JHCP’s Tiger Team: Impact That Can’t Be Tamed

With a global pandemic occupying its latter half, there is no question that fiscal year 2020 was a busy one for the Johns Hopkins Community Physicians (JHCP) Risk, Safety and Service (RSS) team. Beyond working around the clock to ensure the safety of JHCP patients, staff and providers, one achievement in particular stands out: maximizing the effectiveness of the Tiger Team.

The JHCP Tiger Team is a multidisciplinary group of five subject-matter experts who leverage their collective expertise to support practices that have faced numerous challenges. Areas of expertise include organizational development and engagement, risk management, patient experience, patient safety and nursing education. “As a team, we come together to think outside the box to develop and propose recommendations to solve the particular issues a practice might be facing,” says organizational development and training consultant Alissa Putman.

The Tiger Team’s current structure developed over time. Its roots can be traced back to a few years ago, when members of the education and training and RSS teams began visiting practices to address safety culture assessment scores. One by one, representatives from other disciplines began to join them. The team gained their formal name and structure in early 2018.

The main function of the team is to support high-focus sites. These sites may be identified in multiple ways. The foremost is through a review performed by the Johns Hopkins Medicine Armstrong Institute for Patient Safety, which assesses and assigns risk levels based on metrics from three key assessments: the Patient Safety Culture assessment, the annual employee engagement survey and patient experience scores from CG-CAHPS surveys. Regional and central leadership, and members of the RSS team, may also identify practices as high-focus based on other operational or environmental factors. Proposed high-focus practices are then taken to the RSS committee to determine whether intervention is necessary.

According to Keisha Mullings-Smith, director of patient experience, the real highlight of the Tiger Team is the success and development of the practices that they served. “The dedication, time and effort of practice leadership and staff, and the act of actually following through on our recommendations and guidance, is really the most important piece,” she notes. The Tiger Team meets monthly with high-focus practices’ leadership to discuss pitfalls and develop improvement plans. Explains Amanda Cullison, patient safety program administrator, as they show growth, sites have the opportunity to extend the intervals between meetings, from monthly, to bi-monthly, to quarterly. “Eventually,” Cullison says, “the ultimate goal is for practices to graduate out of the program.” To put this work in perspective, the Tiger Team held 138 meetings in FY 20, with five practices graduating.

Danie Noble, practice administrator for pediatrics in Howard County, says that the Tiger Team was able to support her when she needed it most. “It was reassuring to have a table full of people that I consider experts in their fields, to help guide and advise me,” she says. “I felt like I had a support system who sat and listened to me, and helped me to build a stronger team environment.” Examples like Howard County pediatrics, that switch from high focus to high performance, are what proves that the process is worth the time and effort on both the parts of the Tiger Team members, and practice leadership. The proof that it is working, in Putman’s eyes, is manifested in the response of non-high-focus sites. “There have been cases where other practices have heard what we’ve done and have asked to be added to the list,” she recounts.

Noble’s opinion of the Tiger Team represents exactly what they set out to do. “We want practices to know that they are not alone, and to recognize that it is a ‘no judgement zone,’” says Mullings-Smith. “It shows that we care and that these evaluation tools are meaningful,” adds Putman – at the end of the day, improving patient care is a mutual goal.

The magic behind why the Tiger Team works so well is that the team itself works so well together; they are all experts in their own right, but when they collaborate, they come up with a lot of creative solutions. Says Mullings-Smith, “we genuinely enjoy working together, we are genuinely concerned when our leaders face mounting pressures, and we are genuinely thrilled when they reach milestones.”