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Embracing the New Transformation Through Team Approach

  • Rachel CyrusEmail author
  • Kevin J. O’Leary

Abstract

Increasing focus on improving outcomes at lower costs is contributing to a more complex inpatient environment. Sicker patients, quicker pace, and expanding treatment options necessitate highly effective teams. These factors can also create inherent challenges to team performance given the complexity of teams, dispersion of patients, necessity for effective communication, and paucity of team training. Measuring the quality and efficacy of teamwork can be challenging as well. In this chapter we will propose several methods to optimize teamwork in today’s hospital. Ideally, recognizing barriers to teamwork and using a combination of approaches to facilitate these complex interactions will lead to improved patient outcomes.

Keywords

Teamwork Communication Interdisciplinary Patient care team Hospital units/organization Attitude of health personnel 

References

  1. 1.
    Kalra AD, Fisher RS, Axelrod P. Decreased length of stay and cumulative hospitalized days despite increased patient admissions and readmissions in an area of urban poverty. J Gen Intern Med. 2010;25(9):930–5.CrossRefGoogle Scholar
  2. 2.
    American College of Physicians. Achieving a high-performance health care system with universal access: what the United States can learn from other countries. Ann Intern Med. 2008;148(1):55–75.CrossRefGoogle Scholar
  3. 3.
    Zilberberg MD. The clinical research enterprise: time to change course? JAMA. 2011;305(6):604–5.CrossRefGoogle Scholar
  4. 4.
    Epner PL, Gans JE, Graber ML. When diagnostic testing leads to harm: a new outcomes-based approach for laboratory medicine. BMJ Qual Saf. 2013;22(Suppl 2):ii6–ii10.CrossRefGoogle Scholar
  5. 5.
    Institute of Medicine Committee on Quality of Health Care in A. In: Kohn LT, Corrigan JM, Donaldson MS, editors. To err is human: building a safer health system. Washington (DC): National Academies Press (US) Copyright 2000 by the National Academy of Sciences. All rights reserved; 2000.Google Scholar
  6. 6.
    Quality AfHRa. Saving lives and saving money: Hospital-Acquired Conditions Update. Rockville, MD; 2015. Available from: https://www.ahrq.gov/professionals/quality-patient-safety/pfp/interimhacrate2014.html.
  7. 7.
    Makary MA, Daniel M. Medical error-the third leading cause of death in the US. BMJ. 2016;353:i2139.CrossRefGoogle Scholar
  8. 8.
    Commission TJ. Sentinel Event Statistics Released for 2015. 2015 Available from: http://info.jcrinc.com/rs/494-MTZ-066/images/Sentinel39.pdf.
  9. 9.
    Sculli GL, Fore AM, Sine DM, Paull DE, Tschannen D, Aebersold M, et al. Effective followership: a standardized algorithm to resolve clinical conflicts and improve teamwork. J Healthcare Risk Manag. 2015;35(1):21–30.CrossRefGoogle Scholar
  10. 10.
    Sutcliffe KM, Lewton E, Rosenthal MM. Communication failures: an insidious contributor to medical mishaps. Acad Med. 2004;79(2):186–94.CrossRefGoogle Scholar
  11. 11.
    Gawande AA, Zinner MJ, Studdert DM, Brennan TA. Analysis of errors reported by surgeons at three teaching hospitals. Surgery. 2003;133(6):614–21.CrossRefGoogle Scholar
  12. 12.
    Aaronson EL, Mort E, Sonis JD, Chang Y, White BA. Overall emergency department rating: identifying the factors that matter most to patient experience. J Healthc Qual. 2018:1.Google Scholar
  13. 13.
    Kipnis A, Rhodes KV, Burchill CN, Datner E. The relationship between patients' perceptions of team effectiveness and their care experience in the emergency department. J Emerg Med. 2013;45(5):731–8.CrossRefGoogle Scholar
  14. 14.
    Meterko M, Mohr DC, Young GJ. Teamwork culture and patient satisfaction in hospitals. Med Care. 2004;42:492–8.Google Scholar
  15. 15.
    Kalisch BJ, Lee H, Rochman M. Nursing staff teamwork and job satisfaction. J Nurs Manag. 2010;18(8):938–47.CrossRefGoogle Scholar
  16. 16.
