Teamwork In Health Care Research Articles

Teamwork in health care and medical malpractice liability: an experimental investigation

Teamwork in health care and medical malpractice liability: an experimental investigation

Effectiveness of an educational intervention in improving the patient medication reconciliation in the emergency department

This study aimed to evaluate the effectiveness of an educational intervention in improving the patient medication reconciliation process. This was a cross-sectional study that was conducted at St. Jude hospital, California (CA), United States. An educational intervention was provided to the healthcare team working in the emergency department (ED) to explore its effectiveness in improving their patient medication reconciliation practices. A survey was administered to explore the healthcare staff's views on where responsibility lay in their team concerning the fulfilment of appropriate medication reconciliation procedures. Additionally, we identified the barriers facing the completion of appropriate medication reconciliation using open-ended question provided to healthcare staff at the hospital. In the pre-intervention phase, the percentage of patients who received medication reconciliation was statistically significantly higher during the day shift (71.0% compared with 51.3%). In the postintervention phase, the percentage of patients who received medication reconciliation was statistically significantly higher during the night shift (96.7% compared with 75.8%). Overall, the percentage of patients who received medication reconciliation was statistically significantly higher in the postintervention group (81.3%) compared with the pre-intervention group (64.7%) (P<.001). Educational intervention is an effective tool in improving medication reconciliation practices in inpatient settings. The process of medication reconciliation should be conducted based on shared responsibility between healthcare providers and aimed at reducing medication errors and improving patient safety.

Impacts of Transformational and Laissez-Faire Leadership in Health

The health care industry is continuously developing, and constant leadership must maintain high-quality care to patients. Applying certain leadership styles is critical in developing, aligning and fabricating a pathway to effective and reliable care. Leaders can improve their subordinates’ performance, work behavior, and communication of their subordinates through the application of different styles of leadership. The two styles of leadership under investigation in this paper are transformational leadership and laissez-faire leadership.&#x0D; In health care organizations, transformational leadership improves the quality and safety of patient care. Furthermore, transformation enhances staff commitment to organizational goals. In contrast, Laissez-faire leadership is not an ideal style in health care facilities. Laissez-faire leadership increases stress levels, anxiety, and staff turnover rates. As a result, the higher level of stress among staff leads to medical errors, a higher rate of staff turnovers, and suboptimal care to care for patients. Each leadership style has its strengths and weaknesses; leaders need to apply the appropriate leadership style to improve health care quality, patient safety, teamwork, and increase staff motivation and commitment to reduce adverse events in health care facilities.

Development of interprofessional healthcare teamwork skills: mapping students’ process of learning

ABSTRACT Higher education institutions commonly prepare future healthcare workers to engage in increasingly complex, interprofessional healthcare environments through interprofessional education. Development of appropriate teamwork skills is complex and takes time. However, much of the research on student engagement with teamwork in higher education has been focused on the end goal of teamwork. This obscures the process of how students learn to work in interprofessional healthcare teams and in what ways, over time. The current study used an exploratory interpretive approach to obtaining students’ experiences, perceptions and developing understanding of teamwork from the start of their undergraduate studies, through to completion of five semesters of group or teamwork projects. Through qualitative methodology, educators explored student experiences of teamwork, their focus at designated points of their undergraduate teamwork, and the meaning they attributed to being a member of a team. Student perceptions of successful teamwork developed over time to a positive and purposeful orientation toward teamwork, learner attributes that enhanced team function, and a growing awareness of how the assessment context affected team function. By mapping these processes of learning over time, educators can gain a clearer understanding of influences and experiences that impact on student learning in teamwork.

Examining the Influence of Power Distance on Psychological Safety Within Healthcare Teams

Cultivating good teamwork practices within healthcare teams is important for providing effective patient care and preventing adverse health outcomes. Psychological safety is one factor which is instrumental in developing a positive team environment, which fosters effective teamwork. The historically hierarchical nature of healthcare ascribes status to individuals based on profession, and this power differential is a contributing factor to a team member’s psychological safety. This study seeks to identify relationships between cultural backgrounds and teamwork in healthcare through examining how power distance influences psychological safety within healthcare teams. A cross-sectional questionnaire containing the Psychological Safety Scale and the Personal Cultural Orientation Scale was fielded to sets of Internal medicine teams working in a health system located in the Midwest region of the United States ( n=17). Levels of power-distance and psychological safety were similar amongst leaders and their team members. Upon comparison, there was no correlation found between power distance and psychological safety. Moderate to significant correlations were found between other deep cultural constructs.

