Teamwork Quality Research Articles

Assessing the quality of Shared Priorities in teams using content analysis in a microworld experiment

ABSTRACTObjective, easy to use, and easy to comprehend assessment methods for measuring shared understanding in teams are hard to find. This paper describes an experiment where a measure called Shared Priorities, which is based on ranking of self-generated strategic items, is assessed. Trained teams were compared to non-trained teams in a dynamic problem-solving task. The maturity of the participating teams was also assessed using a content analysis measure. The Shared Priorities measure was used alongside other well-documented measures of team awareness based on self-rating. Results show that the Shared Priorities measure correlates with task performance and could also distinguish between trained and non-trained teams. However, the Shared Priorities measure did not correlate with the other team measures (cf. CARS – Crew Awareness Rating Scale – and DATMA – Distributed Assessment of Team Mutual Awareness), suggesting that it captures a different quality of teamwork than the self-rating measures. Further, the Shared Priorities measure was found to be easily administered.

Relationship between job burnout, psychosocial factors and health care-associated infections in critical care units

Burnout is a serious problem for critical care unit workers because they are exposed to chronic psychosocial stressors, including high responsibility, advanced technology and high patient acuity. Recent evidence showed that staff burnout was directly associated with hospital infections, thus affecting quality and safety of care provided. The research aim was to investigate how burnout was associated with some psychosocial factors and with health care-associated infections in hospitalised patients. A total of 130 healthcare professionals from critical care units completed a self-reported questionnaire. The infection data were collected prospectively over a six-month period. The results showed that emotional exhaustion was related to cynicism due to high work demands. Cynicism affected team communication, which in turn was positively related to team efficacy, thus acting as a mediator. Finally, team efficacy was negatively related to infections. The study showed that emotional exhaustion and cynicism were related to psychosocial aspects, which in turn had a significant impact on healthcare-associated infections. Our findings suggest how burnout can indirectly affect healthcare-related infections as a result of the quality of teamwork. Thus, reducing burnout can be a good strategy to decrease infections, thus increasing workers' well-being while improving patient care.

Abstract 15: Quantifying Teamwork at Hospital Discharge for Readmissions Reduction: A Network Analytics Approach

Background: The vulnerable period for hospital readmission begins upon hospital discharge, a complex, interdisciplinary process that necessitates close teamwork for accurate execution of the discharge plan. Thus, better understanding of the quality of teamwork throughout the discharge process may inform strategies to reduce hospital readmissions rates. Novel methods using a network analytics approach to quantify teamwork may better characterize this critical clinical process, facilitate quality improvement (QI), and become an important tool in learning healthcare systems. Methods: We extracted three years of patient, provider, and activity data related to discharge planning for an inpatient cardiology unit from Northwestern Medicine’s Enterprise Data Warehouse. We then created a provider-patient network to identify providers who shared patients and calculated readmissions rates for provider pairs. Using these data, we calculated a novel parameter, the Shared Positive Outcome Ratio (SPOR), an objective composite measure that quantifies the concentration of positive outcomes over a set of shared patients. To identify significant low-readmission and high-readmission collaborative relationships, we compared the observed network to 1000 sample networks containing randomized readmission values. Results: We identified 133,927 actions distributed among 38 discharge activity types performed during 13,720 patient encounters. The collaborative network was composed of 1,542 providers including 503 nurses, 432 residents, 207 physicians, 111 physical and occupational therapists, 59 medical students, 32 dieticians, and other medical and administrative staff. The average encounter involved 4 providers performing 10 discharge-related actions. After pruning the network to include only provider pairs with 6 or more shared patients, we found that 6% of collaborative interactions had a significantly low SPOR, indicating lower than expected readmission rates. Conversely, 12% of collaborative interactions had a significantly high SPOR, indicating higher than expected readmission rates. We identified 21 providers who had a low SPOR for a significant percentage of their collaborations, indicating potential top performers in the teamwork domain. Conclusions: Readmission rates appear to vary across different teams of providers. Team collaboration can be quantified using a composite measure of collaboration across provider pairs. Tracking provider pair outcomes over a sufficient set of shared encounters may inform various QI strategies, such as optimizing team staffing, identifying high-performing teams who can share their best practices, and redesigning discharge care processes. Ongoing work on this model is focused on accurately risk-adjusting outcomes, which will increase the robustness of this method.

