Teamwork Measures Research Articles

A systematic review investigating the effectiveness of interventions in preventing stage 1 and 2 pressure injury of hospitalized elderly patients

Pressure injuries are now the third most costly disease after cancer and cardiovascular disease. Around 60,000 deaths occur annually from the complications of pressure injuries. Pressure injuries are preventable but frequently result in adverse events or severe complications such as infection when developed. This study aims to determine which interventions prevent hospitalized-acquired pressure injuries and are more effective in hospitalized elderly patients. The design used in this study is a systematic review. As presented, it summarizes the studies that were analyzed in the effective interventions in the prevention of pressure injuries in hospitalized elderly patients. Multiple interventions include healthcare professionals’ teamwork measures, education of the healthcare staff, use of risk-assessment tools, offloaded heels or bony prominences, repositioning, and assessment of the nutritional status and the skin. Increasing staff knowledge and patient and family involvement improved health outcomes. There was a significant reduction in the incidence of hospitalized-acquired pressure injuries in elderly patients.

Development and Validation of the Individual Teamwork Behaviors Questionnaire

Although there has been significant research investigating the processes that facilitate how individuals work collectively as a team, there has been little attention to the specific behaviors that individual team members need to exhibit to support teamwork. Despite two such measures currently existing in the literature, both suffer from a few important limitations, which makes it difficult to ensure individual team members are contributing to the team and targeted for the most appropriate developmental efforts. Through a series of studies, we inductively develop the dimensions for such a measure, establish its convergent and discriminant validity against an established peer-evaluated measure, and then show how it fits in the nomological network of established teamwork measures. The resulting measure supports the strengths of a multi-source, peer-rated scale by capturing observable behaviors that can more clearly be evaluated by fellow group members and which are applicable to various organizational environments.

Factors Related to Effective Teamwork Performance in Nursing

Introduction. The importance of teamwork in nursing has gained an increased attention in recent years due to the complexity of the healthcare delivery system, and a shortage of nurses, which has resulted in increased workloads which may result in work errors, thus impacting patient, nurse, and organizational outcomes. Effective nursing teamwork is vital for the provision of high-quality healthcare.Aim. This review examines current research on teamwork in nursing with a focus on factors related to effective teamwork performance.Methods. A narrative review of articles regarding the factors which influence effective teamwork in nursing was carried out between December 2023 and January 2024. An electronic search of the Pub- Med database was applied to select relevant articles using the keywords teamwork among nurses, effective teamwork, and nursing.Results. The online search resulted in 854 articles. Twenty-one articles were then selected for a full-text review. Five articles met the inclusion criteria. Factors related to effective teamwork performance in different domains have been identified and described in the present research. Those factors are: trust among team members, team motivation, effective working environment, effective communication, effective team management, education about team- work, measurement of teamwork, knowledge sharing among team members, and interventions for enhancing nurses’ teamwork.Conclusion. It has been proven that effective teamwork is key to ensuring quality of care, better healthcare outcomes, and patient and healthcare worker safety. Therefore, facilitating and supporting effective teamwork should be one of the priorities of healthcare organizations. To achieve this, it is necessary to take into account the factors related to effective teamwork performance. The emphasis should be on strengthening the effective teamwork of nurses for the benefit of quality patient care.

The Psychometric Properties of Two Brief Measures of Teamwork in Sport.

In the current study, the structural and external validity of data derived from two shorter versions of the Multidimensional Assessment of Teamwork in Sport (MATS) were examined using multilevel analyses. Evidence of model-data fit was shown for both a 5-factor model comprising 19 items (with subscales assessing teamwork preparation, execution, evaluation, adjustments, and management of team maintenance) and a single-factor model comprising five items (providing a global estimate of teamwork). In general, data from both versions were positively and significantly correlated with (and distinct from) athletes' perceptions of team cohesion, collective efficacy, performance satisfaction, enjoyment in their sport, and commitment to their team and their coaches' transformational leadership. The measures appear well suited to detect between-teams differences, as evidenced by intraclass correlation coefficients and acceptable reliability estimates of team-level scores. In summary, the 19-item Multidimensional Assessment of Teamwork in Sport-Short and five-item Multidimensional Assessment of Teamwork in Sport-Global provide conceptually and psychometrically sound questionnaires to briefly measure teamwork in sport.

