Implementation of TeamSTEPPS for improving patient safety was examined via descriptive qualitative analysis of semistructured interviews with 21 informants at 12 hospitals.
Implementation approaches fit three strategies: top-down, bottom-up, and combination. The top-down approach failed to develop enough commitment to spread implementation. The bottom-up approach was unable to marshal the resources necessary to spread implementation.
Combining top-down and bottom-up processes best facilitated the implementation and spread of the TeamSTEPPS safety initiative.
For more info, see Stewart et al. (2015). Empowering sustained patient safety: The benefits of combining top-down and bottom-up approaches. Journal of Nursing Care Quality, 30(3), 240-246.