    Gifford BD, Zammuto RF, Goodman EA. The relationship between hospital unit culture and nurses' quality of work life. J Healthc Manag. 2002;47(1):13–25. discussion -6.CrossRefGoogle Scholar
  17. 17.
    Chang WY, Ma JC, Chiu HT, Lin KC, Lee PH. Job satisfaction and perceptions of quality of patient care, collaboration and teamwork in acute care hospitals. J Adv Nurs. 2009;65(9):1946–55.CrossRefGoogle Scholar
  18. 18.
    Shortell SM, O'Brien JL, Carman JM, Foster RW, Hughes EF, Boerstler H, et al. Assessing the impact of continuous quality improvement/total quality management: concept versus implementation. Health Serv Res. 1995;30(2):377–401.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Salas E, Sims DE, Burke CS. Is there a “big five” in teamwork? Small Group Res. 2005;36(5):555–99.CrossRefGoogle Scholar
  20. 20.
    Baker DP, Salas E, King H, Battles J, Barach P. The role of teamwork in the professional education of physicians: current status and assessment recommendations. Jt Comm J Qual Patient Saf. 2005;31(4):185–202.CrossRefGoogle Scholar
  21. 21.
    Agency for Healthcare Research and Quality. Team Strategies and Tools to Enhance Performance and Patient Safety. 2017, April. Available from: https://www.ahrq.gov/teamstepps/about-teamstepps/index.html.
  22. 22.
    O’Leary KJ, Thompson JA, Landler MP, Kulkarni N, Haviley C, Hahn K, et al. Patterns of nurse-physician communication and agreement on the plan of care. Qual Saf Health Care. 2010;19(3):195–9.CrossRefGoogle Scholar
  23. 23.
    Brindley PG, Reynolds SF. Improving verbal communication in critical care medicine. J Crit Care. 2011;26(2):155–9.CrossRefGoogle Scholar
  24. 24.
    O’Leary KJ, Liebovitz DM, Wu RC, Ravi K, Knoten CA, Sun M, et al. Hospital-Based Clinicians' Use of Technology for Patient Care-Related Communication: a National Survey. J Hosp Med. 2017;12(7):530–5.CrossRefGoogle Scholar
  25. 25.
    Weller J, Boyd M, Cumin D. Teams, tribes and patient safety: overcoming barriers to effective teamwork in healthcare. Postgrad Med J. 2014;90(1061):149–54.CrossRefGoogle Scholar
  26. 26.
    Thomas EJ, Sexton JB, Helmreich RL. Discrepant attitudes about teamwork among critical care nurses and physicians. Crit Care Med. 2003;31(3):956–9.CrossRefGoogle Scholar
  27. 27.
    Sexton JB, Thomas EJ, Helmreich RL. Error, stress, and teamwork in medicine and aviation: cross sectional surveys. BMJ. 2000;320(7237):745–9.CrossRefGoogle Scholar
  28. 28.
    Medicine Io. Health professions education: a bridge to quality. Washington (DC): National Academies Press (US); 2003.Google Scholar
  29. 29.
    O’Leary KJ, Sehgal NL, Terrell G, Williams MV. Interdisciplinary teamwork in hospitals: a review and practical recommendations for improvement. J Hosp Med. 2012;7(1):48–54.CrossRefGoogle Scholar
  30. 30.
    Marlow SL, Hughes AM, Sonesh SC, Gregory ME, Lacerenza CN, Benishek LE, et al. A systematic review of team training in health care: ten questions. Jt Comm J Qual Patient Saf. 2017;43(4):197–204.CrossRefGoogle Scholar
  31. 31.
    Dominick PG, Reilly RR, McGourty JW. The effects of peer feedback on team member behavior. Group Organ Stud. 1997;22(4):508.CrossRefGoogle Scholar
  32. 32.
    Klampfer B, Flin R, Helmreich RL, et al. Enhancing performance in high risk environments: recommendations for the use of behavioural markers. Swissair Training Centre, Zurich; July 5–6, 2001. Retrieved from: http://www.raes-hfg.com/reports/notechs-swiss.pdf.
  33. 33.