Identifying the Impact of Team Size on Team Work Quality (TWQ) in Software Teams through an Empirical Approach

The aim of this research is to investigate the impact that team size creates on team work quality (TWQ) of teams that are involved in software development. This study has considered the seven constructs of a team proposed by Weimar et al (2013) for measuring team work quality of a software team. 112 respondents from various IT based multinational organizations belonging to Chennai, India have been surveyed. A multiple analysis variance analysis was applied on the data collected. The statistical analysis of the primary quantitative data collected reveals that team work quality is greatly affected by the size of the team. Also it has been proven that smaller teams exhibit better overall performance when compared with that of the larger teams.

From the islands of knowledge to a shared understanding: interdisciplinarity and technology literacy for innovation in smart electronic product design

In the context of the evolving Internet, a balance between technological advances and meaning change is crucial to develop innovative and breakthrough “connected electronics” that enable the Internet of Things. Designers and technologists are key enablers of this process respectively, ensuring adequate users’ needs and technology development, inside the evolving context of social environment and human relations. Smart electronic product design must be a truly interdisciplinary process, in which technologists are aware of how much their decisions impact the user-product relationship and designers understand the full potential and associated limitations of technology involved. Shared knowledge and communication are essential in this scenario, but, due to their technological limitations, designers are often excluded from high-level decision processes. In this paper, we address the design of constructivist tools and associated strategy to enhance the technological literacy of designers, as a strong foundation for knowledge-based dialogue between these realms. We demonstrate its effectiveness in a long-term multidisciplinary Project-Based Learning application with Design and Electronics students. We present the cases from 2 years’ experimentation (with the first year as control group) that demonstrate improvement in the quality of teamwork; in learning results; improved performance of the students reflected in the quality of the projects developed; and positive teachers’ and students’ evaluations. We conclude that the use of the proposed tool not only provides the designer an active voice in the process of designing smart electronics, but also promotes an effective common language between these two worlds.

Factors contributing to nursing team work in an acute care tertiary hospital

Effective nursing teamwork is an essential component of quality health care and patient safety. Understanding which factors foster team work ensures teamwork qualities are cultivated and sustained. This study aims to investigate which factors are associated with team work in an Australian acute care tertiary hospital across all inpatient and outpatient settings. All nurses and midwives rostered to inpatient and outpatient wards in an acute care 600 bed hospital in Sydney Australia were invited to participate in a cross sectional survey between September to October 2013. Data were collected, collated, checked and analysed using Statistical Package for the Social Sciences (SPSS) Version 21. Factors reporting a significant correlation with where p < 0.05 were analysed in a multiple regression model. A total of 501 surveys were returned. Nursing teamwork scores ranged between 3.32 and 4.08. Teamwork subscale Shared Mental Model consistently rated the highest. Mean scores for overall communication between nurses and team leadership were 3.6 (S.D. 0.57) and 3.8 (SD 0.6) respectively. Leadership and communication between nurses were significant predictors of team work p < 0.001. Our findings describe factors predictive of teamwork in an acute care tertiary based hospital setting across inpatient and outpatient specialty units. Our findings are of particular relevance in identifying areas of nurse education and workforce planning to improve nursing team work.

