Module 5

SITUATION MONITORING
(DRAFT)

SUBSECTIONS
•
•
•
•

Teamwork Exercise #2
STEP
Situation Awareness
Shared Mental Models

TIME: 45 minutes
VERSION FOR REVIEW ONLY; NOT FOR DISTRIBUTION

INSTRUCTOR OUTLINE: SITUATION
MONITORING

Situation
Monitoring

Instructor Note: In this module, you will present information
about situation monitoring. Participants will learn how to identify
relevant information that will inform situation awareness and
create shared mental models.
The Situation Monitoring module includes the content provided in
the outline below. More content is available than can be covered
in the time provided; therefore, optional content and activities are
noted. It is strongly recommended that instruction not focus solely
on lecture, but also include exercises, videos, and other activities.
As such, instructors should use the information below to plan how
the module will be taught within the time available.

Slide
MODULE
TIME:
45 minutes

MATERIALS:
• Construction
Paper
• Tape

Content

Page #

Approx. Time

• Scissors
• Flipchart or
Whiteboard
(Optional)

1.

Teamwork Exercise #2

5– 6

10 mins*

2.

Introduction

7- 9

4 mins

3.

The STEP Process

10 - 15

10 mins

• Markers
(Optional)

4.

Situation Monitoring
Exercise

16

5 mins

5.

Situation Awareness

17 - 18

4 mins

• STEP Subacute
Video (STEP_
Subacute.mpg)

6.

Shared Mental Models;
When and How To Share

19 - 21

10 mins

7.

Practical Exercise

22 - 24

25 mins*

• Cross Monitoring
Subacute Video
(Cross_
Monitoring_
Subacute.mpg)
• Exercise Script

8.

What Do You See?; How
Shared Mental Models
Help Teams

9.

Tools and Strategies
Summary

25 - 26

5 mins

27

2 mins

28

5 mins

10. Applying TeamSTEPPS
Exercise

• Exercise Role
Information
• Exercise Care
Plan Questions
to Consider

*Although all instructional content and activities are recommended to

• TeamSTEPPS
Implementation
Worksheet

ensure that participants achieve the learning objectives, these activities
may be considered “optional” if time is constrained.
Continued…
TeamSTEPPS for Long-Term Care | Situation Monitoring

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Situation
Monitoring

INSTRUCTOR OUTLINE: SITUATION
MONITORING (Continued)

Slide
Additional Resources: Below are sources of additional
information and videos you may wish to use to customize this
module to your participants.
•

TeamSTEPPS for Long-Term Care DVD: The
TeamSTEPPS for Long-Term Care DVD includes Specialty
Scenarios and additional videos that can be used to
customize your instruction.

•

TeamSTEPPS 2.0: Includes videos specific to the use of
the situation monitoring tools and strategies in multiple
hospital settings.
• http://www.ahrq.gov/professionals/education/curriculumtools/teamstepps/instructor/fundamentals/index.html

•

TeamSTEPPS for Office-Based Care Version: Includes
videos specific to the use of the situation monitoring tools and
strategies in the primary care setting.
• http://www.ahrq.gov/professionals/education /curriculum tools/teamstepps/primarycare/

•

TeamSTEPPS Rapid Response Systems Module (RRS):
Includes videos specific to the use of the situation
monitoring tools and strategies by Rapid Response Teams.
• http://www.ahrq.gov/professionals/education/curriculum tools/teamstepps/rrs/

•

Comprehensive Unit-Based Safety Program (CUSP)
“Implement Teamwork and Communication” Module:
Includes information on some of the situation monitoring
tools and strategies taught in TeamSTEPPS.
• http://www.ahrq.gov/professionals/education/curriculum tools/cusptoolkit/modules/implement/index.html

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Situation
Monitoring

(OPTIONAL) TEAMWORK EXERCISE #2
Instructor Note: This is the second iteration of the teamwork
exercise conducted at the beginning of the course.
SAY:
You’ll recall our paper chain exercise from earlier. Please get back
into your teams, and this time, identify a team leader.