The impact of brief mindfulness meditation on anxiety, cognitive load, and teamwork in emergency simulation training: A randomized controlled trial

BackgroundEmergency simulation training may impose a heavy psychological burden on health professions students (HPS), evoking anxiety, and overwhelming their cognitive load. Mindfulness may have a positive impact on HPS’ anxiety, cognitive load, and teamwork during simulation training. The effects of integration of a brief pre-briefing mindfulness meditation (MM) practice into emergency simulation training, on anxiety, cognitive load, and teamwork remain understudied. MethodsFrom November 2021 to June 2022, 70 undergraduate HPS participated in this pilot randomized controlled study. Participants were randomly assigned to the experimental group (EG, n = 24) that completed a brief in-person mindfulness meditation training program (MMTP) (2 h/week during 4 weeks) or a control group (CG, n = 46). Each group was comprised of teams (2 medical students and 1–2 nursing students). Measures of anxiety, mindfulness, cognitive load, and teamwork were collected at 4-time points: baseline, after the completion of the brief MMTP (for the EG only), at the first simulation assessment within one month later, and the second (6-month follow-up) simulation assessment. Student's t and Wilcoxon Mann-Whiney tests were used to compare the groups' measures and changes over time. A one-way repeated measures ANOVA was conducted to assess anxiety and mindfulness scores' changes over time among EG participants. Results52 participants completed all time-point assessments. EG participants recorded better state-anxiety, cognitive load, and teamwork scores than the CG participants in both simulation assessments. However, no statistically significant differences were recorded between the EG and the CG in trait-anxiety and mindfulness at the 6-month follow-up assessment. ConclusionBrief pre-briefing MM practice mitigates HPS' state-anxiety, and promotes cognitive load, and teamwork during emergency simulation training. Simulation instructors should consider MM practice in the emergency healthcare simulation instructional design.

Teamwork in Cybersecurity: Evaluating the Cooperative Board Game [d0x3d!] as an Experimental Testbed

It is crucial to identify the knowledge, skills, and attitudes (KSAs) that contribute to success in cybersecurity teams. We introduce a board game, [d0x3d!], as an experimental testbed designed to create a controlled environment and set of manageable tasks aimed at exploring teamwork competencies that may be relevant to the cybersecurity workforce. [d0x3d!] requires players to work together and share information to retrieve stolen digital assets. The authors aim to improve the efficacy of cybersecurity team training by incorporating modern teamwork theory and measurement. This testbed provides a low-cost and user-friendly platform for training, evaluation, and research.

Methodology to evaluate the effectiveness of instituting a modified preoperative time out on teamwork: a pilot study.

This study was conducted as a pre-intervention, post-intervention pilot study. A validated survey was used as an instrument to measure overall teamwork in the operating room. Data were obtained in two periods of time: In phase 1 (pre-intervention), the standard preoperative surgical time out was used. In phase 2 (post-intervention), a modification of the standard time out was employed, emphasizing the equality and importance to safety of listening to the opinions of all team members in the room. The use of an enhanced surgical time out was shown to have a small, but measurable positive correlation with a validated measure of operating room teamwork. Mean survey Likert scores increased from 68.03 to 68.81 out of a total survey score of 90, with an appropriate control range shift. Although this small pilot study was insufficiently powered to evaluate subcategories of teamwork, such as clinical leadership, communication, coordination, and respect, we hope to address this in future larger studies. Our data from this pilot study suggest that giving each member of the surgical room team a position of equality in analyzing the operating room environment prior to commencing surgery led to a positive, measurable difference in an objective measure of teamwork. Increases in teamwork have been shown in the literature to lead to an overall safer surgical environment.

