Back to Top Skip to main content Skip to sub-navigation


TeamSTEPPS Model (2019)



Background: Teamwork failures are substantial contributors to 68.3% of patient harm events, making teamwork failures a major source of preventable medical errors.  In 2005-2006, the Department of Defense, in collaboration with the Agency for Healthcare Research and Quality, developed TeamSTEPPS® (Team Strategies and Tools to Enhance Performance and Patient Safety). TeamSTEPPS is an evidence-based framework to optimize team performance across the healthcare delivery system. TeamSTEPPS is scientifically rooted in more than 50 years of research and lessons learned from the application of teamwork principles identified in Crew Resource Management (CRM) and within High Reliability Organizations.  The triangle shows four teachable-learnable skills that are core to TeamSTEPPS: Communication, Situation Monitoring, Leading Teams, and Mutual Support.  These are the skills that each individual brings to each team situation. At the center of the triangle is the patient, family, and core team, who receive the benefits of effective teams, primarily effective communication and decreased harm.

The TeamSTEPPS System: TeamSTEPPS is foundational to a high reliability organization and establishing and maintaining a culture of safety throughout the Military Health System (MHS). A TeamSTEPPS initiative occurs in three phases:

TeamSTEPPS System with Phases
  1. Phase I: Assessment (Set the Stage):The goal of this phase is to determine organizational readiness for a TeamSTEPPS initiative.The organization or unit assembles a multi-disciplinary Change Team. The Change Team identifies an opportunity for improvement using the TeamSTEPPS concepts, tools and strategies.


  2. Phase II: Planning, Training, and Implementation (Decide What to Do and Make it Happen): This phase is the planning and execution of TeamSTEPPS. It involves developing a TeamSTEPPS Implementation/Action Plan, detailing what the organization or unit intends to do during the initiative.TeamSTEPPS Master Instructors conduct training and then instructors work with units and departments to implement the TeamSTEPPS tools and strategies, accomplish its goals and make improvements in teamwork.


  3. Phase III: Sustainment (Make it Stick): The goal of this phase is to sustain and spread any improvements in teamwork performance, clinical processes, and outcomes resulting from the TeamSTEPPS initiative.Users integrate the teamwork skills and tools into daily practice and monitor and measure the ongoing effectiveness of TeamSTEPPS.The organization develops an approach for continuous improvement and spread of the initiative throughout the organization or unit.

Success:  In the past, most MTFs and Services have focused on training. Though training is important, learning intervention plays a relatively minor role in a successful TeamSTEPPS initiative. Figure 4, What It Takes to Be Successful, shows the primary success factor is application in the environment or organizational factors.   MTFs continue to focus on training.  However many are developing plans for MTF-wide implementation and sustainment of the tools, strategies and concepts and can discuss the positive impact on both patients and staff.  Many MTF have integrated TeamSTEPPS into the DNA of their organization.

What It Takes to Be Successful

The DoD Patient Safety program has multiple curricula, materials and resources to assist in all phases of TeamSTEPPS.

TeamSTEPPS Curriculum: TeamSTEPPS consists of a collection of instructions, materials and tools to help drive a successful teamwork initiative from the initial planning to implementation through to sustainment.  Several versions of the TeamSTEPPS curriculum are available to meet the needs of diverse audiences.

TeamSTEPPS Curriculum




TeamSTEPPS Train the Trainer

2 Days

  • Produces Master Trainers/Instructors qualified to facilitate both Train the Trainer and Train the Staff classes
  • Provides resources for training others
  • Ensures that participants gain knowledge and training required to implement and coach the behaviors to achieve positive results
  • Taught by Master Trainers/Instructors
  • Training should be done by teams and include physicians and nurses
  • Day 1: Fundamentals
  • Day 2: Change Management, Coaching, Measurement, Implementation, Practice Teaching

TeamSTEPPS Fundamentals/
Train the Staff

3.5 Hours

  • Focus is on the TeamSTEPPS tools and strategies
  • Training should model teamwork and be done by a team of instructors
  • Curriculum is adaptable to any unit or department

TeamSTEPPS Essentials Course (Optional)

1 – 2 Hours

  • Provides an abbreviated form of the TeamSTEPPS tools
  • Does not contain videos, exercises, discussions
  • Is not interchangeable with Fundamentals/Train the Staff
  • Aligned directly to the TeamSTEPPS Pocket Guide

Train the Staff with Scenarios

3.5 Hours

  • May be used to meet the requirement for a Fundamentals/ Train the Staff or Train the Trainer
  • Introductory TeamSTEPPS course that focuses on the tools and strategies taught in the Fundamentals/Train the Trainer course
  • Focuses on practical application using the tools and strategies by using scenarios to introduce and reinforce learning concepts
  • Curriculum is adaptable to any unit or department

TeamSTEPPS Train the Staff Full Day with Simulation


1 Day

  • May be used to meet the requirement for a Fundamentals/ Train the Staff or Train the Trainer
  • Introductory TeamSTEPPS course that focuses on the tools and strategies taught in Fundamentals/Train the Trainer
  • Focuses on practical application of the tools and strategies by using simulation to introduce and reinforce learning concepts
  • Training should be done by teams of instructors
  • Curriculum is adaptable to any unit or department