Sleep quality, perceived stress, and quality of life of healthcare professionals working in direct contact with COVID-19 (+) patients: A comparative study

Background/Aim: Healthcare workers can be psychologically and physically affected by the COVID-19 pandemic. This study was conducted to evaluate the sleep quality, perceived stress, and quality of life of healthcare professionals during the COVID-19 pandemic. Methods: This cross-sectional and comparative study was conducted with employees of a city hospital in Turkey between 01-20 January 2021. Personal Information Form, Jenkins Sleep Scale, Perceived Stress Scale, and Quality of Life Test Short Form-36 (SF-36) were used to collect data during face-to-face interviews conducted with the hospital staff by the researchers. The sample of the study consisted of a healthcare team providing service for COVID-19 patients in the city hospital (Group 1) and a healthcare team working without direct contact with COVID-19 patients (Group 2). The results obtained from the study were compared between these two groups. There were 213 volunteers in Group 1, and 163 volunteer healthcare workers (doctors, nurses, midwives, medical secretaries, patient transfer staff, and patient support staff) in Group 2. Results: Sleep problems and stress levels were significantly higher among healthcare professionals who had direct contact with COVID-19 (+) patients compared to those who did not (P

Promoting high-functioning mental health treatment teams in the context of low staffing ratios.

Many previous studies of health care teamwork have taken place in clinical teams with high staffing ratios (i.e., high ratios of staff to patients). The aim of this study was to identify clinicians' viewpoints of foundational resources necessary to support good team functioning in the context of low staffing ratios. We used administrative data, validated with local mental health chiefs, to identify mental health teams that had achieved high team functioning despite low staffing ratios in U.S. Department of Veterans Affairs medical centers. Guided by a recently developed model of team effectiveness, the Team Effectiveness Pyramid, we conducted qualitative interviews with 21 team members across three teams within two medical centers. Interview questions focused on the resources needed to support good team functioning despite low staffing ratios. We used directed content analysis to analyze results. We found there were several domains of relevant resources: material, staffing, temporal, organizational, and psychological. These represent an expansion of the domains originally included in the Team Effectiveness Pyramid. Within the five domains, we identified key tensions to be addressed when forming teams, including the balances between providing care for new versus established patients, emphasizing shared caseloads within the team versus matching patients to clinicians based on individual expertise, and establishing reporting structures by clinical discipline versus team membership. Establishing high-functioning health care teams in the context of low staffing ratios requires attention to key resource domains and fundamental trade-offs in how teams are structured.

What Can Analytics for Teamwork Proxemics Reveal About Positioning Dynamics In Clinical Simulations?

Effective teamwork is critical to improve patient outcomes in healthcare. However, achieving this capabilityrequires that pre-service nurses develop the spatial abilities they will require in their clinical placements, suchas: learning when to remain close to the patient and to other team members; positioning themselves correctlyat the right time; and deciding on specific team formations (e.g. face-to-face or side-by-side) to enable effectiveinteraction or avoid disrupting clinical procedures. However, positioning dynamics are ephemeral and caneasily become occluded by the multiple tasks nurses have to accomplish. Digital traces automatically capturedby indoor positioning sensors can be used to address this problem for the purpose of improving nurses' reflection, learning and professional development. This paper presents; i) a qualitative study that illustrateshow to elicit spatial behaviours from educators' pedagogical expectations, and ii) a modelling approachthat transforms nurses' low-level position traces into higher-order proxemics constructs, informed by sucheducatos' expectations, in the context of simulation-based teamwork training. To illustrate our modellingapproach, we conducted an in-the-wild study with 55 undergraduate students and five educators from whompositioning traces were captured in eleven authentic nursing education classes. Low-levelx-ydata was usedto model three proxemic constructs: i) co-presence in interactional spaces, ii) socio-spatial formations (i.e.f-formations), and ii) presence in spaces of interest. Through a number of vignettes, we illustrate how indoorpositioning analytics can be used to address questions that educators and researchers have about teamwork inhealthcare simulation settings.

