T.A.L.K. S.H.O.P. “Teamwork Accelerating Learning & Knowledge through the Support & Helping of Peers”

Oregon Health and Science University, Portland, Oregon

Nov 20, 2024

CSI Summary

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CSI Presentation

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CSI Toolkit

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Project Topic:

Addresses the identified needs of improvement in the AACN CSI Academy HWE Standards of True Collaboration and Skilled Communication

Hospital, City and State:

Oregon Health and Science University, Portland Oregon

Unit:

13A Trauma Acute Care

CSI Participants:

  • Rob Miller, BSN, RN
  • Allison Rogge, BSN, RN
  • Antonia Rose, BSN, RN
  • Victor Zayas, BSN, RN

Project Goals/Objectives:

  1. Increase standard scores for AACN Healthy Work Environment Assessment Tool (HWEAT) True Collaboration and Skilled Communication to at least 4.00 (Moderately Healthy), which is a 33% improvement from initial survey results.
  2. At least 50 entries will be posted from various 13A staff on the T.A.L.K. S.H.O.P online message board for feedback, recognition and unit-specific knowledge transfer.
  3. The team will have completed a debrief huddle utilizing the TeamSTEPPS debrief tool after at least 80% of qualifying significant events.

Project Outcomes:

  1. Our HWEAT standard score for “True Collaboration” was 2.85 (preclinical score was 2.86), relatively unchanged. Note: Postclinical HWEAT survey participation was N=25/68.
  2. Our HWEAT standard score for “Skilled Communication” was 3.18 (preclinical) and decreased to 3.10 (postclinical). Note: Postclinical HWEAT survey participation was N=25/68.
  3. 44 entries were posted on the T.A.L.K. S.H.O.P online message board for feedback, recognition and unit-specific knowledge transfer.
  4. We didn’t meet our debrief tool completion, as we put this on hold after month 10.
  5. We didn’t correlate nurse turnover with this project, but this is a potential future fiscal impact.

Project Overview:

Upon completion of the initial HWEAT survey, 13A Trauma staff indicated there was a need to increase True Collaboration and Skilled Communication within the unit. With a large number of newly hired nurses over the past two years, our CSI/Healthy Work Environments team observed there was a need to foster a more welcoming culture on our unit while also helping to support more senior staff. To foster a culture of excellence, professional development, reflective learning and inclusivity on the unit, we focused our project on giving and providing constructive feedback between peers and supporting staff after significant events and improving patient outcomes/ KPIs through debriefs.

Our team developed an online tool called the T.A.L.K. S.H.O.P feedback tool, accessible via QR code posted in the nurses’ station and the Knowing How We’re Doing Board. The tool allows staff to provide direct feedback or recognition to their peers and allows for the feedback to be provided anonymously if they so choose.

Additionally, our team made progress to incorporate the TeamSTEPPS debrief tool into the work flow of charge nurses to support other staff after qualifying events, such as rapid responses, code green (a processed response after a violent or aggressive patient) or other significant patient events. However, in August (month 10) there was difficulty with getting this work flow to progress so we determined we would put this on hold with plans to readdress the debrief process after the completion of the Healthy Work Environments project.

Overall, there has been an increase in people expressing that they are providing feedback in real time. Our T.A.L.K. S.H.O.P. feedback tool is still available, and we have had even more participation since our official project end date. We have also had providers and ancillary trauma team members interested and participated in the feedback tool. Furthermore, we successfully added how to give and receive feedback into our unit’s new hire onboarding education in order to sustain our project goal fostering a supportive and inclusive culture on our unit beyond our Healthy Work Environments’ project completion.

Permission to Reuse Materials
The materials associated with this AACN Clinical Scene Investigator (CSI) Academy project are the property of the participating hospital noted above, not AACN. Requests to use content contained in the CSI team’s summary, presentation or toolkit should be directed to the hospital. We suggest reaching out to the hospital’s Communications, Marketing or Nursing Education department for assistance.

Disclaimer
The AACN CSI Academy program supports change projects based on quality improvement methods. Although CSI teams seek to ensure linkage between their project and clinical/fiscal outcomes, data cannot be solely attributed to the project and are estimations of impact.