Teamwork In Health Care Research Articles

Changing the conversation: impact of guidelines designed to optimize interprofessional facilitation of simulation-based team training

BackgroundInterprofessional simulation-based team training (ISBTT) is commonly used to optimize interprofessional teamwork in healthcare. The literature documents the benefits of ISBTT, yet effective interprofessional collaboration continues to be challenged by complex hierarchies and power dynamics. Explicitly addressing these issues during ISBTT may help participants acquire skills to navigate such challenges, but guidelines on how to do this are limited.MethodsWe applied an educational design research approach to develop and pilot structured facilitator guidelines that explicitly address power and hierarchy with interprofessional teams. We conducted this work in a previously established ISBTT program at our institution, between September 2020 and December 2021. We first reviewed the literature to identify relevant educational theories and developed design principles. We subsequently designed, revised, and tested guidelines. We used qualitative thematic and content analysis of facilitator interviews and video-recording of IBSTT sessions to evaluate the effects of the guidelines on the pre- and debriefs.ResultsQualitative content analysis showed that structured guidelines shifted debriefing participation and content. Debriefings changed from physician-led discussions with a strong focus on medical content to conversations with more equal participation by nurses and physicians and more emphasis on teamwork and communication. The thematic analysis further showed how the conversation during debriefing changed and how interprofessional learning improved after the implementation of the guidelines. While power and hierarchy were more frequently discussed, for many facilitators these topics remained challenging to address.ConclusionWe successfully created and implemented guidelines for ISBTT facilitators to explicitly address hierarchy and power. Future work will explore how this approach to ISBTT impacts interprofessional collaboration in clinical practice.

Co-designing an interprofessional digital education resource on delirium: a student-led approach

BackgroundInterprofessional education is crucial for healthcare students to develop collaborative skills and provide effective patient care. However, opportunities for interprofessional learning are often limited in healthcare curricula. The present study aimed to engage students from different health professions in co-designing an educational resource on delirium recognition and management through an interprofessional lens and explore their experiences of this process.MethodsTwo co-design workshops were conducted with students from medicine, nursing, pharmacy, and occupational therapy programmes at two universities across the island of Ireland. Focus groups were held following these workshops to explore students’ experiences of the co-design process. The workshops involved a range of activities, including theme generation, scenario development, resource creation (podcasts, simulations), and focus group discussions. Data from focus groups were analysed thematically.ResultsA total of 19 students participated across the two workshops. Three themes were identified: (1) Relationship development, where students identified the benefits of co-creating the resource and valued the flexibility, collaboration, and social aspects of the co-design approach; (2) Interprofessional collaboration, which challenged students’ assumptions about other disciplines, fostered teamwork and communication, and highlighted the need for early and continuous interprofessional learning; (3) Professional growth, with students reporting increased confidence in managing delirium, working with other professions, and engaging in novel experiences like podcasting and simulation.ConclusionsThe co-design process facilitated interprofessional collaboration, peer learning, and personal growth among healthcare students. Students appreciated the opportunity to co-create an educational resource while developing interprofessional skills. The study demonstrates the potential of co-design as a methodology for enhancing interprofessional education and promoting effective teamwork in healthcare.

An activity theory perspective on interprofessional teamwork in long-term care.

Teamwork in healthcare is shaped by reciprocal interactions among individual team members and their clinical context. Cultural Historical Activity Theory (CHAT) provides a framework to study teamwork from a developmental perspective. We observed interactions between members of an Interprofessional Healthcare Team (IHT) to identify practical guidelines for educators. Three Health Care Providers (HCPs) with more than 22-years' experience in a semi-urban LTC facility participated. We video-recorded two regular IHT meetings and selected excerpts for subsequent video-recall interviews. The excerpts were shown and discussed first with each team member, then with members in pairs and finally with all members reunited. We prompted participants to explain what was happening on the videos. All interviews were recorded, transcribed, and analyzed using CHAT's unit of analysis based on Activity Systems. We observed contradictions within the Activity Systems involving diverging views on outcomes of enhancing or maintaining quality of life; using non-traditional tools and spaces to sustain resident mobility; safeguarding community and patient safety despite time constraints and job titles, and unease for being paid to perform unconventional interventions. The contradictions have been grouped into three themes reflecting the Activity Systems: 1) enhancing versus maintaining quality of life; 2) improvising to achieve care goals; and 3) role fluidity. Our findings show that practical goal-oriented and contextual adaptations rely heavily on improvisation and dialogue. Educating HCPs for interprofessional teamwork should focus on developing situational awareness to foster continuous adaptation of disciplinary interventions.