Overview and Summary: Care Coordination: Benefits of Interprofessional Collaboration

Care transitions are recognized as a time of significant vulnerability for children and adults with multiple chronic illnesses and complex health and social needs. Moving between settings or between providers requires comprehensive preparation and education of patients and families and accurate and timely flow of essential information. Lack of effective coordination on both sides of the transition leaves patients at risk for serious adverse outcomes influencing quality of life and function and substantial cost.This OJIN topic captures several important steps in the evolution of knowledge and practice of transitional care and care coordination. Together, the articles included in this topic reflect where we have been and where we still need to go to assure that patients and their families have safe and effective transitional care experiences. The articles range from a summary of over two decades of research on the nurse-led Transitional Care Model (TCM) to recent pilot studies developing new models and tools to expand transitional care and care coordination interventions to new settings and populations.In Continuity of Care: The Transitional Care Model, Hirschman and members of the multiprofessional Transitional Care Model (TCM) team at the University of Pennsylvania detail the evidence supporting the impact of their nurse-led transitional care model on quality and cost outcomes for older adults with multiple chronic illnesses. The TCM has undergone rigorous testing over the past two decades and has consistently demonstrated reductions in hospitalizations and costs for Medicare beneficiaries at high risk for adverse outcomes. This well-recognized model has been implemented in hospitals and health systems including patientcentered medical homes across the United States. The nine core TCM interventions and tools developed to measure them are described in the paper. This latest summary of the body of TCM research and its translation into real-world health care systems is a testament to the importance of rigorous and continuous programs of research for defining and improving care coordination for vulnerable populations with complex care needs.DelBoccio and colleagues describe one hospital's experience in becoming a top performer in transitional care in Successes and Challenges in Patient Care Transition Programming. Spurred to improve transitional care by changes in the Affordable Care Act, Indiana University Health North Hospital launched new programs to enhance patient activation and health team performance in medication management and communication with post-acute providers. Their experience reinforces the importance of effective teamwork and continuous quality improvement in making meaningful improvements in the care transition experience and subsequent performance outcomes.Nurses across academic and clinical settings in Minnesota describe the implementation of two models of care coordination for children with medical complexity (CMC) in their article Pediatric Care Coordination: Lessons Learned and Future Priorities. Cady and colleagues designed the TeleFamilies Model and PRoSPer models of pediatric care coordination to overcome current challenges of integrating complex care for children in healthcare homes (HCH) and to address key components of their state's healthcare reform legislation. Examining the implementation of new care coordination models within the context of unfolding state healthcare reform is a critical aspect of this article. Both the TeleFamilies and PRoSPer models incorporate nurses as drivers of care coordination processes in concert with members of interprofessional teams. They involve different team members and the use of different technologies according to the needs of children and families in rural and urban HCHs. The results of initial model tests show improved family perceptions of their health care experience and provider communication. The authors suggest several opportunities for further evaluation of In their article Registered Nurse Care Coordination: Creating a Preferred Future for Older Adults with Muitimorbiditv. …

Transformational Leadership and Inter-Team Collaboration

We develop and test a model of the effects of transformational leadership beyond the boundaries of a team to the level of collaboration with other teams. We also test team size as a boundary condition in this relationship. In a study using a crisscross design to control common method bias, using a sample of 388 teams from a leading, global electronics company, the results from structural equation modeling (SEM) reveal that teams with transformational leaders are more likely to have higher internal teamwork quality (TWQ) and receive high inter-team collaboration ratings from other teams. Results further support the expectation that the association between transformational leadership and inter-team collaboration is mediated by TWQ and moderated by team size. The importance of transformational leadership for team-level research, as well as its hidden benefits beyond internal team boundaries, is discussed.

Surgical scheduling with antagonistic human resource objectives

Daily operating theatre scheduling is a complex problem with strong constraints and various objectives to optimise. In this article, we aim not only to optimise the classical objectives of scheduling performance, such as the makespan and the cost of overtime, but also, particularly, to upgrade human resource management performance by means of two additional objectives: a short-term objective on the quality of teamwork and a long-term objective on the level of nurses’ skills. The quality of teamwork depends on affinities between team members, which also have a significant impact on the quality and the safety of surgery. It maintains the unity of surgical teams. Such unity is however unfavourable to nurses’ skill diversification. In order to counterbalance this tendency, the long-term objective proposed is for nurses to acquire the widest possible spectrum of skills, in order to be able to assist surgeons in unplanned and emergency surgery. Taking into account these two antagonistic human resources objectives contributes to patient safety through better team building. It is the main originality of this work. In the long term, this method reduces the impact of this antagonism. In addition, we use the multi-objective ε-constraint method to obtain Pareto optimal solutions.