Evaluating the Educational Effectiveness of Hospital Healthcare Providers after Chemical Mass Casualty Response Training Program

Introduction:Chemical exposures can cause direct and indirect injuries to responding medical personnel. Therefore, hospital healthcare providers should be provided with disaster response training that includes identification of chemical hazards, establishment of the hazard zone, personal protective equipment use, decontamination, and chemical injury antidote use. This study evaluates the educational effectiveness of the chemical-mass casualty incident response education module (C-MCIREM) for hospital healthcare providers.Method:This was a retrospective quasi-experimental study. Subjects were hospital providers who enrolled in the C-MCIREM program between May 1, 2021, and July 26, 2022. Subjects were hospital providers from Bucheon, Mokpo, Iksan, Jeonju, and Dae-gu cities in South Korea. Subjects completed pre, post, and three-month knowledge retention and self-assessments of readiness tests, as well as evaluations on tabletop exercises (TTX), and a satisfaction survey (11-point Likert) after the course. The instructors scored teamwork measures via standardized evaluations on TTX throughout the course. The K-paired Sample Friedman test was used to compare samples.Results:127 respondents were enrolled. The median knowledge score rose from 51/100 (39, 66) to 85.5/100 (73.75, 90) with a median retention score of 74/100 (64, 88) (p<0.001). Participants felt their readiness to respond increased in all facets (all p<0.001) on the post and retention test for the MCI situation. All three hospital teams showed significant increases in teamwork between the median of the 1st and 4th TTX as 27/100 (23.5, 29) and 69/100 (66.75, 69.5) (p<0.05). Participants were overall satisfied (9.1/10 SD 1.13) and would recommend the training to others (9.15/10 SD 1.2).Conclusion:C-MCIREM participants had high satisfaction with a significant increase and persistence in knowledge, improved teamwork, and self-assessed readiness to respond to a chemical mass casualty incident.

Teamwork measure relates to provider experience, burnout, and intent to stay.

To develop a brief teamwork measure and determine how teamwork relates to provider experience, burnout, and work intentions. Survey of clinicians. We analyzed data from Optum's 2019 biannual clinician survey, including a validated burnout measure and measures of provider experience and intent to stay. A 6-item measure of team effectiveness (TEAM) focused on efficiency, communication, continuous improvement, and leadership. Construct validity was assessed with content, reliability, and correlation with burnout. Generalized estimating equations with robust SEs determined relationships among TEAM score, provider experience, and intent to stay, controlling for demographics, clustering, and practice factors. Of 1500 physicians and advanced practice clinicians (1387 with complete data; response rate 56%), there were 58% in primary care; 57% were women, and 38% identified as Asian, Black/Hispanic, or another race/ethnicity other than White non-Hispanic. Burnout was present in 30%. The Cronbach α was excellent (0.86), and TEAM correlated with the validated burnout measure (adjusted odds ratio [OR] of lower burnout with high TEAM score, 0.28; 95% CI, 0.19-0.40; P < .0001). Clinicians with TEAM scores of at least 4 were more likely to have positive provider experiences (79% favorable vs 24% with low TEAM score; P < .001), had lower burnout rates (17% vs 44%%; P < .001), and more often intended to stay (93% vs 65%; P < .001). TEAM index score was strongly associated with provider experience (adjusted OR, 11.72; 95% CI, 8.11-16.95; P < .001) and intent to stay (adjusted OR, 7.24; 95% CI, 5.34-9.83; P < .001). The TEAM index is related to provider experience, burnout, and intent to stay, and it may help organizations optimize clinical work environments.