An Overview of Nurses' Teamwork Perceptions at RS in 2024

Background: Ineffective teamwork and communication in healthcare has been identified as a major cause of medical errors that harm both patients and providers. Teamwork is the focus of attention in healthcare as the success and failure of the system largely depends on team performance. Objectives: This study aims to determine the picture of nurses' teamwork perceptions at RS in 2024. Methods: This study is a quantitative study with a cross-sectional design conducted in May-June 2024 at one of the hospitals in Padang, Indonesia. The population in this study were all nurses working in the inpatient room of RS with a sample size of 48 nurses selected through purposive sampling technique. Data were collected using a questionnaire consisting of socio-demographic instruments and teamwork perception instruments adopted from AHRQ 2020. Data were analyzed using computerized software. Results: The socio-demographic frequency distribution of respondents showed that most nurses were aged 17-35 years (62.5%), female (91.7%), had a Diploma of Nursing education (54.1%), and a working period between 1-14 years (79.1%). The perception of teamwork of nurses at RS is generally in the good enough category with a mean perception of teamwork of 128.00 (SD 35.39). The communication dimension obtained the highest score with a mean of 26.17 (SD 19.93) followed by the dimensions of team structure, leadership, situation monitoring, and mutual support. Conclusion: The perception of nurses' teamwork at RS in 2024 was in the good enough category with the communication dimension getting the highest score. Socio-demographic factors such as age, gender, education, and tenure influence perceptions of teamwork where nurses who are more experienced and have higher education tend to have more positive perceptions of teamwork.

Collaborative nursing education between advanced practice registered nurses

The surge in healthcare demands due to the explosion of growth in the aging adult population demands that academic institutions address enhanced education of Advanced Practice Registered Nurses (APRNs). This is particularly challenging amidst nurse faculty shortages in specialty areas, stemming from factors such as lack of pay competitiveness with clinical positions, and doctoral-prepared nurses seeking faculty positions. Despite efforts to address the shortages, recruitment challenges persist, necessitating innovative approaches. This article explores the interprofessional collaborative teaching between Nurse Anesthesia (NA) and Adult Gerontology Nurse Practitioner (NP) programs, focusing on airway management, sedation techniques, chest X-ray interpretation, and ultrasound skills. To date, this collaboration between NA and NP faculty has proven effective. Both synchronous and online asynchronous teaching have received overwhelmingly positive student feedback. Ongoing communication and collaborations between NA and NP faculty facilitate teaching and educational strategies across programs, sharing faculty expertise, and mitigating reduced faculty numbers. This innovative model benefits faculty and students and provides a platform for firsthand interprofessional collaboration, fostering mutual respect and preparing students for effective interdisciplinary healthcare teamwork.

Gap analysis of strategies for promoting interprofessional teams in healthcare units

PurposeA healthcare unit's effectiveness largely depends on how well its interprofessional teams work together. Unfortunately, the strategies used to improve these teams often lack substance. This study analyzed these strategies and found a performance gap.Design/methodology/approachThis study took a unique mixed-method approach, systematically reviewing both qualitative and quantitative studies that identified strategies to enhance interprofessional teams in healthcare units. To gauge the effectiveness of these strategies, the researcher utilized an Importance-Performance Analysis (IPA) in four specialized clinical training centers in Hamadan province, Iran. The analysis of the IPA involved 35 experts from these centers as the statistical population.FindingsBased on a systematic review, there are seven categories: contextual, strategic, communication, organizational, individual, Human Resources Management (HRM), and environmental for promoting interprofessional teams with a total of 36 sub-indicator. Based on the IPA, the HRM aspect shows the most extensive performance gap. The individual and organizational aspects fall under resource wastage, and the environmental aspect is within the indifferent zone. Also, some critical sub-indicators, such as incentives/rewards, roles and responsibilities, financial resources, team-initiated innovation, the culture of respect, partner resources, humility, data availability, set expectations, and team availability, are in the weak areas.Practical implicationsThis research has identified critical areas for improvement in promoting teamwork in clinical training centers through a comprehensive gap analysis. It also presents practical policy solutions to address these weak points, providing a clear roadmap for enhancing interprofessional teams in healthcare units.Originality/valueImproving teamwork in healthcare can be challenging, but it is possible with proper strategies and tools. One of the highlights of the recent study was the combination of systematic review studies with IPA to identify areas for improving interprofessional teamwork in clinical training centers.

