Patient-focused rehabilitation team cohesiveness in veterans administration hospitals

Abstract

Smits SJ, Falconer JA, Herrin J, Bowen SE, Strasser DC. Patient-focused rehabilitation team cohesiveness in Veterans Administration hospitals. Arch Phys Med Rehabil 2003;84:1332–8. Objective To quantify the relation of hospital culture, 3 levels of leadership (hospital-level administrators, discipline-specific supervisors, attending physician on the team), and physician involvement to patient-focused rehabilitation team cohesiveness. Design Survey research. Setting 48 Veterans Administration hospitals (VAHs). Participants Six hundred fifty members of 50 rehabilitation teams. Interventions Not applicable. Main outcome measures Scales measuring hospital culture, administrative support, supervisor expectations, attending physician support, and physician involvement (independent variables), and patient-focused rehabilitation team cohesiveness (dependent variable). Associations between scales were examined by using a hierarchical linear regression model. Results Patient-focused team rehabilitation cohesiveness was significantly ( P<.05) associated with administrative support, supervisor expectations, attending physician support, and physician involvement (Wald χ 2=1192.66, P<.0001) ( R 2=.6431). There was no statistically significant independent association with hospital culture. Conclusions Expectations of discipline-specific supervisors and hands-on team leadership and involvement by the attending physician were associated to a significant degree with the extent to which rehabilitation teams in VAHs reported functioning in a cohesive manner. Higher functioning on patient-focused team cohesion indicates that patient services were likely delivered with greater interprofessional communication and joint effort.