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Needs Assessment and Problem Analysis

Education and training are critical components in promoting patient safety in healthcare. Healthcare experts have observed that education can worsen risk factors by increasing cases of healthcare injuries or act as an intervention by providing possible remedies to the potential harms. Scholars in healthcare education are arguing that training systems used may in themselves impede patient safety. It is in this respect that ISD has been preferred in disseminating healthcare education. The application of ISD using the ADDIE approach can eliminate or prevent education and training from contributing to health-associated injury or harm. It can also effectively prevent injury or damage through systematic analysis, development, design, implementation, and evaluation of the various scenarios in the healthcare sector that affect patients (Clark, 2013).

Problem: Education as Latent Condition

In most organizations: including healthcare, education is used as a latent condition. The use of education as a latent condition predisposes individuals to the sharp end to a greater possibility of failure. The education systems in most institutions rely on the continuum of bureaucratic authority. In such an arrangement, the individuals in the blunt end of the system may be making decisions that will directly impact the activities of the individuals in the sharp end, such as resource allocation and administration of care. The sharp end of the healthcare profession is the level where the care providers who deliver the actual care are: the nurses, clinicians, and doctors. These individuals perceive education as an ingredient that will provide them with the right competency to deliver better services to the patients. Student nurses, for instance, value access to such information as it helps them gain insights on the best practices that they are supposed to apply better patient outcomes (Carbonell, 2013). The continuing professionals perceived any training as an opportunity for enhancing and equipping their knowledge with the latest information in the field of healthcare.

However, the effectiveness of the knowledge and expertise acquired by the individuals in the sharp end of healthcare service delivery depends on the decisions of the administrative continuum. The organizational continuum comprises the individuals who unintentionally create latent hazards through their actions, communication, action/inaction regarding resource allocation and utilization.

Existing Gaps

The advent of new technology has created a lot of impact on the modes of operation in the different organizations, including the healthcare sector. For better outcomes in the healthcare sector, there is a need for the organizational-wide proliferation of information technology and sharing of relevant content and software for different departments. Most healthcare institutions still have structures that impair the effective dissemination of information between various departments. For instance, rigid chimney-like structures within organizations make it difficult to share information between different departments of a healthcare institution. Additionally, most healthcare facilities look at educational programs as an afterthought. Policymakers do not invest in evidence-based scholarship, thus making it difficult for educational programs to positively impact healthcare facilities (Carbonell, 2013).

Secondly, most facilities face a real challenge when it comes to designing and implementing programs that facilitate the development of new skills within healthcare facilities. The challenge makes it difficult for new healthcare professionals to acquire insights on how to foster a positive working environment that can assure patients a safer environment. In most cases, management and the leading wing of healthcare institutions introduce resolutions without involving the care providers. Consequently, the policies fail to be implemented because of failure by the top management to involve the care providers and sometimes even the patients. Thus the main challenge is the lack of an instructional framework that would foster the development and dissemination of information across different departments within the organization is the limiting factor to institutional capacity building that would yield better patient outcomes.

ADDIE Model for Patient Safety

The Application of IDS in real-world problems is the improvement of patient outcomes through effective communication. Bureaucracy and poor communication are some of the leading elements to poor patient outcomes. In the USA, the DoD, in collaboration with the US Agency for Healthcare Research and Quality (AHRQ), has designed a communication curriculum that aims to train care providers in the sharp end of the healthcare administration loop to have hands-on skills necessary for providing the best medical services to the patients.

The two agencies developed a curriculum called TeamSTEEPS (Team Strategies and Tools to Enhance Performance and Patient Safety). The TeamSTEEPS curriculum is implemented through the ADDIE framework. The agencies have reviewed the possible risks associated with poor communication in healthcare institutions and the need for advancing training for care providers. The joint team then developed a curriculum to disseminate the training. The design for the TeamSTEEPS curriculum is a flexible training model that makes the learning interactive and enjoyable to all participants. The curriculum has been implemented in DoD and healthcare institutions with strategies in place to implement the curriculum on a large scale by Quality Improvement Organizations (QIO). The evaluation phase was conducted in military and civilian hospitals.

From the theoretical framework, the TeamSTEEPS curriculum has been designed to help solve a real-world issue-teamwork and effective communication in healthcare institutions. It is a model that aims to improve patients’ quality of life through enhancing collaborative approaches and improved communication protocols.

The ADDIE program Needs Assessment for improvement of care, and overall patient outcome follows five steps as outlined below.

Analysis of the Patient and Professional Needs

This is the first step in the implementation of the ADDIE model. It starts with a detailed review of patient safety reports touching on disjointed communication as the cause of patient risks. At this level, the team also reviews and examines the level of teamwork within the institution. A detailed examination of possible remedial plans that can enhance better outcomes is made. The group discusses the existing gaps within the present framework to understand the leading causes of the problem.


After identifying the existing gaps, the next step in the ADDIE model is to develop a curriculum that captures the core concepts identified as limiting factors in the analysis phase. At this stage, another critical element is to create a strategy for measuring the outcomes of care providers’ performance as indicated in the clinical indicators. In the case of patient safety, the development phase seeks to put in place the best training practices for care providers on the seamless communication protocol.


Designing phase involves selecting the best approach to disseminate information to the care providers in a way that will not face resistance and criticism. The DoD and AHRQ have established the FLEXTRA kit model for implementing the Team Strategies and Tools to Enhance Performance and Patient Safety program. The main elements at this stage are to develop an instruction guide, learners guides, and presentation materials. The materials and content must be reviewed to establish their relevance and ease of absorbing them by the targeted audience/recipients. In the design phase, the program is also given a free trial to develop any areas that need correction before full-blown implementation.


Here a prototype testing of the Team Strategies and Tools to Enhance Performance and Patient Safety in healthcare facilities is conducted. The DoD implemented the TeamSTEPPS in the military healthcare institutions, and after successful piloting, the program was then replicated in public facilities. The implementation of the TeamSTEPPS program was delivered by Quality Improvement Organization (QIO).


This involves conducting institutional trials in the facilities where the program was implemented. At the same time, an assessment to establish the suitability of adoption of this program on a large scale is also conducted.


Carbonell, P. A. (2013). Learning, instruction & design theories. Academic Research International, Vol 4(1), 29-39. Retrieved from

Clark, D. (October 10, 2013).Instructional learning and performance design. Retrieved from

Computer History Archives Project. (February 2, 2016). PLATO computer systems-computer aided learning-CAL CAI CBT education control data. YouTube. Retrieved from


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