Experiences of health care workers' on interprofessional collaborative practice at Mzuzu Central and Ntcheu District hospitals

Interprofessional collaborative practice (ICP) is a new approach to delivery of health care. It is the practice which happens when healthcare providers work together with different professionals such as nurse/midwives, medical officers towards a common goal to improve patient outcomes.There is no evidence on healthcare workers' experiences on ICP in Malawi and a study on healthcare workers experiences would provide insight towards ICP. The objective of this study was to describe healthcare workers' experiences on ICP in model wards. We conducted a qualitative exploratory descriptive study at Mzuzu Central and Ntcheu District Hospitals. We purposely selected nurses, clinical officers and medical doctors out of 25 sampled healthcare workers working in model wards. Data were collected through in-depth interviews using a semi-structured interview guide. Hospital authorities provided permission to conduct the study in their sites. Informed consent was obtained from participants before interviews. The study was approved by College of Medicine Research Committee (COMREC). Content analysis was utilized to analyse data. Four key themes emerged describing healthcare workers experiences on ICP:Increased management/leadership support in terms of resources and structures, good communication among staff, learning together as group of qualified healthcare workers and students and increased teamwork. This study highlights healthcare workers' experiences on ICP: management support, communication, learning together of healthcare workers and teamwork. Findings can be used to inform management and practice for the development and implementation of ICP in service delivery.

Factors Affecting Hand Hygiene Performance of Pediatric Intensive Care Unit Health Care Team during the Outbreak of COVID-19 Disease in Iran: A Qualitative Study

Background:This study aimed to determine factors affecting compliance with hand hygiene from the perspective of the health care team working in the PICU. Materials and Methods:We recruited 35 PICU health care workers, including nurses, attending physicians and medical students, selected by purposive sampling between February to November 2020. Data were collected using deep semi-structured interviews. Then analyzed through Graneheim and Lundman’s (2004) qualitative conventional content analysis method. All interviews were recorded and typed in the MAXQDA software and then analyzed by eight steps including writing interviews, determining the semantic units, text coding, matching codes with text, categorizing and developing categories, reviewing the categories, identifying the subthemes and reporting the findings. Results: 68.5% of the participants were female, with an average age of 32.7 years. Overall, 234 codes were extracted from the interviews and after the integration of similarities 4 main categories were finally extracted: (I) Meta-organizational factors including two subcategories of macro-health policy and sanctions and economic problems, (II) Organizational factors including three subcategories of incoherence in observation of rules, monitoring and evaluation, the prevailing attitude of the organization, (III) Individual factors including three subcategories of attitude of the health care team towards patient, skin reactions to hand sanitizers, concerns about their own health and health of their family, and (IV) Characteristics of the clinical environment including three subcategories of professional relationships, special conditions governing the pediatric ICU, and care facilities. Conclusion:Based on the results, four key themes including Meta-organizational factors, Organizational factors, Individual factors and characteristics of the clinical environment were obtained indicating factors affecting hand hygiene performance of the PICU health care team.

Overcoming Challenges to Teamwork in Healthcare: A Team Effectiveness Framework and Evidence-Based Guidance

Background:Safe and effective patient care depends on the teamwork of multidisciplinary healthcare professionals. Unfortunately, the field currently lacks an evidence-based framework for effective teamwork that can be incorporated into medical education and practice across health professions. We introduce a comprehensive framework for team effectiveness. Common challenges to teamwork in healthcare are identified along with evidence-based strategies for overcoming them.Methods:The framework was developed in four steps: 1) grounding in the existing team science literature, 2) semi-structured interviews (N= 13), 3) thematic analysis and initial framework development, and 4) revision of the framework through input from healthcare professionals representative of different functions across the healthcare system (N= 13). A diagnostic tool consisting of one survey item per team competency was developed to complement the framework. The survey was then administered to healthcare teams across clinical and administrative functions (N= 10 teams, 96 individuals), and results were compiled and then used to conduct debriefs with individual team members and teams. A set of common teamwork challenges were identified using the survey and qualitative data. Qualitative data was analyzed to explore the unique ways these challenges manifest in both clinical and administrative teams.Results:The five most common challenges that face healthcare teams relate to accountability, conflict management, decision-making, reflecting on progress, and coaching. These challenges were similar across both clinical and administrative team types. Based on the authors' collective experience designing and implementing Team Development Interventions (TDIs), strategies for managing each challenge are provided.Conclusions:The proposed framework is unique in two ways. First, it's generally applicable across the many types of teams that contribute to the quality and safety of patient care. Second, the levels of the framework build upon each other to contribute to the development of the ideal team states. The framework and accompanying strategies can provide guidance for where and how to target developmental efforts.