Slide

DO:
Take the leaders out of the room and brief them on the exercise,
using the information below.
SAY (Only to team leaders):

TIME:

When we return to the room, you will direct your team to make the
longest paper chain possible. This time, however, team members
may only use their non-dominant hand, and there will be no talking.
You will have 30 seconds to brief your team. At the end of the 30
seconds, the talking must stop. You will have 2 minutes to work
after I say “Begin.”

10 minutes

ASK:
•

MATERIALS:
• Construction
Paper
• Tape

Does anyone have any questions?

• Scissors

DO:
Provide the team leaders with the materials and return to the
room.
SAY:
You now have 30 seconds to brief your team. After this briefing
period, I will say “Begin” and you will then have 2 minutes to work.

• Flipchart or
Whiteboard
(Optional)
• Markers
(Optional)

DO:
After 30 seconds, say “Begin.”
At the end of the 2 minutes, tell the teams to “Stop” and identify
the longest chains. To conclude the exercise, conduct a debrief
using the discussion questions that follow. You may wish to list
any key points identified during the discussion on a flipchart or
whiteboard.

DISCUSSION: Go to next page >
Continued…
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Situation
Monitoring

(OPTIONAL) TEAMWORK EXERCISE #2
(Continued)

Slide

DISCUSSION:
• What did the leader do before the exercise began?
•

Was there a clear plan? What was the plan?

•

Did you have a clear understanding of your role and
responsibilities? If not, what information would have
been helpful?

•

Did you know the roles and responsibilities of others on
your team?

•

Did your role change during the exercise?

•

How did the lack of communication during the task affect
your work on the task?

•

Were other communication techniques used? If so, what
were they?

•

Given the information your leader shared at the start of
the exercise, what were you monitoring throughout the
task?

•

What would you do differently if you performed this
exercise again?

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OBJECTIVES

Situation
Monitoring

SAY:
Following this module, you will be able to:
• Discuss how situation monitoring affects team processes and
outcomes;
• List components of the STEP mnemonic;
• Explain situation awareness and identify undermining
conditions; and

Slide

• Define a shared mental model and how it is cultivated within a
team.

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Situation
Monitoring

TEAMSTEPPS TEAMWORK SKILLS
SAY:
So far, we have covered the following in the TeamSTEPPS
framework:

Slide

• Team Structure, which facilitates teamwork by identifying the
individuals among which information must be communicated, a
leader must be clearly designated, and mutual support must
occur.
• Communication, which facilitates teamwork by enabling team
members to effectively relay relevant information in a manner
that is known and understood by all.
• Leadership, which facilitates teamwork through leaders’
effective communication with their team members to ensure
that a plan is conveyed, reviewed, and updated; continuous
monitoring of the situation to better anticipate team members’
needs and effectively manage resources; and fostering of an
environment of mutual support through role modeling and
reinforcement.

In this module, we will cover Situation Monitoring.
Situation Monitoring is a way for team members to be aware of
what is going on around them. This awareness will enable
individuals to adapt to changes in the situation and will also create
opportunities to support other team members when needed.
Situation monitoring is moderated by communication, which allows
for the sharing of new and emerging information with other team
members, to develop and maintain a shared mental model.
Because situation monitoring concerns the willingness and ability
to continually monitor situations and share this awareness with
fellow team members, it is enhanced by team leadership, given
that team leaders encourage and role model supportive
behaviors.
Situation monitoring also allows for mutual support through the
ability to anticipate other team members’ needs with accurate
knowledge of their responsibilities.

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A CONTINUOUS PROCESS

Situation
Monitoring

SAY:
Situation monitoring is a continuous process because of the
dynamic situations in which teams function. This process consists
of three components:
• Situation monitoring (an individual skill) is the process of
actively scanning and assessing elements of the situation to
gain information or maintain an accurate understanding of the
situation in which the team functions. Situation monitoring is a
skill, which implies that it can be taught, developed, and
improved. It enables team members to identify potential issues
or minor deviations early enough to correct and handle them
before they become a problem or pose harm to the resident.