Community-based interprofessional education in rural primary care

Health disparities and workforce shortages persist in the rural United States. In response, academic health professions programs are providing opportunities for students to participate in rural clinical rotations. We expanded an existing academic-practice partnership with a rural primary care clinic, in which students completed 4-week rotations in their discipline, to add an interprofessional community-based component. The goals were to: 1. Accelerate students’ acquisition of teamwork competence, specifically skills in team effectiveness, team communication, reflective practice, and situational awareness; and 2. Immerse students in community-based rural primary care practice with patients characterized by high rates of chronic illness and adverse social determinants of health. Teams of students participated in home visits with older adult patients that focused on social determinants of health and reducing barriers to health care.We applied a realist evaluation framework to evaluate the program, using data on patient profiles, student profiles, student pre- and post-scores on a teamwork measure; student reflections; preceptor observations of student performance; and perspectives about the program from clinic staff. The ACE-15 was used to measure teamwork. Forty-eight rural patients and 38 students participated. The ACE-15 mean score at T1 was 51.4 (SD 6.6) and at T2 was 56.7 (SD 3.6), a significant improvement (p < .05). Preceptor observations suggested that students’ teamwork skills improved over time. Student self-reflections indicated their appreciation for the opportunity to work in an interprofessional team and the value of visiting rural patients in their homes. Staff observed that patients received better care, and that the program benefited both students and patients.

Practical resiliency training for healthcare workers during COVID-19: results from a randomised controlled trial testing the Community Resiliency Model for well-being support

ObjectiveTo introduce the Community Resiliency Model (CRM) as mental well-being support for healthcare workers working through the height of the COVID-19 pandemic.DesignRandomised controlled trial with a no treatment control group.SettingTwo...

Intraoperative workload during robotic radical prostatectomy: Comparison between multi-port da Vinci Xi and single port da Vinci SP robots

The goal of this study was to quantify and compare prospective self-reported intraoperative workload and teamwork during robot-assisted radical prostatectomy (RARP) for multi-port da Vinci Xi (MP) and single-port da Vinci SP (SP) robots. The self-reported workload (surgeon and surgical team) and teamwork (surgeon) measures were collected and compared between MP and SP RARPs, as well as the learning curve. Results from 25 MP and SP RARPs showed that overall, the NASA-TLX workload subscales were lower, and the teamwork modified NOTECHS subscales were higher for the MP RARPs compared to the SP RARPs. The underlying reason for the significant differences between these two RARP surgical procedures could be other factors (e.g., robot design factors) in addition to the surgeon and surgical team's experience. The results also suggested learning effects through the 25 SP RARPs; however, twenty-five procedures may not be enough to achieve proficiency with the SP system.

The Rising Return to Noncognitive Skill

This paper uses administrative data from Sweden to document trends in the labor market returns to skills. Between 1992 and 2013, the economic return to noncognitive skill—a psychologist-assessed measure of teamwork and leadership skill—roughly doubled. The return to cognitive skill was relatively stable and decreased modestly during the 2000s, however. Among men with similar levels of education, the return to noncognitive skill is higher than the return to cognitive skill. The increasing return to noncognitive skill is driven by changes at the top of the wage distribution and by sorting into higher-paying occupations. (JEL I26, J24, J31)

An intervention to improve the work system of neonatal resuscitation teams

BackgroundNeonatal resuscitation teams face unique challenges in the delivery of patient care. Our purpose was (a) to understand team challenges and then (b) to improve the work system. MethodsThe user-centred design process involved multiple iterations of requirements gathering, prototype design, evaluation, and redesign. Methods included (1) field observations, (2) interviews with neonatologists (n = 3) and neonatal nurses (n = 4), (3) tabletop evaluations with neonatal clinicians (N = 7), and (4) in-situ simulations (N = 12). ResultsThe intervention comprised the following four prototypes: (1) a four-page resuscitation recording form; (2) a procedural shelf attachment for the resuscitation trolley that provides additional space for sterile procedures; (3) an equipment turntable that allocates equipment layout into four sections that correspond with the steps of resuscitation; and (4) an A3-size display of the neonatal resuscitation algorithm. Simulation-based testing showed a moderate-to-high usability rating of 79.2 on the SUS (system usability scale). ConclusionsA multi-method approach provided (a) novel insight into ‘work as done’ challenges and (b) an intervention designed to address challenges within the work system. This project is an example of a systematic approach to quality improvement in a complex clinical work environment. Subsequent phases will evaluate the prototypes on teamwork and clinical performance measures.