Decoding healthcare teamwork: a typology of hospital teams

ABSTRACT The effectiveness of healthcare depends on successful teamwork. Current understanding of teamwork in healthcare is limited due to the complexity of the context, variety of team structures, and unique demands of healthcare work. This qualitative study aimed to identify different types of healthcare teams based on their structure, membership, and function. The study used an ethnographic approach to observe five teams in an English hospital. Data were analyzed using a combined inductive-deductive approach based on the Temporal Observational Analysis of Teamwork framework. A typology was developed, consisting of five team types: structural, hybrid, satellite, responsive, and coordinating. Teams were challenged to varying degrees with staffing, membership instability, equipment shortages, and other elements of the healthcare environment. Teams varied in their ability to respond to these challenges depending on their characteristics, such as their teamworking style, location, and membership. The typology developed in this study can help healthcare organizations to better understand and design effective teams for different healthcare contexts. It can also guide future research on healthcare teams and provide a framework for comparing teams across settings. To improve teamwork, healthcare organizations should consider the unique needs of different team types and design effective training programs accordingly.

Leadership and Followership in Health Professions: A Systematic Review.

Objective: Leadership discussion, including leadership development programs, is common. However, discussion of followership as a component of leadership seems less frequently discussed. With a focus on leadership and followership, this investigation reviewed the health-professions education literature and characterized leadership-followership within health-professions education. Methods: Using PubMed, ERIC, and Google Scholar, two investigators independently and systematically searched health-professions education literature for articles related to leadership and followership. Reports were categorized based on the articles by type, application, profession, leadership, and followership qualities. Results: Eighty-one articles were included. More than half [59% (48/81)] were theoretical, 27% (22/81) empirical, 7% (6/81) commentaries, and 6% (5/81) letters-to-the-editor). Empirical studies did not share outcomes that could be meaningfully combined quantitatively by meta-analysis; however, the vast majority (96%) of theoretical articles discussed a healthcare-related application of leadership and followership (e.g.,improving patient care, improving communication, improving organizational efficiency). Thus, a qualitative review was completed. Of the 81 articles, 57% (n=46) involved multiple professions, while 43% (n=35) focused on a specific profession [Nursing (n=16), Medicine (n=7), Others (n=5) Surgery (n=3), Pharmacy (n=2), Veterinary Medicine (n=2)]. While most articles (75%) discussed leadership qualities (with top qualities of effective communication, visionary, and delegating tasks), fewer (57%) discussed followership qualities (with top qualities of being responsible, committed, and supportive). Of note, some qualities overlapped in both leadership and followership (with top qualities of effective communication, being supportive, and providing/receiving feedback). Conclusions: Leadership-Followership was described in many health-professions' education literature. However, Pharmacy and Veterinary Medicine had substantially fewer articles published on this topic. Notably, followership did not receive nearly as much attention as leadership. Leadership has a dynamic and complex interaction with followership highlighting that an effective leader must know how to be an effective follower and vice versa. To improve leadership within healthcare teamwork, education should focus on both leadership-followership.