Slide

• Situation awareness (an individual outcome) is the state of
knowing the conditions that affect one’s work. It is a detailed
picture of the situation. Note that situation awareness is not a
static “thing” or concept. Because the situation and context in
which the situation exists are dynamic and ever changing, team
members must continually assess relevant components of the
situation and update their individual situational awareness.
• Shared mental models (a team outcome) are the result of
each team member maintaining his or her situation awareness
and sharing relevant facts with the entire team. Doing so helps
ensure that everyone on the team is “on the same page.”
ASK:
• When have you used situation monitoring in your work?
• How did the information that you obtained from the environment
affect how you approached or responded to the situation?

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Situation
Monitoring

STEP
SAY:

Slide

In a busy health care environment, knowing which elements you
need to monitor, and being able to keep track of each element,
can feel overwhelming. Yet knowing the relevant components of
the situation that provide clues about impending complications or
contingencies is critical for resident safety. STEP is a mnemonic
tool that can help you monitor critical elements of the situation
and the overall environment.
The STEP mnemonic stands for:
•

Status of the resident

•

Team members

•

Environment

•

Progress toward the goal

It is not only the responsibility of the direct care team to monitor
these elements—anyone involved in the care of residents or the
environment should be expected to monitor the situation.
Examples:
• The respiratory therapist notes that a ventilated resident
is showing a marked increase in respiratory rate that
might indicate an increased level of pain that cannot be
communicated (STATUS).
• The resident’s nurse is busy helping another resident (TEAM
MEMBERS).
• It is a shift change, and everyone is busy, so you check the
medication record and note that the resident is overdue for
his morphine (ENVIRONMENT).
• You notify the oncoming nurse of your concern (PROGRESS).

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STATUS OF THE RESIDENT

Situation
Monitoring

SAY:
In a health care setting, the most obvious element of the situation
requiring constant monitoring is the resident’s status. Even minor
changes in the resident’s vital signs may require dramatic
changes in the team’s actions and the urgency of its response.
When assessing resident status, consider the following:
• Resident history;

Slide

• Vital signs;
• Medications;
• Physical exam;
• Plan of care; and

VIDEO TIME:
0:51 seconds

• Psychosocial condition (e.g., resident’s stress level).
Let’s view a video example.
MATERIALS:
DO:
Play the video by clicking the director icon on the slide.

• STEP Subacute
Video
(STEP_Subacute
.mpg

DISCUSSION:
• Why was Olivia concerned about Mr. Larkin when he said
he was o.k. and even made a joke about losing his touch?
– Resident was sweaty and short of breath
– Resident was not keeping up the same pace as in
previous therapy sessions
– Resident denied pain as a reason for frequent pauses in
his exercises

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Situation
Monitoring

TEAM MEMBERS
SAY:
You should also be aware of team members’ status, to include
the following:
• Fatigue level;
• Workload;

Slide

• Task performance;
• Skill level; and

VIDEO TIME:
0:27 seconds

MATERIALS:
• Cross Monitoring
Subacute Video
(Cross_Monitoring_
Subacute.mpg)

• Stress level.
Health care providers are just as prone to human error as the
general population. Teams that recognize and maintain an
awareness of their individual team members’ functioning are
more likely to provide constructive feedback, have a shared
understanding of the situation, and lend support or assistance
when needed.
Observing the actions of fellow team members—or crossmonitoring—is a safety mechanism that can be used to mitigate
error before the resident is harmed. Commonly referred to as
“watching each other’s back,” monitoring other team members by
keeping track of their behavior and providing feedback ensures
that procedures are being followed appropriately. It allows team
members to self-correct their actions if necessary.
Staff members need to constantly be aware of the situation,
anticipate next steps, “watch each other’s back,” and take
appropriate corrective action to prevent errors from reaching the
resident.
In the next video, let’s watch how the team members monitor and
assist each other to ensure that the resident receives timely and
appropriate emergent care.
DO:
Play the video by clicking the director icon on the slide.
DISCUSSION:
•

What actions by the nurse manager demonstrated crossmonitoring?
– Noticed that the physical therapy aide could not find the
appropriate mask and reminded her of the correct oxygen dose to
use with the rebreather mask.

