Team Stripes is a framework used to enhance teamwork and communication for clinicians working at the point of care. It is practical and structured and, recognising the diverse needs of most health care units, it is designed to ensure an individualised unit-specific approach to safety and quality improvement.
Figure 1: The Team Stripes framework
Recognising the diverse needs of most health care settings, Team Stripes starts with a discovery phase (Stripe 1) to gain an understanding of the current state. Participating teams work sequentially through each Stripe to gain a maximum of four Stripes before starting again.
The use of improvement science methodology is needed to progress through the Stripes and teams are supported when building capability in using this methodology. This approach and the ability to choose programs based on priority will ensure sustainability and a unit-specific approach to safety and quality improvement.
Team Stripes is informed by an extensive literature review, draws on the key characteristics of clinical microsystems and builds on the work of the CEC's In Safe Hands program. Clinical microsystems in health care are where hands-on patient care is delivered. They are made up of clinical and non-clinical staff, patients and their families and carers.
The use of the Team Stripes framework will equip clinicians with the tools, education and system awareness to foster a culture of safety with no tolerance for preventable harm.
The discovery phase, designed to help clinicians gain an understanding of the current state of their clinical unit. A key component of Stripe 1 is the invitation to clinical teams to measure their safety climate by either using a validated survey tool or facilitated team conversation. These results are aligned with other diagnostic data considered relevant by the clinical team. Data such as, but not limited to, patient compliments and complaints, voluntary reporting (such as ims+) and hospital acquired complications.
Effective teamwork and communication are foundational elements in building a culture of safety and are key elements of high reliability organisations. High reliability organisations are organisations which recognise that normal mistakes and errors occur. However, they are able to avoid catastrophic harm despite their high risk environment. Our inability to communicate effectively within teams and with patients and their carers is directly linked to patient harm.
In Stripe 2 we focus on introducing fundamental elements to harness strengths and improve teamwork and communication. The 'Safety Fundamentals' are practical, most require a short implementation time and have the potential to bring quick measurable gains.
An area of need or risk is identified through the diagnostic and communication work which will provide the focus for the improvement initiative. Through the guided gap analysis in Stripe 1 teams will decide on their improvement priorities and be guided to resources which they can tailor to the unique needs of their specialty area. At this time the capability of the team will be assessed in relation to their knowledge of improvement science and, if required, education can be provided.
The team will review preceding work to ensure all issues were addressed and no unintended consequences of the improvement have occurred. Evaluation is completed and any outstanding issues are identified. Improvement and safety become business as usual which will bring the team back to Stripe 1.