Inter-Organizational Home Care Nursing Teams: A Comparison of a Region Wide Organizational Change Initiative With Success Factors Identified by Forerunners and Team Theory

Teamwork is considered something positive. While there is much research on teamwork in healthcare, research on teamwork in home care nursing is limited. As the need for home care nursing is likely to increase in the future, it is of great interest to investigate the circumstances associated with the implementation of teamwork in home care nursing. The present study compares the results from a large change initiative intended to foster inter-organizational teamwork between municipal home care nurses and doctors employed by the region, with success factors identified by forerunners and contemporary team theory. Eighteen participants representing the organizations involved in the change initiative, and 6 participants from the forerunners, were interviewed, and 3 success factors were identified: fixed doctors in team, co-location of staff, and a shared team identity. However, for the studied change initiative, few of the success factors were present. Since the success factors are similar to factors associated with effective teamwork in the literature, this is problematic. The results indicate that there was a focus on the division of labor between the municipalities and the region rather than on interdisciplinary cooperation. They also suggest that the change initiative, as it worked in practice, did not always make sense from the perspective of the nurses and doctors involved. Thus, we suggest that measures are taken to ensure that change initiatives, like the 1 studied, also make sense on the local level in the organization where most of the implementation takes place.

Factors and interventions determining the functioning of health care teams in county-level hospitals in less affluent areas of China: a qualitative study.

Teamwork is essential for the quality and safety of care, and research on teamwork in health care has developed rapidly in many countries. However, evidence from less affluent, non-Western countries is scarce, while improving teamwork may be especially relevant to be able to increase the quality of care in these settings. This study aims to understand the main factors that influence, and interventions used to improve, the functioning of health care teams in the context of county-level hospitals in less affluent areas of China. We conducted semistructured interviews to explore the factors that influence team functioning and the interventions implemented to improve team functioning in these hospitals. 15 hospital presidents and 15 team leaders were selected as respondents. From the interviews, we have identified five main factors that influence team functioning in these hospitals: "stuck in the middle", local county setting, difficulty in attracting and retaining talent, strong focus on task design, and strong focus on leadership. The interventions for improving team functioning can mostly be categorized as the following: 1) measures to attract and retain talent (e.g., increase salary, train talent in national or provincial level hospitals, and provide fast-track promotions), 2) interventions focused on monodisciplinary teams (e.g., changing the team structure and leadership, and skill training), and 3) interventions to establish and improve multidisciplinary teams (e.g., simulation training and continuous team process improvements). With the introduction of multidisciplinary teams, interventions into team processes have started to receive more attention. The findings depict an overview of the main factors and interventions as specifically relevant for team functioning in county-level hospitals in less affluent areas of China and may help these hospitals benefit from additional process interventions to improve teamwork and the quality of care.

Healthcare Communication and Teamwork: An Interprofessional Case-Based Approach to Learning

Healthcare Communication and Teamwork: An Interprofessional Case-Based Approach to Learning

Gamification through collaborative learning in medical education

Introduction: Introduction to Health Profession (IHP) was designed to teach first-year medical students the importance of self-directed learning, accountability, and teamwork in healthcare. Due to the COVID 19 pandemic, the course was delivered virtually, incorporating elements of gamification. Methods: Gamification features included collaborative teamwork to simulate and record the roleplay for assignments based on crisis management scenarios. The syllabus involves knowledge checks to promote self-directed learning and personal accountability as well as online questionnaires to identify personality traits followed by discussion. Games like Chinese whispers and charades were introduced to identify listening skills. Additional gamification features include progress mechanics for collecting badges upon successful completion of knowledge checks / assessments and completing collaborative teamwork activities. Results: Results from the descriptive study on the educational usefulness of the IHP module was found to be satisfactory. The feedback was encouraging as >95% of students gave positive feedback that the IHP activities enabled them to understand the value of teamwork, effective communication, professional behavior and enabled them to be resilient and adaptable. 92% agreed that the IHP activities helped to make connections and network with their peers during the pandemic Conclusion: Gamification of IHP course was successful in terms of practicality and usefulness in promoting communication, collaborative work, experiential learning, and teamwork. Students were empowered to take charge of their own learning of both content and development of interpersonal skills and teamwork through gamification. The isolation caused by the pandemic was alleviated by the networking that occurred during collaborative group activities.

The impact of COVID-19 vaccination on psychiatric symptoms in schizophrenia patients: A retrospective study.