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Situation
Monitoring

I’M SAFE CHECKLIST
SAY:
Being aware of, and honest about, your own current state is also a
vital component of a safe environment. W e will now discuss how to
assess your own condition, as well as the condition of your team
members.
“I’M SAFE” is a simple checklist that can be used to determine
your ability to perform safely. I’M SAFE stands for:

Slide

• Illness. Am I feeling so bad that I cannot perform my duties?
• Medication. Is the medication I am taking affecting my ability
to maintain situation awareness and perform my duties?
• Stress. Is there something—such as a life event or situation at
work—that is detracting from my ability to focus and perform
my duties?
• Alcohol/Drugs. Is my use of alcohol or illicit drugs affecting
me so that I cannot focus on the performance of my duties?
• Fatigue. Am I tired? The effects of fatigue should not be
ignored. Team members should alert the team regarding their
state of fatigue. For example, saying “W atch me a little closer
today. I only had 3 hours of sleep last night.”
• Eating and Elimination. Has it been 6 hours since I have
eaten or used the restroom? Many times we are so focused on
ensuring our resident’s basic needs that we forget to take care
of our own. Not taking care of our elimination needs affects our
ability to concentrate and stresses us physiologically.
ASK:
• In your current situation, would you feel able to express that
you’re not safe?
• What are the factors that inhibit you from doing so or that
contribute to your inability to do so?
• If you feel inhibited, what can you and your team do to change
the culture?

TeamSTEPPS for Long-Term Care | Situation Monitoring

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Situation
Monitoring

ENVIRONMENT
SAY:

Slide

The environment directly affects the quality of care delivered. Is the
needed equipment present? Are there enough staff to tend to all the
residents? The environment can change quickly and dramatically, and
teams must be able to adapt to the dynamic nature of the situation.
When assessing the environment, consider the following:
• Facility information;
• Administrative information;
• Human resources;
• Acuity of residents’ and other team members’ assignments; and
• Equipment status.

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PROGRESS TOWARD GOAL

Situation
Monitoring

SAY:
By monitoring progress toward the team’s established goals, team
members will be able to alert the team when strategies or the plan
of care may need to be reconsidered or revised, or when additional
resources are needed. When assessing progress, team members
need to consider the following:
• Status of the team’s residents;

Slide

• Goal of the team;
• Tasks/actions completed or that need to be completed; and
• Continued appropriateness of the plan.
Goals were established and agreed on at the team briefing. If
something has changed, a huddle should be called to discuss how
the plan needs to be modified.

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Situation
Monitoring

EXERCISE: SITUATION MONITORING
SAY:
Review the scenario shown here while keeping in mind how well
members of this team worked together.

Slide

TIME:
5 minutes

MATERIALS:
• Flipchart or
Whiteboard
(Optional)
• Markers
(Optional)

Mrs. Johnson, who uses a walker, falls while trying to walk
independently to her bathroom. Her head is bleeding and she
has fallen directly on her hip. A nurse and a nursing assistant
hear Mrs. Johnson cry for help and immediately go to her
room. Nancy, the nurse, promptly assesses Mrs. Johnson.
Nancy calls the nursing station and asks them to call EMS
and Mrs. Johnson’s physician immediately. Nancy then
directs Judy, the nursing assistant, to retrieve 4x4 gauze from
the treatment cart. David sees Judy urgently leaving Mrs.
Johnson’s room and goes in to see if he can help. Upon his
arrival, Nancy tells him to maintain C-spine precautions until
EMS arrives. Noticing David’s confused expression, Nancy
explains, “Place one hand on each side of Mrs. Johnson’s
head and keep it in straight alignment with her spine.”