    Arora VM, Berhie S, Horwitz LI, Saathoff M, Staisiunas P, Farnan JM. Using standardized videos to validate a measure of handoff quality: the handoff mini-clinical examination exercise. J Hosp Med. 2014;9(7):441–6.CrossRefGoogle Scholar
  34. 34.
    Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists' Non-Technical Skills (ANTS): evaluation of a behavioural marker system. Br J Anaesth. 2003;90(5):580–8.CrossRefGoogle Scholar
  35. 35.
    Frankel A, Gardner R, Maynard L, Kelly A. Using the communication and teamwork skills (CATS) assessment to measure health care team performance. Jt Comm J Qual Patient Saf. 2007;33(9):549–58.CrossRefGoogle Scholar
  36. 36.
    Malec JF, Torsher LC, Dunn WF, Wiegmann DA, Arnold JJ, Brown DA, et al. The mayo high performance teamwork scale: reliability and validity for evaluating key crew resource management skills. Simul Healthc. 2007;2(1):4–10.CrossRefGoogle Scholar
  37. 37.
    Sevdalis N, Davis R, Koutantji M, Undre S, Darzi A, Vincent CA. Reliability of a revised NOTECHS scale for use in surgical teams. Am J Surg. 2008;196(2):184–90.CrossRefGoogle Scholar
  38. 38.
    Sevdalis N, Lyons M, Healey AN, Undre S, Darzi A, Vincent CA. Observational teamwork assessment for surgery: construct validation with expert versus novice raters. Ann Surg. 2009;249(6):1047–51.CrossRefGoogle Scholar
  39. 39.
    Lineberry M, Bryan E, Brush T, Carolan TF, Holness D, Salas E, et al. Measurement and training of TeamSTEPPS dimensions using the medical team performance assessment tool. Jt Comm J Qual Patient Saf. 2013;39(2):89–95.CrossRefGoogle Scholar
  40. 40.
    Hays RB, Davies HA, Beard JD, Caldon LJ, Farmer EA, Finucane PM, et al. Selecting performance assessment methods for experienced physicians. Med Educ. 2002;36(10):910–7.CrossRefGoogle Scholar
  41. 41.
    Yang LY, Yang YY, Huang CC, Liang JF, Lee FY, Cheng HM, et al. Simulation-based inter-professional education to improve attitudes towards collaborative practice: a prospective comparative pilot study in a Chinese medical centre. BMJ Open. 2017;7(11):e015105.CrossRefGoogle Scholar
  42. 42.
    Schmidt E, Goldhaber-Fiebert SN, Ho LA, McDonald KM. Simulation exercises as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5_Part_2):426–32.CrossRefGoogle Scholar
  43. 43.
    Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, et al. The safety attitudes questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Serv Res. 2006;6:44.CrossRefGoogle Scholar
  44. 44.
    Baggs JG. Development of an instrument to measure collaboration and satisfaction about care decisions. J Adv Nurs. 1994;20(1):176–82.CrossRefGoogle Scholar
  45. 45.
    Hojat M, Fields SK, Veloski JJ, Griffiths M, Cohen MJ, Plumb JD. Psychometric properties of an attitude scale measuring physician-nurse collaboration. Eval Health Prof. 1999;22(2):208–20.CrossRefGoogle Scholar
  46. 46.
    Starmer AJ, Sectish TC, Simon DW, Keohane C, McSweeney ME, Chung EY, et al. Rates of medical errors and preventable adverse events among hospitalized children following implementation of a resident handoff bundle. JAMA. 2013;310(21):2262–70.CrossRefGoogle Scholar
  47. 47.
    Starmer AJ, Spector ND, Srivastava R, Allen AD, Landrigan CP, Sectish TC. I-pass, a mnemonic to standardize verbal handoffs. Pediatrics. 2012;129(2):201–4.CrossRefGoogle Scholar
  48. 48.
    Starmer AJ, Spector ND, Srivastava R, West DC, Rosenbluth G, Allen AD, et al. Changes in medical errors after implementation of a handoff program. N Engl J Med. 2014;371(19):1803–12.CrossRefGoogle Scholar
  49. 49.
