There we go. Because I need a microphone. 30 seconds remaining. 50 burpees go! There might be a laggard. I'm not gonna start early. Everybody just like stare at the door. Okay let's do this. Welcome to Thursday April 20th 145 p.m. Today's session is team steps. Okay thank you for attending the AAOE annual conference. The annual conference council has worked tirelessly to develop an amazing line of presentations for you. Please take a moment to turn your cell phones on vibrate. However please feel free to post to social media throughout the session. The AAOE annual conference hashtag is hashtag AAOE 2023. To continue to improve the education that is offered our event or at our events your feedback is critical. The AAOE annual conference whoa I got to slow down. The AAOE annual conference council reviews each evaluation to continue to improve the education and to better meet your needs. Please take a moment after the session to complete the session evaluation form. You can complete the form through the AAOE mobile app. Your feedback is invaluable when putting together events like this. In order to receive credit for the session be sure to use the mobile app and click the check-in icon in the sessions detail screen. Enter the check-in code and click submit I believe. Okay here we go. Yeah there we go. Enter the check-in code and click submit. The check-in code for this session is do I have a Vanna White 219 780 219 780. I like to make it fun guys come on. Okay today's session is team steps. The presenter for today's session is Andrea Allen. Andrea Allen is the clinic and sports medicine director for Heartland Orthopedic Specialists a service of the Alamir Health located Alamir Health located in Alexandria. My did I say all that correctly? Okay perfect. There we go. Located in Alexandria West Central Minnesota. She's been with the group for over 15 years and in leadership role for the past 10 years. Her current role includes oversight of day-to-day clinical and orthopedic physical therapy operations, leadership of orthopedic nursing, physical therapy, sports medicine teams, risk management, and participation in a variety of the hospital and organizations committees. Andrea has been active on the variety of council since 2013. Oh active on the AAOE since 2013. Is that what that's supposed to say? Okay. With the most recent involving being a board member on AAOE right? Yeah that's why she's got the big bright yellow lanyard. Yeah thanks Addy. Yeah so from one Andrea to another please join me in welcoming Andrea Allen. First things first I have no financial disclosures. All right so what are we going to cover here today? What is TeamSTEPPS? We're gonna my goal is to just really give you an overview of what it is. So you can bring this back hopefully to your clinics. Insight into how our organization has implemented this, our lessons learned, tidbits you might want to consider if you choose to bring this back. So see they switched up the order here a little bit on me. All right what is TeamSTEPPS? I'm guessing is a common question. So has anyone ever heard of this? Has anyone ever seen it in use? Do I have anybody? All right we're all brand new. That's awesome. So STEPPS actually stands for, it's an acronym, Strategies and Tools to Enhance Performance and Patient Safety. So this is an evidence-based set of tools. The training curriculum has a goal to successfully integrate communication, teamwork, and principles into any healthcare system. It is based on decades of experience and lessons learned from highly reliable organizations that actually come from military operations, aviation, and nuclear power. This is kind of interesting tidbits of it where it came from. It's been around for quite some time and continues to constantly evolve the curriculum and how it's presented. Interestingly it started with the Agency for Healthcare Research and Quality and the US Department of Defense. And so they started TeamSTEPPS in the mid-2000s and then in 2011 the American Hospital Association became involved with it and really helped with a national implementation. And then the federal program ended in 2017 so the Hospital Association has continued to support the efforts of TeamSTEPPS to this day. So why consider this? Honestly it's affordable. Majority, we'll get into this a little bit later, majority of your implementation expense is going to be training a master trainer or two or a team of them. It has proven results through a variety of studies that cover all aspects of the orthopedic clinic listed out here. Positive change behaviors, process efficiencies, increased patient satisfaction, cost savings, improved outcomes, enhanced staff satisfaction, engagement. And really those studies, the studies are out there and so again as we're working with physicians who sometimes really want that data, it has it. Absolutely even on that history it had a lot of studies built into it as they were putting it together. And then I will constantly be referencing this but I really encourage everyone to check out the website. I have it here at the bottom. It's on a lot of almost all of the slides because they have a ton of free resources out here on this website. Videos that you can help to teach it, all the they have webinars, it's a lot of great stuff. So just encourage everyone to go out there like I said I'll reference that again here a couple more times probably. So all right we're gonna get into the nuts and bolts of TeamSTEPPS. I want to go through this. It'll go a little quickly but I just felt it was important for you to see the actual content that goes into most initial training sessions. So again as you can see how you may roll this out at your clinic. So the flywheel on the left helps gives us an overview and representation of the four competencies, areas of focus that really build TeamSTEPPS and really always