Teamwork Pengembangan Kemitraan (Studi Kasus Kelompok Kerja Pengembangan Kemitraan dalam Penangulangan Kemiskinan di Kota Bogor)

The title of this research is “Teamwork of Development Partnership (Case Study Development Partnership Teamwork of Poverty in Bogor)”. This research aims to describe the teamwork process conducted by the Working Group on Development Partnership include communication, compromise, cooperation, coordination, and consummation. Teamwork that made the Working Group in an effort to reduce poverty in Bogor. Researcher used a qualitative research approach with case study method, while the instruments used in data collection is interview, observation guidelines, and guidance documentation. The technique used an in-depth interviews, non-participatory observation, and literature study. Informants in this research is 11 people, they are 4 persons from SKPD, 2 persons from BUMD, 2 persons from BUMN, and 3 persons from private sector. The results of this research indicate that good teamwork is determined by communication, compromise, cooperation, coordination, and consummation. Communications flow into upward, downward, and horizontal, both formally and informally, through the medium of verbal and non-verbal communication. Compromises is used to resolve the differences that determined the best alternative. Cooperation as a form of cooperation through the participation of members in carrying out its duties and responsibilities. Coordination is used to integrate the goals and activities of the Working Group in order to direct, there is no overlap. Then, the consummation is used through improvements in poverty reduction activities in Bogor. Thus, the researchers suggest a training program “Team Building Training to Improve the Quality of Teamwork”. The purpose of this training is to raise awareness of Pokja members so that they understand the importance of teamwork that goes with effective and implement a strategy or technique in achieving teamwork, so that the Pokja was able to develop and implement effective teamwork in tackling poverty.Keywords: Human Service Organization, Teamwork, Komunikasi dan Kooperasi

Nurses' perceptions of using an evidence-based care bundle for initial emergency nursing management of patients with severe traumatic brain injury: A qualitative study

Evidence to guide initial emergency nursing care of patients with severe traumatic brain injury (TBI) in Thailand is currently not available in a useable form. A care bundle was used to summarise an evidence-based approach to the initial emergency nursing management of patients with severe TBI and was implemented in one Thai emergency department. The aim of this study was to describe Thai emergency nurses' perceptions of care bundle use. A descriptive qualitative study was used to describe emergency nurses' perceptions of care bundle use during the implementation phase (Phase-One) and then post-implementation (Phase-Two). Ten emergency nurses participated in Phase-One, while 12 nurses participated in Phase-Two. In Phase-One, there were five important factors identified in relation to use of the care bundle including quality of care, competing priorities, inadequate equipment, agitated patients, and teamwork. In Phase Two, participants perceived that using the care bundle helped them to improve quality of care, increased nurses' knowledge, skills, and confidence. Care bundles are one strategy to increase integration of research evidence into clinical practice and facilitate healthcare providers to deliver optimal patient care in busy environments with limited resources.

Impacts of collaborative IS on software development project success in Indian software firms: a service perspective

The collaborative work of team members has become a common occurrence in software development projects. Collaborative information systems (CIS), designed to facilitate and support teamwork, appear critical for software project success. However, the quality and convenience of the services and functions delivered by CIS have not received robust attention in academia. Hence, the current study investigates the role of the CIS service characteristics of service quality and service convenience in teamwork and software development project success using DeLone and McLean's (D&M) Information System (IS) Success Model as the theoretical framework. This study incorporates the success indicators of teamwork quality, teamwork performance, and project success as measured by software quality and project performance. Data from 153 Indian software companies confirm that collaborative IS services, as well as teamwork quality/performance, are central to software development project success. We believe that the findings of this study will be helpful to project managers of software development firms.

