Team Check-up Tool
CUSP Toolkit
Purpose of the tool: This tool helps assess unit strengths and opportunities for improving unit processes and upgrading unit safety culture.
Who should use this tool? Health care providers.
Directions: Your team should collectively complete one Team Check-up Tool every month and submit it to the project lead. The information collected will be used for individual coaching assistance and reported in aggregate with other units' Team Check-up Tool results.
State:
Hospital Name:
Date:
Knowledge/Skills |
Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree | |
|---|---|---|---|---|---|---|
| 1 | Five randomly selected staff members (e.g., nurses, physicians) from our unit can list at least three interventions that are part of the CUSP project. | |||||
| 2 | Unit staff are confused about how to proceed with project activities to improve safety. | |||||
| 3 | All staff can communicate the project's goals. | |||||
| 4 | All team members can list the number of days between incidents on the unit. | |||||
| 5 | There are good systems in our unit to ensure we meet the goal of <Insert a safety measure here>. | |||||
| 6 | There is a lack of quality improvement skills on our team. | |||||
| 7 | We perform a unit analysis for each incident using the Learning from Defects Tool. | |||||
| Attitudes/Beliefs | Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree | |
| 1 | We have had ownership from staff members in this unit. | |||||
| 2 | We have had good ownership from physician staff in this unit. | |||||
| 3 | We have had good ownership from nursing staff in this unit. | |||||
| 4 | Staff in this unit do not believe that <incident> is an issue for this unit. | |||||
| 5 | A junior staff member feels comfortable questioning a more senior staff member who is not following the <Insert a safety measure here>. | |||||
| 6 | Our senior executive can state three safety concerns the staff have identified. | |||||
| Resources | Strongly Disagree | Disagree | Neither Agree nor Disagree | Agree | Strongly Agree | |
| 1 | Our team meets at least once a month. | |||||
| 2 | There is not enough time to get our team's work done. | |||||
| 3 | Unit leadership (managers, physicians, opinion leaders) is stable (i.e., low turnover). | |||||
| 4 | Data collection has not been a burden. | |||||
| 5 | Staff do not have time to collect maintenance data. |