have that focus back around our patient, family, and care teams which we know is what we're all focusing on daily. So as we're leading teams we're taking in you know we're just really considering how can we keep our teams aligned, keep them task-oriented, keep the teams motivated. Situation monitoring as our teams are working, what are some common understandings that they can all work together from to enhance their performance, to be more efficient and effective in what they're doing. Communication we know this is all vital to everything we do. No one's ever perfect I like to say and everyone can always improve on communication. And so here we give team members some shared techniques and tools that they can help ensure efficient accurate communication really on a consistent basis throughout the day. And also kind of go to go to tools for maybe some of those more intense situations. And then mutual support. Lastly but not least really looks on how can we ensure our teams are working together, they have each other's backs, and ensure that anyone feels they can speak up at any time. Again it's not a hierarchy system. Everyone's on the team, everyone should be able to speak up. So specifically with communication these are the the tools that we most commonly or that I most commonly tend to highlight. Again these are tools that you can use in your daily interactions amongst your teams. Hopefully you'll quickly see how getting into the habit of these can really actually save you time in addition to unnecessary frustration or misunderstandings. It might take an extra second or minute but really look at what you can save by taking that extra second or minute. And that should show that in the long run again it's worth it. So SBAR this is one that I really I know nursing tends to use a lot, clinical uses it a lot, but I challenge us all to say all areas of our clinic can use it including the non-clinical folks in RevCycle. And so that's just something to consider it it's not just clinical even though I know that's probably the most common place we do see it used. There's call out, there's check back. This one I call close the loop. I feel it's so important especially in our fast-paced lives, our can't you read my mind conversations. And so really check back is think about all the times the statements made, there's confusion, was that an ask, were they just stating that, was up to be an action item, you know you're kind of just left going not really sure. So think about check back then as a way that an example that I would say is the physician says let's get an MRI. And I check back with her and I say so I'm gonna order a right hip MRI arthrogram. Yes that's correct and send it to Reyes. That would be your check back. So the physician said something, I'm working with them, I checked back, they said yep confirming I heard it right. And they remembered that they forgot one detail where to send that order. And so again it it's a great example I find of it takes maybe 30 seconds to do the three steps. But think about everything that you were to cover when you say something back to someone how often do you notice oh that's not what I meant even as you're the one telling. And so that's when I really really like to use handoffs. Really I like to phrase this as this helps set the next person up for success. Patients family members are constantly being passed from one employee to another team throughout their journeys of our clinics. And so how can we allow that next person in line to really pick up where we left off and and try to maybe when we can and when it's safe limit the repeats. Asking the same question every time trying to get an idea of where we're at what you're here for you know. Sometimes we do have to ask those questions but again how can you set that person up for even just the phrase of handing off and being like I know you're in great hands here with so and so. All right leading teams. So really consider where you could implement this concept. Again every department can do them and so the concepts are brief, huddle, debrief. So a brief always is going to happen at the beginning of a day at the start of something beginning of a week. Your huddle is going to kind of be an ad hoc as needed as you're going through that day going through that week maybe in the middle of a urgent situation. And then your debrief happens obviously at the end and it's really important that your debriefs are always timely and really timely in that do it the same day do it at the end of the day. What went well, what could have gone better, what are our opportunities are typically the three three three hits I always take people through. And really again doing it timely doing it at the end of the day allows everybody to get that conversation out to share their thoughts their viewpoints. Everyone should speak up in these because again everybody sees things differently as maybe you're dealing with a clinic that totally went sideways 45 minutes late or a patient who got the wrong x-rays or just think about the different hiccups you experience throughout the day. But then everyone gets that out you take it down and you go home for the day and you're not wondering like gosh holding it with you when are we gonna talk about this those types of things it just happens right away and they don't take long. All all three of these don't need to be more than really five minutes maybe if it's a bigger situation they could go a little bit longer but they don't have to be time-consuming. So I just gave some examples of where we brief within our organization start of clinic days the nurses the athletic trainers rad techs all meet to really get a good idea of what the needs are for x-rays because we know that that's a typically a sticking point of clinic flow. And then they have a game plan for the day our OR team anesthesia do it each morning