The objective was to investigate the impact of COVID-19 vaccination on anxiety, depression, stress perception, and psychiatric symptoms in patients with schizophrenia, and to explore severity of psychiatric symptoms is associated with vaccine hesitancy in individuals with schizophrenia. Mental health symptoms were evaluated in 273 hospitalized schizophrenia patients who received COVID-19 vaccination, and in 80 patients who refused vaccination, both before and after immunization. The study assessed the effects of vaccination on psychiatric symptoms and the potential association between vaccination behavior and psychological distress. Our findings suggest that COVID-19 vaccination is associated with a small worsening of schizophrenia symptoms in older inpatients. Moreover, vaccination behavior may increase anxiety, depression, and stress perception in hospitalized schizophrenia patients, which has implications for the mental health care team working in the context of the pandemic. The study highlights the importance of monitoring the mental health status of patients with schizophrenia during the COVID-19 pandemic, particularly in relation to vaccination behavior. Further research is needed to better understand the mechanisms underlying the observed effects of COVID-19 vaccination on psychiatric symptoms in patients with schizophrenia.

The importance of embedding an inclusive culture within healthcare teamwork education; an evaluation of implementation methods.

Teamworking is a fundamental concept within most organisations and healthcare is no different. It is at the core of everything we do as professionals and has a multitude of impacts including on patient safety, the quality of care that we provide, and staff morale. This paper looks at why we should prioritize advancing teamwork education; argues the advantages of developing an all-encompassing, inclusive team training approach; and summarizes the different methods of how to implement teamwork education within your organisation. Key messages Good teamworking processes have significant effects on patient safety and staff well-being. Inclusive training has wide-reaching benefits for staff morale, fostering colleague relationships and breaking down hierarchies. Teamwork education should be embedded within all healthcare organisations with the method used depending on organisational culture, hierarchy gradient and learners' starting knowledge.

Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context

Introduction:Saudi Arabia has experienced special challenges calling for effective teamwork in the management of disasters and emergencies, such as wars, earthquakes, and major accidents linked to the Hajj pilgrimage over the years. In 2015, 769 pilgrims died in a crowd stampede during Hajj. The outcome of the incident could have been different if the rescuers had the necessary multiagency and collaborative disaster education. This study aims to determine the development of Saudi HCWs’ teamwork during collaboration exercises.Method:This study employed two methods to gather data: (observational) during three-level-collaboration (3LC) tabletop-exercises and semi-structured interviews, by employing two theoretical models (team development models). The number of participants was (100) HCWs.Results:The results of these exercises had a positive impact on the functionality of HCWs and helped them prepare for disaster management and mitigation inside and outside of a medical facility. Based on the theoretical framework of the integration of team members, the participants reported that the trans-professional team developed because they understood the scenarios. In addition, the participants underscored they developed their skills and knowledge of disaster management because of the attempts made in scenario one. Furthermore, on the theoretical framework of team maturity, several participants indicated that immaturity in scenario one is because of the team members not having the same knowledge and skills. While in scenario two, they are mature because of training and challenges resulting in individual development.Conclusion:This study focused on determining the development of healthcare teamwork during collaborative exercises. HCWs were exposed to two scenarios. The tabletop training enabled HCWs to gain the maturity in team building and disaster management. Immature and overripe HCWs cannot easily embrace teamwork. In addition, the public should be made aware of disasters that may come their way. Continuous training of HCWs and creating public awareness are essential parts of disaster management.

Disaster Collaborative Exercises for Healthcare Teamwork in a Saudi Context

This study aimed to evaluate the development of healthcare teamwork during and after the collaboration tabletop exercises, through observation and interview methods. Integration and maturity theoretical models were employed to explain the collaborative challenges in teams that may suffer from unequally distributed power, hierarchies, and fragmentation. Using three-level collaboration tabletop exercises and the Command and control, Safety, Communication, Assessment, Treatment, Triage, Transport (CSCATTT) instrument, 100 healthcare workers were observed during each step in the implementation of the CSCATTT instrument using two simulated scenarios. The results show a lack of integration and team maturity among participants in the first scenario, leading to the delayed start of the activity, task distribution, and decision making. These shortcomings were improved in the second scenario. In-depth interviews with 20 participants in the second phase of the study revealed improved knowledge and practical skills, self-confidence, and ability in team building within trans-professional groups in the second scenario, which in concordance with the integration theory, was due to the attempts made in the first scenario. Additionally, there was an improvement in the team’s maturity, which in concordance with the maturity theory, was due to the knowledge and practical skills during scenario plays. These results indicate the importance of continuous tabletop training, and the use of CSCATTT as a collaborative instrument, to promote the development of collaboration and to test the concept of preparedness.