The Study of Teamwork Processes Within the Dynamic Domains of Healthcare: A Systematic and Taxonomic Review

Teamwork in healthcare is particularly salient in the dynamic domains of critical care: emergency medicine, surgery, and trauma and resuscitation. Within and across these services, teams must be coordinated to provide optimal care in order to provide optimal delivery of health care. Although many disciplines study teamwork, it is unclear how scholars and clinicians conceptualize, study, and apply these processes. The current systematic review investigates how these fields 1) study teams through the application of a teamwork processes rubric and 2) distinguish themselves from other medical disciplines through the empirical research. We drew upon a taxonomy of teamwork processes (Marks et al., Acad. Manag. Rev. 26, 356 ‐376; LePine et al., Person. Psychol. 61, 273 ‐307), operationalizing transition, action, and interpersonal processes, to guide this work. Overall, the dynamic domains of literature studied teamwork processes at high rates, relative to other medical fields. Specifically, they were strongly associated with transition and action processes and the content areas of leadership and performance. Given these emphases, research and practical interventions may want to focus on more interpersonal and collaborative approaches in teamwork

Improvisation Theater Exercises: A Novel Approach to Teach Communication Skills.

Nurse practitioner students need effective communication skills to provide patient-centered care and work in diverse health care teams. Improvisation exercises, adapted from theater training, have been used to improve communication skills with health professions education and can be used in nurse practitioner education. Fifty-eight family nurse practitioner students participated in a 2-hour workshop where they learned four improvisation exercises to improve listening skills, observational skills, and the ability to respond in the moment. Students learned the application of these skills for health care conversations. The workshop was well received by the students, and evaluations reflected that students anticipated using the skills in professional practice and personal communications. Improvisation exercises can be used in nursing education to teach communication skills. [J Nurs Educ. 2021;60(2):116-119.].

A systematic literature review of board diversity in agile healthcare supply chain

The healthcare supply chain plays a fundamental role in addressing the healthcare needs of local and global communities. The composition of the healthcare sector, particularly regarding cultural and gender diversity, is an antecedent to effective medical healthcare management, and achieving organisational performance. Following an appraisal of the selected literature, six themes emerged in the research area of diversity in healthcare. These were cultural diversity management, gender diversity management, governance and leadership, board management, Indigenous healthcare, and healthcare workers and teamwork. Findings from the study suggest the advancement of critical elements of organisational diversity research in the agile medical supply chain, including aspects of the influences of workforce heterogeneity on board governance practices, organisational culture and climate-specific studies, organisational performance and non-performance outcomes, and diversity disparities in senior and executive-level leadership roles. This study can influence regulatory decision-making, strategic policy origination, and operational diversity management programs.

Perceptions of medical students toward interprofessional practice at King Abdulaziz University Hospital: a cross-sectional study

Background: Interprofessional education contributes to the progression of interprofessional practice (IPP), which plays a crucial role in providing adequate care to patients. There is a lack of knowledge about the dimensions of IPP and its influence on future professional practice. This study evaluated the perceptions of medical students from various academic levels toward IPP and their ability to integrate with interdisciplinary teamwork. Methods: A cross-sectional survey consisting of a 14-item tool on the Attitudes Toward Healthcare Teamwork Scale was utilized to measure patient\&amp;apos;s care quality. This study was conducted at King Abdulaziz University, Saudia Arabia. Results: A total sample size of 540 medical students was included with a total mean attitude score of 60.50 ± 5.07. Females (n = 347, 64.30%) were more than males (n = 193, 35.70%). The mean attitude score was significantly higher among male medical students with p = 0.009. Moreover, the male students in their advanced clinical years had a more positive attitude toward IPP than female peers with p = 0.018. The educational level was not statistically significant (p = 0.833). Conclusion: Most of the students had a good knowledge of interprofessional team working and acknowledged that IPP promotes optimal patient care. More broadly, researches are needed to include all disciplines and cover other regions in the kingdom of Saudi Arabia.

Understanding adaptive teamwork in health care: Progress and future directions.

Health care teamwork is a vital part of clinical work and patient care but is poorly understood. Despite poor teamwork being cited as a major contributory factor to adverse events, we lack vital knowledge about how teamwork can be improved. Teams in health care are diverse in structure and purpose, and most patient care depends on the ability of different professionals to coordinate their actions. Research in this area has narrowly defined health care teams, focused mainly on a small range of settings and activities and addressed a limited range of research questions. We argue that a new approach to teamwork research is needed and make three recommendations. First, the temporal and dynamic features of teamwork should be studied to understand how teamwork unfolds sequentially. Second, contextual influences should be integrated into study designs, including the organization of work, tasks, patients, organisational structures, and health care system factors. Finally, exploratory, rather than confirmatory, research designs are needed to analyse the complex patterns of social interaction inherent in health care work, to build our theoretical understanding of health care teams and their work, and ultimately to develop effective interventions to support better teamwork for the benefit of patients.