again to kind of have that game plan who's gonna be in what room who's taking what cases what's the anesthesia types. And then we have our like our IT and our HR teams that brief on a weekly basis so they brief to start the week and they debrief at the end of the week really kind of saying like what is what are maybe some different schedules what are the projects for the week focuses and then at the end of the week they debrief okay did we get those projects done nope this came up instead so that they can kind of wrap up the week go on to the weekend and and then jump into to the following week. Situation monitoring this is this is good awareness just a concept to remind employees that it's easy and natural to get lost in a situation or the day we get busy we do it we're doing things so fast so furious repeat on repeat sometimes and so just a couple of again tools that they can become very familiar with and ensuring that they're they're always having that situational awareness of what's going on. Think about one example I like to say is you know think about when a clinics running behind who's the first to notice it's not the surgeon it's the front desk commonly it's not the nurse because she's just bringing every patient back she can find okay so situation monitoring is we need the front desk to say something like do you realize you're 45 minutes behind no I mean I know I've been busy but no you know and so then that's a great opportunity to go back and huddle quick and say okay what's our game plan are we gonna be able to catch up is he stuck in the ER or what are we gonna tell patients how can we make sure we're phrasing it giving those little options and so again anyone on the team can speak up at any point in time to recognize something's off is how I another way I kind of will will phrase it you know surgeons are actually I always point out kind of trained to lose that situational awareness in the or they depend on the or team to have their backs to have know what's going on in the room and so again it's just knowing the importance of this and and keeping it at the front and speaking up like who's gonna notice somebody's agitated a patient or a family member anybody may notice that that might be facilities because they're just walking through doing who knows what you know it it really can be anyone on the team to recognize that and so anyone can recognize it anyone should recognize it speak up and then get the team then you kind of can go back to some of your leading of team steps of maybe huddling or such and our last module here mutual support so to work efficiently is really the goal here ensure outstanding patient experiences positive outcomes and to have engaged employees I really it's we must have each other's backs and that's really what I really like to put mutual support in so there's a couple of tools here the two challenge rule because you can cuss and again you're concerned you're uncomfortable this is a safety issue or I really the one I wanted to highlight here is desk it's a great tool in times of conflict or maybe you just have two people that aren't working together or just not jiving and this is really a great tool that two staff people can use they can know that I okay I need to describe what's going on I need to express what I'm seeing what I'm feeling what are my suggestions what are some consequences to what I'm seeing and again it's just something that they can remember and we had a great example of this just recently between a phlebotomist and a who was brand-new really young and a nurse who was very experienced been with the organization for a long time and the phlebotomist got down to lab and just felt totally distraught by the situation with the way something went down and was said in front of the patient. And so they were able to, it was so cool. They obviously first talked with their supervisors, but then on their own, the phlebotomist asked the nurse to just, can I talk to you? Went through a desk and explained how she felt in that situation. The nurse felt horrible, had no idea that's how she'd come off. That's how her words came across. And then it was total happenstance that one of their supervisors was in the area and she's like, I hear this all going down and then there's a hug. Okay. So there's a situation where two people could have had a beef against each other for a couple of weeks, who knows, forever. But that person spoke up really quick, just said, hey, that situation back there five, 10 minutes ago, this is ran right through desk. And then look, they were able to bury the hatchet, like a better description and move on with their day and really grow from that situation. They have great videos to just even out on the website. They have one where two staff people, somebody is always late to a staff meeting. The other one has to cover. So again, some pretty relevant concepts within our clinics. And then two staff people gossiping at the front desk about the doctors. So how do you handle that discussion? And so again, I just, the website has great resources that I would encourage you to check out. All right. So a little bit about our story and where we've been. Big overview, we started this in 2015. We did an initial introduction session with our key leaders and providers across our entire organization. From there, we trained and formed our own master trainers, which I am a master trainer with TeamSTEPPS. And so these are in-person, mostly training sessions. All staff and providers went through an introductory session back in, I think it was more like 2016 by the time we got there. We've formed a TeamSTEPPS team. It's multiple, but a team of us that are the master trainers that really work to keep the efforts going. We're a point of contact for any leaders that may want to refresh those types of things. And then we are still educating new staff