One of the interesting things about government programs, including those sponsored by the Department of Defense (with whom this educator worked for many years in his capacity as a military legislative assistant to members of the U.S. House and Senate Armed Services Committees) is the extent to which they represent themselves as revolutionary improvements when, more often than not, they are simple codifications of existing practices and policies. TeamSTEPPS is a case in point. It’s stated objectives, including improving patient safety and teamwork, integrating teams for more efficient administration of medical care, and improving information sharing and cooperation among and within departments or divisions, are simple commonsense goals that are shared by most organizations, including exceptionally large ones like the Department of Defense. That said, TeamSTEPPS does represent an admirable acknowledgement of the continued need to reduce barriers to information sharing and cooperation between teams and organizations.
The lessons of organizational failures from time immemorial involve failures to establish the requisite organizational structures, to train personnel in their missions, to identify and remove obstacles to cooperation, including information-sharing, and to improve the level of service or support to the “client” or customer. TeamSTEPPS involves a series of “phases,” one through three, “based on lessons learned, existing master trainer or change agent experience, the literature of quality and patient safety, and culture change.” [www.teamstepps.ahrq.gov/about-2cl_3.htm]:
Phase 1: Assess the need, which involves a detailed analysis of the existing system with special attention to training requirements;
Phase 2: Planning, training, and implementation, which involves “planning and execution” of the TeamSTEPPS program; and
Phase 3: Sustainment, which includes, among other measures, continued examination of the medical system’s operation to ensure quality does not diminish over time and to integrate new processes as they are developed.
TeamSTEPPS is entirely meritorious. There is an element, not unusual with the armed services, of “reinventing the wheel.” At its core, it sets forth the kind of organizational procedures that should have been in place for the past fifty years anyway. Teamwork and cross-organizational cooperation are always vital to effective performance. When the mission involves caring for service personnel wounded in combat or injured during training exercises, or providing health care for the families of those service members, the public expects professionalism. That a program like TeamSTEPPS is being developed in the 21st Century is a reminder that, the more things change, the more they stay the same.