Measuring team effectiveness in healthcare: A comprehensive and practical tool.

Abstract

e19188 Background: Publication trends reveal that research on teams and teamwork in healthcare has surged over the past decade. Efforts to improve team effectiveness have also become pervasive, with team training being identified as a top strategy for improving patient outcomes. Unfortunately, measures of team effectiveness in the literature vary greatly and are aimed largely toward clinical teams. The aim of this effort, therefore, is twofold: (1) to provide a tool that can be adapted and used to diagnose performance and guide targeted team training across team types, and (2) to further our understanding of teams across all areas of a healthcare system (clinical, research, and administrative) by providing a standard measurement tool. Methods: We began with a comprehensive framework of team effectiveness developed through a top down (i.e., literature review) and bottom-up (i.e., focus groups, interviews) approach. The framework includes 23 constructs identified as critical to teams (e.g., clear roles, supportive culture, conflict management, shared mental models). Next, three subject matter experts (SMEs) identified and compiled measures of team effectiveness published in the healthcare teams literature. Items were reworded as needed to be generally applicable across healthcare team types. The three SMEs then matched each revised item to the framework by independently labeling each with the framework construct it best represents. Items on which 2 out of 3 experts agreed were kept, and new items were generated as needed for construct coverage resulting in a refined item bank. This item bank was again independently rated on quality of item (e.g., clarity, avoidance of double-barreled questions) and construct representativeness (i.e., ensuring the most important aspects of each construct were captured). Two additional subject matter experts then reviewed the ratings, and kept the top five rated items for each construct, ensuring full coverage of the construct (i.e., removing items that were duplicative and tapped the same part of a construct). Results: The processes above resulted in a measure with 115 items that capture 23 fundamental constructs for teams in healthcare. Conclusions: The measure developed is applicable across team types. It can be adapted and used to diagnose team performance, inform training, and further understanding of what facilitates effective teamwork in multi-team systems performing diverse functions across the healthcare system.