title: Practice and quality improvement: successful implementation of TeamSTEPPS tools into an academic interventional ultrasound practice.
abstract: OBJECTIVE
  The goal of this study was to implement an evidence-based teamwork system to improve communication and teamwork skills among health care professionals (TeamSTEPPS) into an academic interventional ultrasound program and to assess safety and team-work climate across team members both before and after implementation.
  
  
  METHODS
  Members of a change team (including master trainers) selected specific tools available within TeamSTEPPS to implement into an academic interventional ultrasound service. Tools selected were based on preimplementation survey data obtained from team members (n = 64: 11 attending faculty physicians, 12 clinical abdominal imaging fellows or residents, 17 sonographers, 19 nurses, and five technologist aides or administrative personnel). The survey included teamwork climate and safety climate domains from the Safety Attitudes Questionnaire. Four months after implementation, respondents were resurveyed and post-implementation data were collected.
  
  
  RESULTS
  Teamwork climate scores improved from a mean of 67.9 (SD, 12.8) before implementation to a mean of 87.8 (SD, 14.1) after implementation (t = -7.6; p < 0.001). Safety climate scores improved from a mean of 76.5 (SD, 12.8) before implementation to a mean of 88.3 (SD, 13.4) after implementation (t = -4.6; p < 0.001). In particular, teamwork items about "input being well received" and "speaking up" were the most responsive to the intervention.
  
  
  CONCLUSIONS
  The implementation of TeamSTEPPS tools was associated with statistically significant improvements in safety and teamwork metrics in an academic interventional ultrasound practice. The most notable improvements were seen in communication among team members and role clarification. We think that this model, which has been successfully implemented in many nonradiologic areas in medical care, is also applicable in imaging practice.
authors.affiliation: 1 Department of Radiology, Duke University Medical Center, DUMC Box 3808, Durham, NC 27710.
authors.forename: Rajan T
authors.initials: RT
authors.lastname: Gupta
authors.forename: J Bryan
authors.initials: JB
authors.lastname: Sexton
authors.forename: Judy
authors.initials: J
authors.lastname: Milne
authors.forename: Donald P
authors.initials: DP
authors.lastname: Frush
mesh_terms: D000046:Academic Medical Centers / Q000458:organization & administration*; D019091:Critical Pathways / Q000458:organization & administration*; D017408:Guidelines as Topic; D009657:North Carolina; D010348:Patient Care Team / Q000458:organization & administration*; D015397:Program Evaluation; D058996:Quality Improvement / Q000458:organization & administration*; D017751:Safety Management / Q000458:organization & administration*; D018084:Ultrasonography, Interventional / Q000592:standards*
keywords: TeamSTEPPS; evidence-based teamwork system; interventional ultrasound; noninterpretive skills (NIS); practice and quality improvement