Customized Courses

TeamSTEPPS for Office-Based

3.5 Hours or 2 Days

  • May be used to meet the requirement for a Fundamentals/Train the Staff or Train the Trainer
  • Adapts the TeamSTEPPS core concepts to reflect the environment of office-based (outpatient) teams
  • The examples, discussions, and exercises are tailored to the medical office environment
  • A full version of TeamSTEPPS including all of the Fundamentals materials as well as modules to assist in implementation


Dental Module


Customized Dental Videos Only

  • Videos show how dental staff who perform oral surgery and general dentistry can use the tools and strategies in their practice
  • Scenarios specific to dentistry may also be inserted into the Fundamentals/Train the staff or Train the Trainer curriculum


Safety for Patients with Limited English



3.5 Hours or
2 Days

  • Designed to help trainers develop and deploy a customized plan to educate staff in teamwork skills and lead teamwork improvement in an MTF from initial concept development through sustainment of change
  • Provides insight into core concepts of teamwork as they apply to patients who have difficulty communicating in English
  • Customized Case studies and videos illustrating teamwork opportunities and successes are included





1 Hour

  • Focuses on core concepts as they apply to rapid response teams and the system
  • Customized Case studies and videos illustrating teamwork opportunities and successes are included

Using Simulation in TeamSTEPPS Training

48 Slides and Guide

  • Provides instruction on using simulation-based training with TeamSTEPPS
  • Can be customized to meet the needs of specific healthcare teams and programs
  • Encouraged to submit own scenarios for simulation
  • Intended as a Train the Trainer course


Continuing Education: Continuing education (CE) is available for physicians, dentists, nurses, pharmacists, psychologists, and administrators for various TeamSTEPPS courses.  MTF course coordinators may obtain CE through the Online Registration Center (ORC) to obtain CE. The ORC is the tool that the Patient Safety program uses for registration, monitoring post-course evaluation, and disseminating CE. Table 2 summarizes various TeamSTEPPS courses approved for CE and the number of hours approved per course:


TeamSTEPPS Curriculum:  Continuing Education Hours

TeamSTEPPS Course

Approved CE Hours

Train the Trainer


Fundamentals/Train the Staff


Train the Staff with Scenarios


Train the Staff with Simulation



Ordering TeamSTEPPS Materials

  • All materials on the Patient Safety Learning Center may be downloaded and printed or copied as needed.
  • To access detailed information on ordering materials, go to Patient Safety (PS) Educational Materials website Step-by-Step Guide.
  • TeamSTEPPS 2.0 Instructor Guides:  The Patient Safety Program shipped several Instructor Guides to each MTF to be maintained in their library and to be available to all instructors.  PSP will no longer ship TeamSTEPPS 2.0 Instructor Guides for each instructor.
  • TeamSTEPPS 2.0 Pocket Guides:  There are limited number of copies available for shipment. The Agency for Healthcare Research and Quality developed a free TeamSTEPPS Pocket guide app, which may be downloaded through the app store.
  • TeamSTEPPS Fundamentals Pocket Guide (2019):  Under development
  • Badge cards and posters:  Available for ordering


Accessing TeamSTEPPS Curriculum and Materials on the Patient Safety Learning Center

  • To access the 2019 TeamSTEPPS Fundamentals curriculum developed by DoD, and materials developed by DoD and AHRQ, click here. (TeamSTEPPS Fundamentals Pocket Guide: Under development)
  • To access the 2014 TeamSTEPPS 2.0 Curriculum and Materials click here.

Customized models, developed by the Agency for Healthcare Research and Quality and miscellaneous TeamSTEPPS materials, identified by various sources, coming soon.

Annual TeamSTEPPS Conference

The DoD Patient Safety Program (PSP) has sponsored travel costs (air fare, lodging, registration, M&IE), allowing MTF, Market, and Service, champions and experts to participate in the Annual Conference, since 2009. The National Conference is a 2-day event sponsored by the American Hospital Association.  In addition, DoD PSP facilitates a 1.5 day DoD Session.  The purpose of both sessions are to provide opportunities for attendees to particiapte in educational offerings, networking, and community building. It brings together military, federal, and civilian healthcare professionals and teamwork champions to discuss innovations, lessons learned, and mitigation of barriers and challenges toward eliminating patient harm through teamwork.  In recent years, the DoD Session has focused on Service and MTF success stories, innovation and lessons learned as well as how to leverage TeamSTEPPS to accelerate transformational change and high realiability, and apply team-based practices to gain insight on the MHS perspective for teamwork.

In order for the DoD PSP to sponsor travel costs for active duty and civilian government employees, the PSP must obtain approval from the Director, Defense Health Agency.  Once that is obtained, the Service and Markets identify their participants based on the numbers approved. The priority for identification should be those active duty and civilian government employees who have been actively engaged as TeamSTEPPS instructors, coaches and implementers. For information on attending the TeamSTEPPS Conference, contact your Service or Market TeamSTEPPS lead.


To Get more information on Past Annual TeamSTEPPS Conferences, click here:


Contact or Access Information

General Patient Safety Program information


Continuing Education Credit


DHA-PM 6025.13, Volume 2

Patient Safety Implementation Guide


  • Briefs and huddles
  • Debriefs
  • SBAR


Contact MTF or Market TeamSTEPPS Point of Contact or email DHA at:

Webinars and Learning Circles



DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

Some documents are presented in Portable Document Format (PDF). A PDF reader is required for viewing. Download a PDF Reader or learn more about PDFs.