DISCUSSION:
• What TeamSTEPPS tools and strategies were exhibited in
this scenario?
• Identify each component of the STEP framework in this
scenario. How was the STEP framework useful?

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SITUATION AWARENESS IS…

Situation
Monitoring

SAY:
Situation awareness is the state of knowing the conditions that
affect one’s work. This awareness is achieved by constantly
monitoring the ever-changing situation. Situation awareness is the
extent to which team members are aware of the following:
• Status of the resident;

Slide

• Status of other team members;
• Status of the environment; and
• Status of the progress toward the goal.
The health care environment is dynamic, requiring team members
to continually reassess situations to update their situation
awareness. What results is a sense of “knowing what’s going on
around them” and the ability to support each other where needed.

MATERIALS:
• Flipchart or
Whiteboard
(Optional)
• Markers
(Optional)

A loss of situation awareness results in:
• Ambiguity;
• Confusion; and
• Decreased communication.

Instructor Note: (Time Permitting): The question below is
intended to prompt discussion prior to showing the next slide.

ASK:
• What are the factors that undermine situation awareness?

DO:
As participants respond to the question, you may wish to use a
flipchart or whiteboard to list their responses and then compare
them with the information you will present on the following page.

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Situation
Monitoring

CONDITIONS THAT UNDERMINE SITUATION
AWARENESS
SAY:
There are numerous barriers to maintaining situation awareness.
They are the result of team members’ failure to:
• Share information with the team;

Slide

• Request information from others;
• Direct information to specific team members;
• Include resident or family in communication;
• Utilize resources fully (e.g., status board, automation);
• Maintain documentation that is adequate, complete, and timely;
• Know and understand where to focus attention;
• Know and understand the plan; and
• Inform team members the plan has changed.

Here are some examples of where failure can occur in the STEP
process:
• Status of the Resident: Failure to take a resident’s vital signs
• Team: Failure to assist a team member who you know is
overloaded
• Environment: Failure to know where the necessary equipment
is stored
• Progress Toward Goal: Failure to call a huddle and update the
team when the plan has changed

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A SHARED MENTAL MODEL IS…

Situation
Monitoring

SAY:
A mental model is a mental picture or sketch of the relevant facts
and relationships defining an event, situation, or problem. When
all members of a team share the same mental model, this is
referred to as a “shared mental model.” Sharing your situation
awareness with fellow team members results in a shared mental
model, or in “everyone being on the same page.” This is a
continuous process requiring relevant input from all team
members.

Slide

Similar to the way situation awareness is the result of an individual
team member’s situation monitoring, a shared mental model is
the result of each team member maintaining his or her situation
awareness and sharing relevant facts with the entire team. In
isolation, it is possible for an individual team member to
misinterpret cues or to place too much emphasis on one piece of
information. Shared mental models are knowledge structures of
the relevant facts and relationships about tasks or situations that
the team is engaged in and about the way the team members
interact. Shared mental models enable the team to anticipate and
predict each other’s needs; identify changes in the team, task, or
teammates; and adjust the course of action or strategies as
needed.
Shared mental models are sustained by:
•
•
•
•

Huddles;
Briefings;
Monitoring; and
Communication.

Shared mental models provide team members with a common
understanding of who is responsible for which task and what
the information requirements are. In turn, this allows them to
anticipate each other’s needs so that they can work (i.e.,
provide resident care) in synchronicity.
ASK:
• What is an example from your own experiences of being “on
the same page” with others on your team?
• How was a shared understanding maintained?

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Situation
Monitoring

SHARED MENTAL MODEL?
SAY:
On our continuum of situation monitoring, situation awareness,
and shared mental model, where are these two groups? How can
lack of a shared mental model affect safety?