Advancing Teamwork in Health Care Through Continuing Education Joint Accreditation.

Teamwork is a necessity for effective care of patients in the current health care environment. Continuing education providers are best positioned to teach health care professionals about teamwork. However, health care professionals and continuing education providers largely operate in single-profession-based environments and thus need to change their programs and activities to achieve team improvement education goals. Joint Accreditation (JA) for Interprofessional Continuing Education is designed to advance teamwork to improve quality care through education programs. However, achieving JA requires significant changes to an education program that are multifaceted and complex to implement. Although challenging, implementation of JA is an effective way to advance interprofessional continuing education. Here, we discuss numerous practical strategies that can aid education programs to prepare for and achieve JA, such as attaining organizational alignment and provider adaptation to expand curriculums, reinventing the education planning process, and implementing tools to help manage the joint accredited program.

Outcomes of pregnant women hospitalized with unrepaired congenital heart disease: Insights from a multidisciplinary center in Vietnam

Background In developing countries, fewer women have access to multidisciplinary congenital heart disease and reproductive programs staffed by experts. We report pregnancy outcomes of a multidisciplinary healthcare strategy utilizing an in-hospital teamwork approach in Vietnam. Methods This retrospective cohort study included pregnant women with unrepaired congenital heart disease managed at a referral cardiovascular center. Results Undiagnosed congenital heart disease before pregnancy, a lack of pre-pregnancy cardiology counseling, and modified World Health Organization class III/IV were common. Under the multispecialty healthcare strategy, although the rate of maternal death was 8.2% in the modified World Health Organization class IV group, no deaths occurred in any other group. Fetal/neonatal complications occurred in 54% of pregnancies, and 49.4% of neonates survived. Poor pregnancy outcomes were associated with admission during the first/seconde trimester for fetus/neonates, third trimester for mother, modified World Health Organization class III/IV, cyanosis, and heart failure. Conclusion The outcomes of pregnant women with unrepaired congenital heart disease were poor but seemed to improve with a multidisciplinary in-hospital healthcare teamwork strategy.

Global Health Care Experiences of Female Survivors Who Experienced Trafficking: A Meta-Ethnography.

Most nurses and midwives do not feel adequately prepared to respond to the complex trauma and social and cultural needs of female clients who have experienced trafficking. There are data to support a lack of knowledge among health care providers about the types of human trafficking as well as poor structural supports within health care systems. The purpose of this review was to gain a more comprehensive understanding of the global health care experiences of females who have experienced trafficking. Noblit and Hare's 7-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using reciprocal translations. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). The collaborative search process in the PsycINFO, CINAHL, and Scopus databases resulted in 7 high-quality research studies published between January 2016 and January 2021. Most studies explored individuals' experiences of trafficking and views of health care services, challenges, and service use barriers. A total of 228 female survivors who experienced trafficking participated. They primarily experienced trafficking within different parts of North America, Eastern Europe, Africa, and South and Southeast Asia. Three main themes emerged: privacy, confidentiality, and identity problems; powerlessness; and clinician recognition and responsiveness. All participants reported being exposed to extremely high levels of physical and mental abuse before, during, and after exiting trafficking. Therefore, clinicians will require ongoing training and clearer guidance from clinical leadership to adequately care for the varying health needs of women and girls who have experienced trafficking or are currently in a trafficking situation. Adoption of a culturally sensitive, patient-centered, and trauma-informed approach is needed, as clients' reasons for staying in a trafficking situation vary. Relationships of trust should be formed in which rapport is cocreated and in which members of the health care team and client work hand in hand together to envision, identify, and pursue future-oriented and strength-based goals toward healing.

The Benefits of Teamwork in Health Care

The Benefits of Teamwork in Health Care