and physicians, providers on a monthly basis. So I'll go dive into each of these a little bit further. That initial introduction session that we did, we brought external master trainers on site. One happened to be a healthcare leader. One was a physician. So kind of that dyad piece again. It was offsite, so we could be focused. And it was like a half to three quarters of a day long. So it was intense. It was a lot of information. It was a select group of our leaders and physicians. Our master trainers happened to be out of Minneapolis-St. Paul area. So they were able to come out. And it was a lot of information. And in hindsight, maybe too much and not enough time because that's just the reality of everything that all the information that's out there. But it got us going. And really, you have to start somewhere is what I would say to this. And this is how we kicked it off. Just a piece as I kind of take you through our journey here a little bit. I mean, at this time, we were a recently integrated system. So an orthopedic clinic, a hospital, and a multi-specialty group that had just integrated. We had three missions, three values, no commonality across us all as we kind of joked around at that point. We were kind of newlyweds going, okay, what are we doing here? We're all integrated. We're all a service of. And so really, this was a tool that we were able to bring to all of our teams as one to kind of get us all on the same page. And then, so the formal training for master trainers, I believe it's still two days. Sometimes you can see a variance there, but it's about two full days. It's a lot of content. They're very interactive sessions, mixed lecture. They introduce some of the videos, activities, really giving you education around the curriculum, but also helping you to teach the curriculum, knowing you're going to go back and teach it. It's a great... So we've always sent at least two people because it is really great learning and sharing across our teams and those attending. You share like what your organization has or hasn't done, or how you think you may go and implement this back once you go back to your organizations. And so they do currently, obviously, within the last couple of years, they went to an online version. They still have in-person. We actually, just a tidbit here, again, kind of lessons learned is we had somebody do, we had a couple of people do the online version, self-paced, on your own, did it great. She completed it. And then she just attended an in-person session just in the last six months. And she's like, whoa, I don't know what I did on my own online, but that was not what I got covered in the in-person session. So really from that, we learned the value of honestly sending them to an in-person session. There's just so much more that even these two individuals got out of attending in-person. And here they felt like they'd completed it online and it just didn't quite set in the same way. So that was very interesting because we were kind of excited when they released the online. But I would say a recommendation would be to attend in-person. So are all staff and physician training initial rollout. And you have heard me correctly, all physicians attended. Okay. And that was an intentional piece that we put out there and they attended. And honestly, at the end of it, they all survived. It wasn't so bad. And what we did was it was about a two-hour session. So we tried to keep it pretty condensed. We worked hard to get, we did assign groups. And again, that just allowed us to get a variety of teams and roles across our entire organization. Again, being a hospital, orthopedic clinic, multi-specialty group, just to get different specialties, different teams in the rooms together, interacting with each other. Again, we were all kind of new to each other. And so the initial rollout is tough. I don't think that, you know, this is one of those where there's no right or wrong. You just kind of have to pick something and try it and go with it and you'll get it rolled out. In that two-hour session, we did do a mix of lecture videos, team activities. Team activity is, there's numerous different activities you can do as you teach this, but we happened to do a paper chain one that got people competitive because, you know, in healthcare, we're always competitive. And so people to this day still talk about, oh yeah, my team rocked that paper chain. And others are going, yeah, we couldn't figure that out for the life of us. And then we handed out pocket guides. So that is something you can purchase. That would be another expense if you were to roll this out, but we've really found it valuable for each employee to have their own personal pocket guide. We encourage them to take it with them, put it in your locker, put it on your desk. It's your quick reference to all those tools that I just went through. So even when they're in that situation wondering, now, what was that? How can I do this? They can quickly reference that back. So we did choose to give everybody one of those at that time. So our TeamSTEPPS team of Master Trainers, we at this time are meeting quarterly. Again, it's comprised of our Master Trainers. We set annual goals, focuses around really commonly we'll pick a TeamSTEPPS focus for the year. Last year, I think we did feedback. This year, I forget what we're doing. That's horrible. But each year we set one and that's really just a focus that all departments can really settle in on and focus. Sometimes there may be a reason why we pick what we pick. Other times we just feel it's a good topic to cover. We haven't covered it for a couple of years maybe. And then we are available to support departments as needed. We will conduct review sessions. Let's see. Yeah, I think, and again, we were a group of probably about 900 that we were trying to roll out for. So our team