Slide

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WHEN AND HOW TO SHARE?

Situation
Monitoring

SAY:
Sharing information with other team members is necessary to
establish and maintain a shared mental model. When each team
member shares his or her unique information, the team will have
a more accurate assessment of the situation.
There are both ad hoc and structured opportunities to share vital
information with team members.

Slide

Some examples of when information can be shared include team
events such as:
• Briefs;
• Huddles; and
• Debriefs.
It is important to establish the expectation that these team events
will occur and that all team members are empowered to speak up.
Some examples of how to share information include:
• SBAR;
• Call-outs; and
• Check-backs.
Teams should communicate often and at the right time to ensure
that everyone is on the same page and has a comprehensive view
of the situation.

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Situation
Monitoring

(OPTIONAL) PRACTICAL EXERCISE
Instructor Note: Prepare for the exercise in advance so
that the envelopes are prepared and copies of the “Care Plan
Questions to Consider” are available for distribution.
The goal of this exercise is to explore and discuss the role and
value of all team members in achieving a shared mental model.

Slide
TIME:
25 minutes

MATERIALS:
• Exercise Script
• Exercise Role
Information
• Exercise Care
Plan Questions
to Consider

This exercise simulates an interdisciplinary care plan meeting and
demonstrates how the information that each team member brings
is important to developing a thorough and thoughtful care plan. In
the exercise, some of the team members are not at the meeting, so
their contributions are not heard by the group. The group sees how
the care plan developed differs when only some members are
present and contribute in contrast to when all members of the team
are heard.
The exercise may be presented to a small group with individuals
playing roles of care plan team members or as a large group
discussion.
To prepare for the exercise:
1) Review the exercise sheets for this activity:
 Exercise Script
 Role Information Exercise Sheet
 Care Plan Questions To Consider Exercise Sheet
2) Designate one envelope for each of the eight roles:
 Nurse
 Activity Assistant
 Social Worker
 Occupational Therapist
 Mrs. Valdez
 Rose, Mrs. Valdez’s Daughter
 Nursing Assistant
 Housekeeper
3) Using the information provided on the “Role Information”
exercise sheet, place the appropriate information for each
person in the designated envelope. This is the information
each person should know about Mrs. Valdez.
4) Make copies of the “Care Plan Questions to Consider”
exercise sheet for the entire audience.
Continued…

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(OPTIONAL) PRACTICAL EXERCISE
(Continued)

Situation
Monitoring
Slide

DO (SMALL GROUP EXERCISE):
•

Ask for eight volunteers. Randomly assign each volunteer
an envelope with a role designation (e.g., social worker,
daughter, nurse).

•

Read the script provided on the Exercise Script out loud to
the group.

•

Display the Practical Exercise slide on Mrs. Valdez. The
information displayed is “common knowledge” about Mrs.
Valdez. Review the information with the group.

•

Provide copies of the Care Plan Questions to Consider to
the care plan team (and the audience).

•

Have all eight volunteers open their envelopes.

•

Participants not attending the care plan meeting can have
no input. They must be quiet! The team attending the care
plan meeting meets to 10 minutes to create an initial plan of
care, considering the supplied questions.

•

Ask each team to report its care plan about Mrs. Valdez to
the group.

•

Discuss the role of all team members and the relationship
between communicating information, including team
members, and developing a shared mental model. To not
include Mrs. Valdez, her daughter, the housekeeper, and
the nursing assistant in the process is to create a plan of
care missing significant information.

•

As a group, review the questions and care plan again with
all of the available information. Share new insights and
perspective related to “everyone being on the same page.”

•

Ask the group:
– What lessons were learned?
– What can be incorporated in current care planning
processes within your nursing home?

OR
DO (WHOLE GROUP EXERCISE) on the next page.

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(OPTIONAL) PRACTICAL EXERCISE
(Continued)

Situation
Monitoring

DO (WHOLE GROUP EXERCISE):
•

Display the Practical Exercise slide on Mrs. Valdez. The
information displayed is “common knowledge” about Mrs.
Valdez. Review the information with the group.

