About TeamSTEPPS

Summary of AHA Team Training and TeamSTEPPS

TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) is designed to help health care professionals improve patient safety and quality through effective communication and teamwork skills. The genesis of the material comes from the airline industry in the 1970s and ‘80s as well as safety movements in high-risk industries like nuclear power and the military. The Agency for Healthcare Research and Quality (AHRQ) and the U.S. Department of Defense developed TeamSTEPPS specifically for health care organizations in the mid-2000s. Health care teams that communicate effectively and have mutual support reduce the potential for error, resulting in enhanced patient safety and improved performance. From 2011-2017, the American Hospital Association (AHA) managed AHRQ’s National Implementation of TeamSTEPPS. With the federal program having ended in September 2017, the AHA is dedicated to supporting the movement in the form of AHA Team Training.

TeamSTEPPS competencies and teamwork tools

TeamSTEPPS curriculum is based on a framework of four core competencies.

Leading Teams

Direct and coordinate, assign tasks, motivate team members, facilitate optimal performance.

  • Brief
  • Huddle
  • Debrief

Mutual Support

Anticipate other team members’ needs through accurate knowledge, shift workload to achieve balance during periods of high workload or stress.

  • Two-challenge Rule
  • DESC Script
  • CUS

Situation monitoring

Develop common understandings of team environment, apply strategies to monitor team members’ performance, maintain a shared mental model.

  • STEP
  • I’M SAFE checklist
  • Situation monitoring
  • Cross-monitoring


Effectively exchange information among team members, regardless of how it is communicated.

  • SBAR
  • Check-back
  • Call-out
  • Handoff

WHY TeamSTEPPS? The evidence

Recent research estimates that medical errors took 400,000 lives1 and are the third leading cause of death in the U.S.2 The cost is minimal compared to the savings. Many studies have found that teamwork training can lead to a stronger culture of safety:

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Adoption of team strategies was higher with teamwork education, with up to 31 percent of staff adopting teamwork behaviors.3

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Teamwork training was associated with significant improvements in results on the Hospital Survey on Patient Safety Culture.4

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Teamwork training resulted in improved health outcomes, with one study showing a 60 percent reduction in falls.5

  1. James JT. A new, evidence-based estimate of patient harms associated with hospital care. J Patient Safe. 2013;9(3):122-128.
  2. Makary MA and Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;3(353):i2139.
  3. Jones KJ, Skinner AM, High R, Reiter-Palmon R. A theory-driven, longitudinal evaluation of the impact of team training on safety culture in 24 hospitals. BMJ Qual Saf. 2013 May;22(5):394-404.
  4. Thomas L, Galla C. Republished: Building a culture of safety through team training and engagement. Postgrad Med J. 2013 Jul;89(1053):394-401.
  5. Spiva L, Robertson B, Delk ML, Patrick S, Kimrey MM, Green B, Gallagher E. Effectiveness of team training on fall prevention. J Nurs Care Qual. 2014 Apr-Jun;29(2):164-73.