    Olson DP, Fields BG, Windish DM. Geographic localization of housestaff inpatients improves patient-provider communication, satisfaction, and culture of safety. J Healthc Qual. 2015;37(6):363–73.CrossRefGoogle Scholar
  50. 50.
    O'Leary KJ, Wayne DB, Landler MP, Kulkarni N, Haviley C, Hahn KJ, et al. Impact of localizing physicians to hospital units on nurse-physician communication and agreement on the plan of care. J Gen Intern Med. 2009;24(11):1223–7.CrossRefGoogle Scholar
  51. 51.
    Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat AH, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491–9.CrossRefGoogle Scholar
  52. 52.
    Russ S, Rout S, Sevdalis N, Moorthy K, Darzi A, Vincent C. Do safety checklists improve teamwork and communication in the operating room? A systematic review. Ann Surg. 2013;258(6):856–71.CrossRefGoogle Scholar
  53. 53.
    Agarwal S, Frankel L, Tourner S, McMillan A, Sharek PJ. Improving communication in a pediatric intensive care unit using daily patient goal sheets. J Crit Care. 2008;23(2):227–35.CrossRefGoogle Scholar
  54. 54.
    Narasimhan M, Eisen LA, Mahoney CD, Acerra FL, Rosen MJ. Improving nurse-physician communication and satisfaction in the intensive care unit with a daily goals worksheet. Am J Crit Care. 2006;15(2):217–22.PubMedGoogle Scholar
  55. 55.
    Pronovost P, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C. Improving communication in the ICU using daily goals. J Crit Care. 2003;18(2):71–5.CrossRefGoogle Scholar
  56. 56.
    Gausvik C, Lautar A, Miller L, Pallerla H, Schlaudecker J. Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. J Multidiscip Healthc. 2015;8:33–7.CrossRefGoogle Scholar
  57. 57.
    Cao V, Tan LD, Horn F, Bland D, Giri P, Maken K, et al. Patient-centered structured interdisciplinary bedside rounds in the medical ICU. Crit Care Med. 2018;46(1):85–92.CrossRefGoogle Scholar
  58. 58.
    Mudge A, Laracy S, Richter K, Denaro C. Controlled trial of multidisciplinary care teams for acutely ill medical inpatients: enhanced multidisciplinary care. Intern Med J. 2006;36(9):558–63.CrossRefGoogle Scholar
  59. 59.
    Boyko WL Jr, Yurkowski PJ, Ivey MF, Armitstead JA, Roberts BL. Pharmacist influence on economic and morbidity outcomes in a tertiary care teaching hospital. Am J Health Syst Pharm. 1997;54(14):1591–5.PubMedGoogle Scholar
  60. 60.
    Curley C, McEachern JE, Speroff T. A firm trial of interdisciplinary rounds on the inpatient medical wards: an intervention designed using continuous quality improvement. Med Care. 1998;36(8 Suppl):As4–12.PubMedGoogle Scholar
  61. 61.
    Pannick S, Beveridge I, Wachter RM, Sevdalis N. Improving the quality and safety of care on the medical ward: a review and synthesis of the evidence base. Eur J Intern Med. 2014;25(10):874–87.CrossRefGoogle Scholar
  62. 62.
    Bhamidipati VS, Elliott DJ, Justice EM, Belleh E, Sonnad SS, Robinson EJ. Structure and outcomes of interdisciplinary rounds in hospitalized medicine patients: a systematic review and suggested taxonomy. J Hosp Med. 2016;11(7):513–23.CrossRefGoogle Scholar
  63. 63.
    Clark RC, Greenawald M. Nurse-physician leadership: insights into interprofessional collaboration. J Nurs Adm. 2013;43(12):653–9.CrossRefGoogle Scholar
  64. 64.
    Kim CS, Calarco M, Jacobs T, Loik C, Rohde J, McClish D, et al. Leadership at the front line: a clinical partnership model on general care inpatient units. Am J Med Qual. 2012;27(2):106–11.CrossRefGoogle Scholar
  65. 65.
    Kim CS, King E, Stein J, Robinson E, Salameh M, O'Leary KJ. Unit-based interprofessional leadership models in six US hospitals. J Hosp Med. 2014;9(8):545–50.CrossRefGoogle Scholar
  66. 66.
