader could ask how comfortable staff are with reporting problems to their supervisors, says McCaffrey. If staff have problems relating to the team, they may need more education about how to work as a team or could benefit from working with a mentor.

"You need to instill the concept of team training in your staff," says McCaffrey. "Team training needs to be just as important as educating staff about fire safety, emergency preparedness, and preventing needle-stick injuries. You need to make it a priority at your facility."

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