Can SBAR be implemented with high fidelity and does it improve communication between healthcare workers? A systematic review

ObjectiveTo characterise the extent to which health professionals perform SBAR (situation, background, assessment, recommendation) as intended (ie, with high fidelity) and the extent to which its use improves communication clarity...

Safety climate, leadership and patient views associated with hip fracture care quality and clinician perceptions of hip fracture care performance.

Hip fracture is a major public health concern for older adults, requiring surgical treatment for patients presenting at hospitals across Australia. Although guidelines have been developed to drive appropriate care of hip fracture patients in hospitals, data on health outcomes suggest these are not well-followed. This study aims to examine whether clinician measures of safety, teamwork and leadership, and patient perceptions of care are associated with key indicators of hip fracture care and the extent to which there is agreement between clinician perceptions of hip fracture care performance and actual hospital performance of hip fracture care. Retrospective analysis was performed on a series of questionnaires used to assess hospital department- and patient-level measures from the Deepening our Understanding of Quality in Australia study. Data were analysed from 32 public hospitals that encompassed 23 leading hip fracture clinicians, 716 patient medical records and 857 patients from orthopaedic public hospital wards. Aggregated across all hospitals, only 5 of 12 of the key hip fracture indicators had ≥50% adherence. Adherence to indicators requiring actions to be performed within a recommended time period was poor (7.2-25.6%). No Patient Measure of Safety or clinician-based measures of teamwork, safety climate or leadership were associated with adherence to key indicators of hip fracture care. Simple proportionate agreement between clinician perceptions and actual hospital performance was generally strong, but few agreement coefficients were compelling. The development of strong quality management processes requires ongoing effort. The findings of this study provide important insights into the relationship between hospital care and outcomes for hip fracture patients and could drive the design of targeted interventions for improved quality assurance of hip fracture care.

Measuring interprofessional education and collaborative practice competencies: a content validity study of the Jefferson Teamwork Observation Guide®

ABSTRACT Collaborative practice (CP) is integral in meeting the Quadruple Aim of healthcare, with effective team-based practice linked to improving all four components. Evidence of the validity of tools measuring collaborative practice competencies is lacking in educational and practice settings. The Jefferson Teamwork Observation Guide® (JTOG®), a real-time, 360-degree competency-based assessment tool administered via mobile app, provides formative feedback to learners in educational settings and helps practitioners develop and refine team-based behaviors in clinical settings. This study examines content validity evidence in terms of the linkage of JTOG items with the four Interprofessional Education Collaborative (IPEC) core competencies, along with two additional domains of leadership and patient-centeredness. Results provide content validity evidence to support use of the JTOG in interprofessional collaborative practice (IPCP) settings. The Teams and Teamwork competency was linked with every item, which is consistent with JTOG as a measure of teamwork. Aligning with the 2016 IPEC update, the JTOG items are all intercorrelated and together represent coverage across all competency areas. While items were typically linked to multiple competencies, each item only had one primary linkage. Analyses revealed that there is sufficient evidence of content validity relative to the intended IPCP competencies, and the JTOG tool is promising in its role to fill a gap in extant literature to measure collaborative practice behaviors.

Rapid Response System Restructure: Focus on Prevention and Early Intervention.

