Assessing Interprofessional Teamwork in Inpatient Medical Oncology Units.

Abstract

Teamwork is important to providing safe and effective care for hospitalized patients with cancer; however, few studies have evaluated teamwork in this setting. We surveyed all nurses, residents, hospitalists, and oncology physicians in oncology units at a large urban teaching hospital from September to November 2012. Respondents rated teamwork using a validated instrument (Safety Attitudes Questionnaire; scale, 0 to 100) and rated the quality of collaboration they had experienced with other professionals using a 5-point ordinal response scale (1, very low quality; 5, very high quality). Respondents also rated potential barriers to collaboration using a 4-point ordinal response scale (1, not at all a barrier; 4, major barrier). We compared ratings by professionals using analysis of variance (ANOVA). Overall, 129 (67%) of 193 eligible participants completed the survey. Teamwork scores differed across professional types, with nurses providing the lowest ratings (69.7) and residents providing the highest (81.9; ANOVA P = .01). Ratings of collaboration with nurses were high across all types of professionals. Ratings of collaboration with physicians varied significantly by professional type (P ≤ .02), with nurses giving lower ratings of collaboration with all physician types. Similarly, perceived barriers to collaboration differed by professional type, with nurses perceiving the biggest barrier to be negative attitudes regarding the importance of communication. Oncologists did not perceive any of the listed options as major barriers to collaboration. In inpatient oncology units, discrepancies exist between nurses' and physicians' ratings of teamwork and collaboration. Oncologists seem to be unaware that teamwork is suboptimal in this setting.