A CLIMATE OF PSYCHOLOGICAL SAFETY ENHANCES THE SUCCESS OF FRONT END TEAMS

This paper contributes to the discussion about initiative in teams at the front end of new product development processes (innovative teams). In contrast to the general opinion presented in the literature, this study points out that unstructured innovative teams are as much initiative in developing new ideas or in finding quick solutions when compared to structured innovative teams. Therefore we analyse the relationship between teamwork quality and team initiative in structured and unstructured teams at the front end of a new product development process and, in particular, we focus on a climate of psychological safety. To examine this relationship, data were collected by surveying 100 team members from different departments in a multinational company. It has been pointed out in the literature previously that where a team leader provides little structure at the micro level for team members there is a negative effect on the displays of initiative in the very early stages of the innovation process. However we can demonstrate that this effect can be reduced by a climate of psychological safety. Thus, it can be stated that unstructured teamwork combined with a climate of psychological safety is the way for teams at the front end of a new product development process to be successful.

Are balanced groups better? Belbin roles in collaborative learning groups

In a sample of 459 students organized in 84 groups this study tests the impact of group role balance on teamwork quality and three performance indicators in collaborative learning groups (group cognitive complexity, perceived performance and objective performance). The results show that group role balance positively predicts group performance in preliminary phases of the group project but not in later phases. Moreover, group role balance positively predicts group cognitive complexity and is negatively related to teamwork quality. The results hold only when role balance is conceptualized as a configural property of groups instead of a sum of individual roles. The findings of the study have implications for the design of collaborative learning groups.

Relational Coordination as an Indicator of Teamwork Quality: Potential Application to the Success of e-Learning at Universities

Teamwork has emerged as a contemporary management technique, the no adoption of which has been considered as a cause of failure to implement change initiatives in organizations. Studying teamwork in relation to the implementation of organizational routines to improve results in on line Educational Systems is important because many practices for improving e-learning systems cannot be used without a collaborative teamwork. The relational coordination model is applied to measure teamwork to a representative sample of lecturers and students that teach on e-learning based systems in Spain and in this paper, the results are presented. Given the importance of interactions among educational professionals, the model of relational coordination is well positioned to address teamwork quality in the University contexts. However, to the researchers’ knowledge, this is the first research applying relational coordination model in the context of organizational routines implementation in e-learning processes.

Assessing interprofessional teamwork: pilot test of a new assessment module for practicing physicians.

Teamwork is a basic component of all health care, and substantial research links the quality of teamwork to safety and quality of care. The TEAM (Teamwork Effectiveness Assessment Module) is a new Web-based teamwork assessment module for practicing hospital physicians. The module combines self-assessment, multisource feedback from members of other professions and specialties with whom the physician exercises teamwork, and a structured review of those data with a peer to develop an improvement plan. We conducted a pilot test of this module with hospitalist physicians to evaluate the feasibility and usefulness of the module in practice, focusing on these specific questions: Would physicians in hospitals of different types and sizes be able to use the module; would the providers identified as raters respond to the request for feedback; would the physicians be able to identify one or more "trusted peers" to help analyze the feedback; and how would physicians experience the module process overall? 20 of 25 physicians who initially volunteered for the pilot completed all steps of the TEAM, including identifying interprofessional teammates, soliciting feedback from their team, and identifying a peer to help review data. Module users described the feedback they received as helpful and actionable, and indicated this was information they would not have otherwise received. The results suggest that a module combining self-assessment, multisource feedback, and a guided process for interpreting these data can provide help practicing hospital physicians to understand and potentially improve their interprofessional teamwork skills and behaviors.

Understanding how colorectal units achieve short length of stay: an interview survey among representative hospitals in England.

