Abstract
Background and problem statement:Team climate describes shared perceptions of organisational policies, practices and procedures. A positive team climate has been linked to better interprofessional collaboration and quality of care. Most studies examine team climate within health or social care organisations. This study uniquely explores the team climate of integrated health and social care teams implementing integrated care initiatives for older people in thirteen sites across seven European countries, and examines the factors which contribute to the development of team climate.Theory and methods:In a multiple case study design, data collected as part of the European SUSTAIN (Sustainable Tailored Integrated Care for Older People in Europe) project were analysed. The short-form Team Climate Inventory (TCI-14) was administered before and after implementation of the integrated care initiatives. Qualitative data was used to explain the changes in TCI-14 scores over time.Results and discussion:Overall, team climate was found to be high and increased over time in eight of the thirteen sites. The development of a shared vision was associated with a strong belief in the value and feasibility of the initiative, clear roles and responsibilities, and a reflective approach. Strong inter-personal relationships, shared decision-making, and high levels of commitment and motivation contributed to the development of participative safety. Support for innovation increased when staff had the ‘space’ and time to work together.Conclusion:This mixed methods study offers significant insights into the development and maintenance of team climate in complex, integrated care systems in Europe.
Highlights
The dominant approach to understanding team climate focuses on shared perceptions of individuals
This paper explored the team climate of health and social care professional teams implementing integrated care initiatives for older people in Europe, and examined the factors contributing to team climate
This emphasis on improving quality of care has been found to be important in securing engagement and buy-in from practitioners, influencing their decision to take part in integrated care initiatives [19, 20]
Summary
The dominant approach to understanding team climate focuses on shared perceptions of individuals. SUSTAIN was a fouryear research project (2015–2019) which aimed to support and monitor improvements to integrated care services for older people living at home with multiple health and social care needs, and in so doing move towards more personcentred, prevention-oriented, safe and efficient care [8]. This aim of this paper is to explore the team climate of health and social care teams implementing integrated care initiatives for older people in Europe, and examines the factors which contribute to the development of team climate. The TCI-14 was completed at the start and end of the implementation period to capture changes in team climate over an 18 month period
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