is approximately six to eight people. We kind of vary. So it's not a large team. It's a doable team. And then we teach monthly new staff introductions. We keep the content current. We've updated the videos. Obviously, over the last few years, there's been much more entertaining videos to add. So we've tried to keep it fresh as we go. All right, so our new staff and physician monthly sessions. And again, so any physician or provider that joins our organization or new employees, they will be able to do a or new employees. They all attend a monthly. We hold monthly sessions so that anyone who's joined in the last month attends. And this is a piece of, we call it service excellence half day. But a piece of that service excellence is a TeamSTEPPS session. So we've gotten it down to a 50-minute session that is a mix again of lectures, videos, team activities. So I talked about the paper chains. That one, you're like huddled at a table together. So obviously, for a few years, we couldn't do that. So we went to a drawn object, which was a little bit better. We spread people out. But that one's actually been pretty fun too. And so we also still give out the pocket guides again, just really valuing that they can take something back with them to reference, to quick glance at, to help them use the tools throughout their days. And so the people that are attending these sessions have been with the organization about two to six weeks. So we also, it's fun to say, hey, have you noticed any of these tools being used amongst your team? And a lot of times, sometimes they'll be like, well, yeah, I never knew it, but we're briefing. And just those types of things. So we can help really drive home what they're seeing, why they're doing it. And then one thing that's fun too, as we set the tone for why are we going through this is just, we kick our sessions off with a interactive piece of, think about a total joint patient that comes into our facility for their surgery. How many teams do they encounter in there? Maybe they're here for eight hours, maybe they're here for 32 hours and we have them call them out and really start thinking how many teams is it? This one patient and their family members are, we've got registration, we've got x-ray, we've got the surgeon, we've got the surge checks. You just start pharmacy. They probably maybe got some food afterwards or at least some drinks and water and pharmacy. And then we have our coders and just think about all the teams that go into us providing that surgery. And so it really tries to bring in the importance of all teams have to work together because we all are working on the same task. Then we flip over to say a clinic visit. Okay, that might be 20 minutes, 30 minutes, maybe 60 minutes max. Think about all the teams that go into making that clinic visit happen. And so that's just again a way to make sure that all know their teams are involved, are important, and really play a valuable role in these different services that we're providing. So that's kind of a fun way that we kick off and try to introduce the sessions. So challenges, what's next? Honestly, our largest challenge over the last eight years has been our turnover of master team trainers. You know, you have those groups that it's like the minute we got someone trained, they like left. And we're like, oh no. So for a while it was down to me and one other person. I think I'm the only original one from the initial group in 2015. But that's where I said we've kind of landed on a goal of having six to ten available, again for our group size, so that we're not having to teach it every month. We do like one or two months a year. There's many of us that can jump in to help a re-education session that might be requested. So our HR director now currently, who is a senior leadership team member, leads the team, which has been a really nice fit. For a while we kind of, we didn't maybe have as much. It was just happenstance, kind of, who may have led the team. And really having our HR director has been just a good fit for these tools and the topic, to be honest. And again, as I mentioned, we keep all the curriculum updated. We do retrains with teams as needed. This is where really, this shouldn't be used as a punitive measure. So as we've, some of those situations have come up and they've asked for a retrain. I know at one point they wanted to just do one-on-ones, and we did it. And afterwards, I happened to do one of them. It happened to be with a physician, and somebody else did it with the other staff member. And what we're training is working as a team. And so if we can't train them as a team, it just, it doesn't work. You know, I got done with that session and I was like, I talked with the HR director and I was like, okay, I know we did this. I know we didn't love what we were doing as we did it. We did it. We're not doing that again. And so really, again, if a team's just not jiving, having some issues, and we have done it now, retrained as a team, it works great. Because again, you're working as a team all day, so train as a team. Really, I would encourage that, again, kind of through our lessons learned. If you know what issues they're having, handoffs, mutual support, having each other's back, you can, again, we work with the leaders to know that, and then kind of maybe focus in the training there, give a few more examples there, or have some discussions. And have them ask about, hey guys, how do you think you could use these? So they do kind of become interactive on the retraining front. As we look to, you really do have to embed this within your organization. And that ties into ensuring accountability across all teams and positions. We've embedded it within our annual reviews so that it's standardized. It's centered around our values, which happen to be integrity, accountability, excellence, hospitality, and