Evidence-based development in nurse-led interprofessional teams

Abstract

Team-based care is often described as the best way to provide health care. However the effective use of teams in primary care is not yet prevalent in the US and nurse-led interprofessional collaborative teams are rare. Over the past three years the US Department of Health and Human Services has put great emphasis on the development of nurse-led interprofessional teams and this article describes the development of one such team in a primary care setting and the evidence base behind it.

A systematic review of team-building interventions in non-acute healthcare settings

“…All three studies were conducted on the same sample. Training based on the Toronto Framework Pilon et al, 2015 [ 20 ] The Toronto Framework focuses on three competency domains (Values/Ethics, Communication, Coordination) built over three phases (Exposure, Immersion, Competency). The exposure phase is achieved via a 2-day team retreat, informed by a previously-completed self-assessment.…”

“…The Immersion phase consists of ongoing team meetings focused on complex case studies; Competency is assessed at repeated team retreats conducted every 6 months. One study [ 20 ] Interdisciplinary Management Tool (IMT) Smith et al, 2012 [ 67 ] Developed via research on British intermediate care teams, the IMT is described in detail in a publicly available three-part workbook. Part 1 describes an evidence-based, structured organizational development intervention designed to improve teamwork over a 6-month period with the help of a facilitator.…”

“…comfortable being assertive in working toward shared goals), but findings were not evaluated via statistical testing. One-year follow-up showed regression for some of these measures (apparently based on frustration at slow rate of change and bureaucratic restrictions) Team Training Programme (no formal title provided) Bunnell et al, 2013 [ 31 ] Team Functioning: Staff consistently reported post-intervention improvements in team-related clinical care processes, although this was not subject to statistical testing; missing orders for unlinked visits dropped significantly post-intervention (30 to 2%, p < .001); no statistically significant change in uncommunicated order changes pre- to post-intervention TIPS Bajnok et al, 2012 [ 47 ] Trainee Evaluations: Generally positive, especially related to setting shared team goals, but results were not subject to statistical tests Teamwork Attitudes/Knowledge: Quantitative pre-post surveys showed statistically significant improvements in W(e)Learn [ 48 ] constructs of content, service, and outcomes Team Functioning: Surveys suggested improved team functioning but not subjected to statistical tests Patient Impact: Provider surveys suggested improved clinical outcomes but not subjected to statistical tests TOPS Sehgal et al, 2008 [ 43 ] Trainee Evaluations: Almost universally positive, with 99% of attendees reporting that they would recommend the training to their peers; mean overall rating of the training was 4.5 (sd = 0.79) on 1–5 Likert scale (but not subjected to statistical tests) Blegen et al, 2009 [ 38 ] Team Functioning: Within-unit teamwork HSOPSC [ 74 ] showed no statistically significant change from pre- to post-intervention (statistically significant findings emerged only when one site was dropped from the analyses) Auerbach et al, 2011 [ 37 ] Team Functioning: Patients were significantly more likely to report good team functioning on the part of their clinicians post-intervention Patient Impact: No statistically significant effects on readmission or length of stay; patients were more likely post-intervention (at the trend level) to indicate that their providers had made a mistake that affected their care Toronto Framework Pilon et al, 2015 [ 20 ] Team Functioning: No change in TDM [ 50 ] scores over 2 years …”

“…[ 19 ]), or one of a host of other terms (e.g. [ 20 ]). For simplicity we have chosen to adopt the term “team-building intervention” to refer to any systematic approach to improving healthcare team functioning for the purposes of this review (see Methods for details).…”

Shift‐work nurses’ work environments and health‐promoting behaviours in relation to sleep disturbance: A cross‐sectional secondary data analysis

“…In particular, shift-work nurses who work closely with patients and have frequent contact with physicians often report unsatisfactory or poor communication with doctors (Galdikienė, Asikainen, Balčiūnas, & Suominen, 2014), which eventually increases their job stress and deteriorates care practices (Ulrich et al, 2010). In this sense, in order to im- (Pilon, Ketel, & Davidson, 2015).…”