    Rich VL, Brennan PJ, May L. Unit clinical leadership: a successful partnership between frontline clinicians, quality and senior leaders. 21st Annual National Forum on Quality Improvement in Health Care. Orlando; 2009; Found at https://pdfs.semanticscholar.org/presentation/f851/93b38c420b1969da2aac47d0d3c7290ec676.pdf.
  67. 67.
    Rich VL, Brennan PJ. Improvement projects led by unit-based teams of nurse, physician, and quality leaders reduce infections, lower costs, improve patient satisfaction, and nurse–physician communication. (AHRQ Health Care Innovations Exchange. Apr 14, 2010. (Updated: Jul 16, 2014.); https://innovations.ahrq.gov/profiles/improvement-projects-led-unit-based-teams-nurse-physician-and-quality-leaders-reduce.
  68. 68.
    Cortese DA, Smoldt RK. 5 success factors for physician-administrator partnerships: Medical Group Management Association; Available from: https://www.mgma.com/practice-resources/mgma-connection-plus/online-only/2015/september/5-success-factors-for-physician-administrator-partnerships.
  69. 69.
    Zeltser MV, Nash DB. Approaching the evidence basis for aviation-derived teamwork training in medicine. Am J Med Qual. 2010;25(1):13–23.CrossRefGoogle Scholar
  70. 70.
    Morey JC, Simon R, Jay GD, Wears RL, Salisbury M, Dukes KA, et al. Error reduction and performance improvement in the emergency department through formal teamwork training: evaluation results of the MedTeams project. Health Serv Res. 2002;37(6):1553–81.CrossRefGoogle Scholar
  71. 71.
    Hansen KS, Uggen PE, Brattebo G, Wisborg T. Training operating room teams in damage control surgery for trauma: a followup study of the Norwegian model. J Am Coll Surg. 2007;205(5):712–6.CrossRefGoogle Scholar
  72. 72.
    Rudy SJ, Polomano R, Murray WB, Henry J, Marine R. Team management training using crisis resource management results in perceived benefits by healthcare workers. J Contin Educ Nurs. 2007;38(5):219–26.CrossRefGoogle Scholar
  73. 73.
    McEwan D, Ruissen GR, Eys MA, Zumbo BD, Beauchamp MR. The effectiveness of teamwork training on teamwork behaviors and team performance: a systematic review and meta-analysis of controlled interventions. PLoS One. 2017;12(1):e0169604.CrossRefGoogle Scholar
  74. 74.
    Reeves S, Perrier L, Goldman J, Freeth D, Zwarenstein M. Interprofessional education: effects on professional practice and healthcare outcomes (update). The Cochrane database of systematic reviews. 2013(3):Cd002213.Google Scholar
  75. 75.
    Kuy S, Romero RAL. Improving staff perception of a safety climate with crew resource management training. J Surg Res. 2017;213:177–83.CrossRefGoogle Scholar
  76. 76.
    Buljac-Samardzic M, Dekker-van Doorn CM, van Wijngaarden JD, van Wijk KP. Interventions to improve team effectiveness: a systematic review. Health policy (Amsterdam, Netherlands). 2010;94(3):183–95.CrossRefGoogle Scholar
  77. 77.
    Hughes KM, Benenson RS, Krichten AE, Clancy KD, Ryan JP, Hammond C. A crew resource management program tailored to trauma resuscitation improves team behavior and communication. J Am Coll Surg. 2014;219(3):545–51.CrossRefGoogle Scholar
  78. 78.
    Lemieux-Charles L, McGuire WL. What do we know about health care team effectiveness? A review of the literature. Med Care Res Rev. 2006;63(3):263–300.CrossRefGoogle Scholar
  79. 79.
    Manser T. Teamwork and patient safety in dynamic domains of healthcare: a review of the literature. Acta Anaesthesiol Scand. 2009;53(2):143–51.CrossRefGoogle Scholar
  80. 80.
    Weaver SJ, Lyons R, DiazGranados D, Rosen MA, Salas E, Oglesby J, et al. The anatomy of health care team training and the state of practice: a critical review. Acad Med. 2010;85(11):1746–60.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Internal MedicineNorthwestern Feinberg School of MedicineChicagoUSA

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