compassion. Each one of those has corresponding behaviors in it. The use of TeamSTEPPS is tied into a couple of those different areas. So yes, we have finally gotten to one mission, one vision, one values across our system. And again, as I kind of went back to do this, I was like, okay, we have come a long way since our newly integrated state. And we do commonly use this, and I said not punitive, but we definitely do use, again, encouragement of these tools as we may be dealing with coaching sessions, performance improvement plans, day-to-day team operations. So it really, when you're identifying that something's just not working, a lot of times you can go back and grab one of these tools to help move the team forward. And so, like I said, we're, this is really, it's been huge for us. We continue to enhance things. We've grown as an organization. And so, we have just developed Alamir Experience, which is a little bit more on the actual customer service standpoint. We're just rolling that out now. It has 13 modules. And so, we're already envisioning it's going to be tricky doing both TeamSTEPPS and Alamir Experience. They're very different and very similar. So we're figuring out how maybe we can blend them together because we're doing another initial rollout with everybody. And so, again, that's just a challenge. We're doing it a little bit differently this time and doing, on the Alamir Experience, we're doing one module a quarter, trying to hit department meetings, holding group sessions as a way to reach everybody. Again, staff and physicians are all attending those sessions. And so, like I said, we totally plan to keep TeamSTEPPS going, but how we can meld it into our new program that we've brought out of Alamir Experience is something that we're working on now just because we know keeping up two programs can be tricky. But they really, they happen to mirror each other. So lastly, again, I said it earlier and I can't say it enough. Seriously, check out this website. A ton of free resources. They have great e-newsletters. They have ongoing webinars that you can sign up for that you really, you can just listen to them. They're great. And really, it keeps, this is a very affordable tool that you can really bring on. And that's really what I like about it. It's not, I know there's a lot of different tools out there, but sometimes they're expensive and we don't have that. And so that's why I really wanted to share this. And so also check out YouTube. Actually, a lot of their videos are out there also. And that's where you can see if it's, if the video or content is AHRQ, that's a little bit of the older content. The newest content is actually the AHA, American Hospital Association, because they're currently keeping it going. So there's that checkout code we all need for those CEUs. So 047-615. And then also for the AAPC. Give everyone a moment there to catch up. Your code there is 83584STU. And then I'm hoping I left some time, that was my goal, for questions. So really I would, what questions do you guys have? I put my email address, phone number up there. Happy to be a resource. Yeah, you know, it's, what's this? Why do I have to do this? Drag the physicians in by their ears a little bit. Yeah, I mean, I think, you know, with any new initiative you try to roll out, to be honest, we're dealing with the exact same pushback as we roll out Alamir Experience. Why do I have to do this? Instead of seeing like, hey, we're offering this to you. Look at, I mean, you can use a lot of these tools at home, too, with the family members or your spouse or, you know. So yes, definitely there's that pushback. But again, it was across all leadership of all sites that, hey, we're doing this. Everyone's attending. And really holding to that just, yeah, there's some people that sat in the room like this. And then there's some people that warmed up as the session goes on. So that's what I would say. And like I said, ironically, now we're seeing the same thing as we roll up that our new customer service initiatives, so. Other questions? Yes. So, I'm sorry, you were talking about this new program you're rolling out. Yeah. What's it called? We termed it Alamir Experience. So Alamir Health is our overarching name. And so it's what, it's a customer service initiative, really trying to frame all of our employees around how can we improve the experience for everybody, for our patients. And then really another piece of it is think about who your customers are. And so we're just rolling out effective communication. And so I taught that a couple of times last week and I'm totally tied into TeamSTEPPS on that one. So it's something we decided to roll out to try to focus on patient experience. Yep. And so, but like I said, we're finding that TeamSTEPPS and it are very similar. All right, well, I won't keep everyone here, so thank you. I'll stick around if you do have just questions wanna come up. Thank you so much, Andrea. I also am surprised that you had no physician loss of life going through that. That's fantastic, great, yeah. Okay, everyone, thank you so much. And again, if you need the AAPC credit, you can come up here and get it. And I'm gonna go ahead and turn it over to Andrea. If you need the AAPC credit, you can come up here and grab that from me. Or actually, we can go to this. Oh, too many cooks in the kitchen. There we go. Okay, enter that code in the mobile app by clicking the checkout icon and click submit. And as a reminder, please be sure to complete the evaluation for the session and the mobile app. Your thoughtful and constructive feedback ensures that future programming meets your needs. Thanks all and have a great rest of your day.

TeamSTEPPS

communication

teamwork

patient safety

SBAR

call out

check-back

mutual support

training sessions

customer service initiatives

continuous improvement