Does Team Training Work? Principles for Health Care

Salas, Eduardo; DiazGranados, Deborah; Weaver, Sallie J.; King, Heidi B.

doi:10.1111/j.1553-2712.2008.00254.x

Cited by 272 publications

(226 citation statements)

References 21 publications

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“…physically side by side/face to face). 23,222 However, the concept of 'team' in healthcare is rapidly evolving to include a greater emphasis on interprofessional collaboration, 223 as well as new team structures. With the advent of restricted duty hours, 224 and frequent hand-offs, 29,30 team members are often working in shifts [225][226][227] and are also becoming dispersed geographically.…”

Section: Discussionmentioning

confidence: 99%

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

et al. 2013

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OBJECTIVE: Valid teamwork assessment is imperative to determine physician competency and optimize patient outcomes. We systematically reviewed published instruments assessing teamwork in undergraduate, graduate, and continuing medical education in general internal medicine and all medical subspecialties. DATA SOURCES: We searched MEDLINE, MEDLINE In-process, CINAHL and PsycINFO from January 1979 through October 2012, references of included articles, and abstracts from four professional meetings. Two content experts were queried for additional studies. STUDY ELIGIBILITY: Included studies described quantitative tools measuring teamwork among medical students, residents, fellows, and practicing physicians on single or multi-professional (interprofessional) teams. STUDY APPRAISAL AND SYNTHESIS METHODS:Instrument validity and study quality were extracted using established frameworks with existing validity evidence. Two authors independently abstracted 30 % of articles and agreement was calculated. RESULTS: Of 12,922 citations, 178 articles describing 73 unique teamwork assessment tools met inclusion criteria. Interrater agreement was intraclass correlation coefficient 0.73 (95 % CI 0.63-0.81). Studies involved practicing physicians (142, 80 %), residents/fellows (70, 39 %), and medical students (11, 6 %). The majority (152, 85 %) assessed interprofessional teams. Studies were conducted in inpatient (77, 43 %), outpatient (42, 24 %), simulation (37, 21 %), and classroom (13, 7 %) settings. Validity evidence for the 73 tools included content (54, 74 %), internal structure (51, 70 %), relationships to other variables (25, 34 %), and response process (12, 16 %). Attitudes and opinions were the most frequently assessed outcomes. Relationships between teamwork scores and patient outcomes were directly examined for 13 (18 %) of tools. Scores from the Safety Attitudes Questionnaire and Team Climate Inventory have substantial validity evidence and have been associated with improved patient outcomes. LIMITATIONS: Review is limited to quantitative assessments of teamwork in internal medicine. CONCLUSIONS:There is strong validity evidence for several published tools assessing teamwork in internal medicine. However, few teamwork assessments have been directly linked to patient outcomes. 3,4 Recognizing this, the Institute of Medicine, the Joint Commission, the Agency for Healthcare Research and Quality (AHRQ), and others have made teamwork a top priority in their recommendations for improving healthcare. [5][6][7][8][9] Teamwork is also prominently positioned within the American Board of Internal Medicine (ABIM) requirements for maintenance of certification for internists, 10 as well as the Accreditation Council for Graduate Medical Education's core competencies, 11 milestones, 12 and medical student competencies. 13 As such, every physician at the undergraduate, graduate, and continuing professional level must demonstrate competency in teamwork.While there is broad agreement on the imperative to improve teamwork, there is littl...

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Section: Discussionmentioning

confidence: 99%

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

et al. 2013

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“…The include complexity science, 1,7 relational coordination (which is grounded in complexity science), 10 high reliability, 11 and the Big Five for teamwork. 12 Research indicates that interactions among healthcare providers can have important influences on outcomes. [13][14][15][16][17] Additionally, the initial implementation of checklists to prevent central-line associated infections appeared to change provider relationships in a way that significantly influenced their success.…”

Section: Discussionmentioning

confidence: 99%

Relationships within inpatient physician housestaff teams and their association with hospitalized patient outcomes

McAllister

Leykum

Lanham

et al. 2014

Journal of Hospital Medicine

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IMPORTANCE Improving inpatient care delivery has historically focused on improving individual components of the system. Applying the complexity science framework to clinical systems highlights the important role of relationships among providers in influencing system function and clinical outcomes. OBJECTIVE To understand whether inpatient medical physician teams can be differentiated based on the relationships among team members, and whether these relationships are associated with patient outcomes, including length of stay (LOS), unnecessary length of stay (ULOS), and complication rates. DESIGN Eleven inpatient medicine teams were observed daily during attending rounds for 2‐ to 4‐week periods from September 2008 through June 2011. Detailed field notes were taken regarding patient care activities, team behaviors, and patient characteristics and outcomes. Behaviors were categorized using the Lanham relationship framework, giving each team a relationship score. We used factor analysis to assess the pattern of relationship characteristics and assessed the association between relationship characteristics and patient outcomes. SETTING Observations occurred at the Audie L. Murphy Veterans Affairs Hospital and University Hospital in San Antonio, Texas. PARTICIPANTS Physicians were chosen based on rotation schedules, experience, and time of year. Patients were included based on their admission to the inpatient medicine teams that were being observed. MAIN MEASURES Relationship scores were based on the presence or absence of 7 relationship characteristics. LOS, ULOS, and complication rates were assessed based on team discussions and chart review. The association between relationships and outcomes was assessed using the Kruskal‐Wallis rank sum test. RESULTS We observed 11 teams over 352.9 hours, observing 1941 discussions of 576 individual patients. Teams exhibited a range of 0 to 7 relationship characteristics. Relationship scores were significantly associated with complication rates, and presence of trust and mindfulness among teams was significantly associated with ULOS and complication rates. CONCLUSIONS Our findings are an important step in understanding the impact of relationships on the outcomes of hospitalized medical patients. This understanding could expand the scope of interventions to improve hospital care to include not only process improvement but also relationships among providers. Journal of Hospital Medicine 2014;9:764–771. © 2014 Society of Hospital Medicine

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“…Em seguida, foi apresentado um vídeo didático (8) abordando o histórico da construção do SISVAN e destacando a importância dos dados desse sistema para monitorar a situação alimentar e nutricional da população e, a partir disso, propor melhorias aos problemas prevalentes na comunidade. Nesse momento, os participantes esclareceram suas dúvidas sobre o funcionamento do sistema e ainda contribuíram com sugestões para a sua incorporação na rotina das equipes, o que foi de grande relevância, pois as capacitações devem representar uma troca de experiências, na qual, além de transmitir informações e reforçar atitudes positivas, seja possível conhecer a diversidade de vivências e dificuldades enfrentadas pela equipe em sua rotina, bem como suas dúvidas, opiniões e sugestões para melhorar o serviço (9,10) .…”

Section: Síntese Dos Dadosunclassified

Operacionalização do Sistema de Vigilância Alimentar e Nutricional (SISVAN) no município de Balneário Piçarras: relato de experiência

Soares

Mezadri

Nunes

2017

RBPS

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Does Team Training Work? Principles for Health Care

Cited by 272 publications

References 21 publications

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

Teamwork Assessment in Internal Medicine: A Systematic Review of Validity Evidence and Outcomes

Relationships within inpatient physician housestaff teams and their association with hospitalized patient outcomes

Operacionalização do Sistema de Vigilância Alimentar e Nutricional (SISVAN) no município de Balneário Piçarras: relato de experiência

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