Enhancing team development in an internal medicine resident continuity clinic

Abstract

Interprofessional teamwork is important for the provision of safe, high value patient care and is recognized as essential by the ACGME. We aimed to assess the impact of an interprofessional continuity clinic teamwork curriculum on perceptions of team development and patient safety. This project was conducted in an IM Resident Continuity Clinic where 96 residents, supported by 28 faculty and 48 interprofessional team members, attended continuity clinic two afternoons per week during alternating months of a 50/50 outpatient-inpatient training model. Teams were configured into two groups of residents, faculty and interprofessional team members. The randomly selected intervention group participated in strategically-timed TeamSTEPPS training. The control group received usual clinic education. Teamwork and safety climate were measured using the Team Development Measure (TDM) and Safety Attitudes Questionnaire (SAQ) collected before and after the intervention. Following the teamwork curriculum, team development improved in the intervention group as compared to control [mean change (95% CI) +13.9 (+9.3, +18.6) versus + 4.8 (+0.4, +9.1), p = 0.007]. Though 30% of the individual items on the SAQ improved significantly in the faculty intervention group as compared to control, the overall improvement in SAQ [intervention mean change + 0.4 (+0.2, +0.5), control mean change + 0.2 (−0.1, +0.5)] was not statistically significant ( p = 0.36). It is feasible to implement a TeamSTEPPs-based interprofessional teamwork curriculum among IM residents in a block clinic model and achieve enhanced teamwork and safety attitudes. Additional assessment of clinical and educational outcomes is ongoing.