•

Ask the group to formulate an initial care plan about Mrs.
Valdez. Provide copies of the Care Plan Questions to
Consider.

•

After the group discusses its conclusions, provide the class
with information from those roles designated as being in
attendance (nurse, social worker, activity assistant,
occupational therapist).

•

Discuss how the additional information alters the group’s
initial plan of care.

•

Provide information from those who were not in attendance
(Mrs. Valdez, Rose, nursing assistant, housekeeper). Discuss
how this additional information changes the group’s plan of
care.

•

Focus discussion on the relationship between the
communication of information and the development of a
shared mental model.

* Mrs. Valdez exercise was adapted with permission from
Healthcentric Advisors.
http://www.healthcentricadvisors.org/individualized-care.html

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WHAT DO YOU SEE?

Situation
Monitoring

SAY:
Each team member has a unique perspective and
information that benefits the team as a whole when shared.
Different people may view the same situation differently,
but without sharing and communicating, each team
member may have a different understanding.

Slide

DISCUSSION:
•

When looking at these images, what do you see?

•

Do you see different images if you look right to left
versus left to right?

•

How did discussing these different perspectives
increase your ability to see the whole picture?

Answers:
•

Left image: American Indian and Alaska Native

•

Center image: Duck and rabbit

•

Right image: Old lady and young woman

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Situation
Monitoring

HOW SHARED MENTAL MODELS HELP TEAMS
SAY:
Teams will work more efficiently and effectively if all members of the
team are “on the same page.” If teams are better able to predict and
anticipate, the team will know what is supposed to happen and will
have a better understanding of how the case is progressing.

Slide
Shared mental models can help teams by:
• Leading to a mutual understanding of problems, goals, team
strategies, residents’ condition, and plan of care
• Leading to more effective communication to ensure that team
members have the necessary information for task performance
• Enabling team members to back up and fill in for each other
• Helping team members understand each other’s roles and how they
interplay
• Improving the ability of individual team members to provide mutual
support by predicting and anticipating the needs of the team
• Creating commonality of effort and purpose
Most important, shared mental models help teams avoid errors that put
residents at risk.

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TeamSTEPPS for Long-Term Care | Situation Monitoring

TOOLS AND STRATEGIES SUMMARY

Situation
Monitoring

SAY:
Situation monitoring is an integral piece of the
TeamSTEPPS framework and directly links to
communication, leadership, and mutual support. Engaging
in effective communication techniques will enable team
members to relay relevant and timely information.

Slide

Leadership’s role in continually monitoring and updating the
team when changes to the plan are necessary helps to
maintain a shared mental model. Likewise, when team
members are aware of the situation, they are better able to
support each other, either when asked or when they see a
need.
The tools and strategies introduced in this module include
STEP and the I’M SAFE checklist. Use of these tools will
aid in awareness of the situation and development of a
shared mental model, which will enable team members to
anticipate, prevent, and correct potential errors in care.

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Situation
Monitoring

EXERCISE: APPLYING TEAMSTEPPS
Instructor Note: This slide is intended for the Master
Training course only. The previous slide should be the last one
shown to staff participants at your nursing home.

Slide

MATERIALS:
• TeamSTEPPS
Implementation
Worksheet

SAY:
Now return to your TeamSTEPPS Implementation Worksheet.
Think about whether any aspect of your teamwork issue is
related to situation monitoring and answer the questions for this
module.
Think about:
• Whether the team or individuals targeted for your
TeamSTEPPS implementation have an issue related to their
ability to monitor the situation?
• If so, which of the Situation Monitoring tools or strategies might
you use to address the issue?

DO:
Ask a few individuals to report on issues they have identified as
related to Situation Monitoring and which TeamSTEPPS tools or
strategies they might use to address the issue in their
implementation plan.

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