Reliability and structural validity of the Norwegian version of the TeamSTEPPS Teamwork Attitudes Questionnaire: A cross-sectional study among Bachelor of Nursing students.

AimTo test the reliability and structural validity of the Norwegian version of the TeamSTEPPS® Teamwork Attitudes Questionnaire (T‐TAQ) among Bachelor of Nursing students.DesignCross‐sectional study.MethodsBachelor of Nursing students (N = 1,624) at three campuses in different regions of Norway were invited to complete the survey. The data were analysed with descriptive statistics, Cronbach's alpha and confirmatory factor analysis (CFA). Three models were tested. Model 3 was a post hoc modification with a correlation between four negatively worded items. The data was collected in September 2018 and May‐June 2019.ResultsA total of 509 students were included in the study. Cronbach's alpha ranged from 0.44–0.70 for the dimensions and was 0.79 for the total questionnaire. The fit indexes of model 3 were as follows: RMSEA = 0.043, chi‐square = 724.3 (p < .000), normed chi‐square = 1.862, TLI = 0.812 and CFI = 0.832. The questionnaire shows some potential to display attitudes towards teamwork in health care among Bachelor of Nursing students. Low Cronbach's alpha in the dimensions might indicate that the questionnaire should be considered used as a unidimensional questionnaire.

The Collective Leadership for Safety Culture (Co-Lead) Team Intervention to Promote Teamwork and Patient Safety.

Traditional hierarchical leadership has been implicated in patient safety failings internationally. Given that healthcare is almost wholly delivered by multidisciplinary teams, there have been calls for a more collective and team-based approach to the sharing of leadership and responsibility for patient safety. Although encouraging a collective approach to accountability can improve the provision of high quality and safe care, there is a lack of knowledge of how to train teams to adopt collective leadership. The Collective Leadership for Safety Cultures (Co-Lead) programme is a co-designed intervention for multidisciplinary healthcare teams. It is an open-source resource that offers teams a systematic approach to the development of collective leadership behaviours to promote effective teamworking and enhance patient safety cultures. This paper provides an overview of the co-design, pilot testing, and refining of this novel intervention prior to its implementation and discusses key early findings from the evaluation. The Co-Lead intervention is grounded in the real-world experiences and identified needs and priorities of frontline healthcare staff and management and was co-designed based on the evidence for collective leadership and teamwork in healthcare. It has proven feasible to implement and effective in supporting teams to lead collectively to enhance safety culture. This intervention overview will be of value to healthcare teams and practitioners seeking to promote safety culture and effective teamworking by supporting teams to lead collectively.

Qualitative investigation of trace-based communication: how are traces conceptualised in healthcare teamwork?

ObjectivesThis interview-based qualitative study aims to explore how healthcare providers conceptualise trace-based communication and considers its implications for how teams work. In the biological literature, trace-based communication refers to the...

Improving Team Performance and Patient Safety on the Job Through Team Training and Performance Support Tools: A Systematic Review

IntroductionEfforts to improve teamwork in health care have received considerable attention. The current systematic review was conducted to identify recent studies that implemented practices to improve teamwork and were associated with positive improvements on the job.MethodsElectronic searches of 2 databases (i.e., CINAHL and MEDLINE) were conducted to identify relevant articles published between 2008 and 2018.ResultsTwenty articles were selected for inclusion in this review. The studies most often used quasiexperimental designs and interventions were applied in a variety of hospital settings including labor and delivery, operating rooms, and emergency departments. Across studies, measures assessing teamwork skills on the job were most often collected and showed sustained improvements up to 12 months. Moreover, evidence of improved clinical processes (e.g., compliance with guidelines and efficiency) and increased patient safety (e.g., reduction in adverse events) was found in both studies of team training interventions, as well as in those that introduced performance support tools (e.g., checklist).ConclusionsThe results of the current review are consistent with previous research and add to the evidence base on the practices to improve teamwork within hospital settings. Although efforts to improve teamwork have spread to other health care settings such as office-based care, published studies are lagging behind.