BackgroundWide variation in the outcomes of colorectal surgery persists, despite a well-established evidence-base to inform clinical practice. This variation may be attributed to differences in quality of care, but we do not know what this means in practical terms of care delivery. This telephone interview study aimed to identify distinguishing characteristics in the organisation of care among colorectal units with the best length of stay results in England.MethodsTen English National Health Service hospitals were identified with the shortest length of stay after elective colonic surgery between January 2011 and December 2012. Semi-structured telephone interviews were conducted with a senior colorectal surgeon and ward nurse, who were not informed of their performance, at each site. Audio recordings were professionally transcribed and thematically analysed for similarities and differences in practice between units.ResultsAll ten short length of stay units approached agreed to participate, and 19 of 20 interviews were recorded. These units standardised clinical care based upon an Enhanced Recovery Program. Beyond this, they organised the clinical team to efficiently and reliably deliver this package of care, with the majority of day-to-day care delivered by consultants and nurses. Patients were closely monitored for postoperative deterioration, using a combination of early warning scores, nurses’ clinical judgement and regular senior medical review. Of note, operative volume and laparoscopy rates in these units were not statistically significantly different from the national average (p = 0.509 and p = 0.131, respectively). The postoperative analgesic strategy varied widely between units, from routine epidural use to local anaesthetic infiltration or patient-controlled analgesia.ConclusionsThe Enhanced Recovery Program may be seen as necessary but not sufficient to achieve the best length of stay results. In the study units, consultants and nurses led and delivered the majority of patient care on the ward. High quality teamwork helped detect and resolve clinical issues promptly, with nurses empowered to contact consultants directly if needed. Other units may learn from these teams by adopting protocol-based, consultant- or nurse-delivered care, and by improving coordination and communication between consultants and ward nurses.Electronic supplementary materialThe online version of this article (doi:10.1186/s13037-014-0050-5) contains supplementary material, which is available to authorized users.

Connecting HRM and change management: the importance of proactivity and vitality

Purpose – Organizations are continuously under pressure to adapt to changing circumstances. Job proactivity and vitality are important in changing environments. For instance, vital employees can better deal with change because they possess more energy. However, it is still unclear how organizations can stimulate proactivity and vitality. The purpose of this paper is to connect HRM and change management by analyzing how HRM practices can stimulate job proactivity and vitality. Design/methodology/approach – The authors used survey data collected in three large public healthcare organizations in the Netherlands (n=1,507) to investigate the effects of five important HRM practices on proactivity and vitality. Analyses were performed using structural equation modeling. Findings – Results suggest that three HRM practices are particularly effective for improving proactivity and vitality: high autonomy, high participation in decision making and high quality teamwork. Based on these results, the authors discuss the...

Teamwork in the operating theatre: the German Observational Teamwork Assessment for Surgery (OTAS-D) and its first application in Germany

The quality of surgical teamwork contributes to performance of the operating theatre team, service quality and patient safety in surgery. Observational tools are a feasible and reliable way to capture and evaluate teamwork in the operating theatre (OT). We introduce the German version of the Observational Teamwork Assessment for Surgery (OTAS-D) and present the first observational results from German OTs. Quality of surgical teamwork was assessed with observational teamwork assessment for surgery (OTAS-D). It evaluates five dimensions of OT teamwork: communication, coordination, cooperation/backup behaviour, leadership, and team monitoring/situation awareness. Each dimension is evaluated for each profession (surgical, nursing, and anaesthesia team) as well for each phase of the procedure (pre-, intra-, and post-operative). We observed n = 63 procedures, mainly in abdominal/general and orthopaedic surgery. Additionally, all OT team members scored their individual evaluation of the intra-operative teamwork (standardised 1-item questions). The OTAS-D evaluations showed meaningful results and differences for the OT professions as well as across the different phases of the procedures. Overall, a medium to good level of the OT teamwork was observed. There were no differences in regard to type of surgery (minimally invasive vs. open) or surgical specialties. With an increased coordination of the surgical team we observed a significantly increased cooperation of the nursing team (r = 0.36, p = 0.004). Concerning the OT staffs self-reports, the surgical and nursing teams reported higher scores for quality of surgical teamwork during the procedure than their anaesthesia team members. No significant relationships between observed quality of OT teamwork and self-reports were found. The German version of OTAS-D is a psychometrically robust method to capture the quality of teamwork in operating theatres. It enables the analyses of teamwork between the surgical, nursing and anaesthesia professions in acute surgical care. Limitations of the first application results are considered. Finally, potential applications for surgical teaching, research and quality management are discussed.

Relationship between Teamwork Quality and New Product Development Cycle Time in Telecom Industry

Relationship between Teamwork Quality and New Product Development Cycle Time in Telecom Industry