This article describes the staged restructure of the rapid response program into a dedicated 24/7 proactive rapid response system in a quaternary academic medical center in the southern United States. Rapid response nurses (RRNs) completed clinical leadership training on artificial intelligence, electronic risk stratification alerts, expert nurse rounding, emergency response, teamwork, closed-loop communication, and outcome measurement. The program goal was to reduce preventable deaths and resuscitation events outside the intensive care unit (ICU). Program outcomes between 2017 and 2019 included a 65% decrease in cardiac arrests outside the ICU, a 27% decrease of cardiac arrests inside the ICU, a 4.7% decrease in patients admitted to the ICU from inpatient beds, and a 27% reduction in the risk-adjusted mortality index for patients with expert proactive rounding encounters. Hospital peer group ranking on the Hospital Survey of Patient Safety improved in the areas of events reported, actions promoting patient safety, and continuous improvement suggesting a positive cultural shift. Implementation of a dedicated 24/7 RRN model of care integrating proactive rounding, technology, and ART can improve outcomes for patients and staff.

Action Research to Develop Mathematical Learning Activities by Using Games

The objectives of this research were 1) to design and develop mathematical learning activities by using games and 2) to study the results of mathematics learning activities by using games. There were two groups of population. The first group was the fourth year mathematics program with a number of 24 people who are responsible for the design and develop mathematical learning activities by using games. The second group consisted of 81 students in Mathayomsuksa 1, which were used to study the results of mathematics learning activities by using games. The research instruments were operational research processes, mathematics achievement test and the teamwork measures. The statistics used for data analysis were mean, standard deviation, t-test dependent and content analysis.

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) to Improve Collaboration in School Mental Health: Protocol for a Mixed Methods Hybrid Effectiveness-Implementation Study.

BackgroundPublic schools in the United States are the main providers of mental health services to children but are often ill equipped to provide quality mental health care, especially in low-income urban communities. Schools often rely on partnerships with community organizations to provide mental health services to students. However, collaboration and communication challenges often hinder implementation of evidence-based mental health strategies. Interventions informed by team science, such as Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), have the potential to improve treatment implementation and collaboration within schools.ObjectiveThe objective of this study is to improve communication and collaboration strategies among mental health and school staff by adapting an evidence-based team science intervention for school settings. We present a protocol for a hybrid effectiveness-implementation study to adapt TeamSTEPPS using stakeholder feedback, develop a tailored implementation plan, and pilot the adapted content in eight schools.MethodsStudy participants will be recruited from public and charter schools and agencies overseeing school mental health services in the local metro area. We will characterize current services by conducting a needs assessment including stakeholder interviews, observations, and review of administrative data. Thereafter, we will establish an advisory board to understand challenges and develop possible solutions to guide additional TeamSTEPPS adaptations along with a complementary implementation plan. In aim 3, we will implement the adapted TeamSTEPPS plus tailored implementation strategies in eight schools using a pre-post design. The primary outcome measures include the feasibility and acceptability of the adapted TeamSTEPPS. In addition, self-report measures of interprofessional collaboration and teamwork will be collected from 80 participating mental health and school personnel. School observations will be conducted prior to and at three time points following the intervention along with stakeholder interviews. The analysis plan includes qualitative, quantitative, and mixed methods analysis of feasibility and acceptability, school observations, stakeholder interviews, and administrative data of behavioral health and school outcomes for students receiving mental health services.ResultsRecruitment for the study has begun. Goals for aim 1 are expected to be completed in Spring 2021.ConclusionsThis study utilizes team science to improve interprofessional collaboration among school and mental health staff and contributes broadly to the team science literature by developing and specifying implementation strategies to promote sustainability. Results from this study will provide knowledge about whether interventions to improve school culture and climate can ready both mental health and school systems for implementation of evidence-based mental health practices.Trial RegistrationClinicalTrials.gov NCT04440228; https://clinicaltrials.gov/ct2/show/NCT04440228International Registered Report Identifier (IRRID)DERR1-10.2196/26567