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Tanja Manser - One of the best experts on this subject based on the ideXlab platform.
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how effective is Teamwork really the relationship between Teamwork and performance in healthcare teams a systematic review and meta analysis
BMJ Open, 2019Co-Authors: Jan B Schmutz, Laurenz L Meier, Tanja ManserAbstract:Objectives To investigate the relationship between Teamwork and clinical performance and potential moderating variables of this relationship. Design Systematic review and meta-analysis. Data source PubMed was searched in June 2018 without a limit on the date of publication. Additional literature was selected through a manual backward search of relevant reviews, manual backward and forward search of studies included in the meta-analysis and contacting of selected authors via email. Eligibility criteria Studies were included if they reported a relationship between a Teamwork process (eg, coordination, non-technical skills) and a performance measure (eg, checklist based expert rating, errors) in an acute care setting. Data extraction and synthesis Moderator variables (ie, professional composition, team familiarity, average team size, task type, patient realism and type of performance measure) were coded and random-effect models were estimated. Two investigators independently extracted information on study characteristics in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results The review identified 2002 articles of which 31 were included in the meta-analysis comprising 1390 teams. The sample-sized weighted mean correlation was r=0.28 (corresponding to an OR of 2.8), indicating that Teamwork is positively related to performance. The test of moderators was not significant, suggesting that the examined factors did not influence the average effect of Teamwork on performance. Conclusion Teamwork has a medium-sized effect on performance. The analysis of moderators illustrated that Teamwork relates to performance regardless of characteristics of the team or task. Therefore, healthcare organisations should recognise the value of Teamwork and emphasise approaches that maintain and improve Teamwork for the benefit of their patients.
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the interplay between Teamwork clinicians emotional exhaustion and clinician rated patient safety a longitudinal study
Critical Care, 2016Co-Authors: Annalena Welp, Laurenz L Meier, Tanja ManserAbstract:Background Effectively managing patient safety and clinicians’ emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that Teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of Teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of Teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral Teamwork.
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Teamwork and patient safety in dynamic domains of healthcare a review of the literature
Acta Anaesthesiologica Scandinavica, 2009Co-Authors: Tanja ManserAbstract:Aims/background This review examines current research on Teamwork in highly dynamic domains of healthcare such as operating rooms, intensive care, emergency medicine, or trauma and resuscitation teams with a focus on aspects relevant to the quality and safety of patient care. Results Evidence from three main areas of research supports the relationship between Teamwork and patient safety: (1) Studies investigating the factors contributing to critical incidents and adverse events have shown that Teamwork plays an important role in the causation and prevention of adverse events. (2) Research focusing on healthcare providers' perceptions of Teamwork demonstrated that (a) staff's perceptions of Teamwork and attitudes toward safety-relevant team behavior were related to the quality and safety of patient care and (b) perceptions of Teamwork and leadership style are associated with staff well-being, which may impact clinician' ability to provide safe patient care. (3) Observational studies on Teamwork behaviors related to high clinical performance have identified patterns of communication, coordination, and leadership that support effective Teamwork. Conclusion In recent years, research using diverse methodological approaches has led to significant progress in team research in healthcare. The challenge for future research is to further develop and validate instruments for team performance assessment and to develop sound theoretical models of team performance in dynamic medical domains integrating evidence from all three areas of team research identified in this review. This will help to improve team training efforts and aid the design of clinical work systems supporting effective Teamwork and safe patient care.
Beatrice J. Kalisch - One of the best experts on this subject based on the ideXlab platform.
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the psychometric testing of the nursing Teamwork survey in iceland
International Journal of Nursing Practice, 2016Co-Authors: Helga Bragadóttir, Beatrice J. Kalisch, Sigríður Bríet Smáradóttir, Heiður Hrund JónsdóttirAbstract:The purpose of this study was to test the psychometric properties of the Nursing Teamwork Survey-Icelandic (NTS-Icelandic), which was translated from US English to Icelandic. The Nursing Teamwork Survey, with 33 items, measures overall Teamwork and five factors of Teamwork: trust, team orientation, backup, shared mental models, and team leadership. The psychometric testing of the NTS-Icelandic was carried out on data from a pilot study and a national study. The sample for a pilot study included 123 nursing staff from five units, and the sample for a national study included 925 nursing staff from 27 inpatient units. The overall test-retest intraclass correlation coefficient in the pilot study was 0.693 (lower bound = 0.498, upper bound = 0.821) (p < 0.001). The Cronbach's alpha reliability for the total scale and subscales ranged from 0.737 to 0.911. A confirmatory factor analysis indicated a good fit of the data from the national study with the five-factor model for nursing Teamwork. The NTS-Icelandic tested valid and reliable in this study. Study findings support further use of the Nursing Teamwork Survey internationally.
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an intervention to improve nursing Teamwork using virtual simulation
Western Journal of Nursing Research, 2015Co-Authors: Beatrice J. Kalisch, Michelle Aebersold, Margaret Mclaughlin, Dana Tschannen, Sarah LaneAbstract:The purpose of this study was to test the use of virtual simulation to improve Teamwork among nursing staff. Using a quasi-experimental design, nursing staff (n = 43) from one patient care unit participated in a 1-hr session, which focused on common nursing Teamwork problems. The overall mean Teamwork scores improved from pre- (M = 3.25, SD = 0.58) to post-intervention (M = 3.49, SD = 0.67, p < .012). The intervention also had large (0.60 ≤ d ≤ 0.97) and significant effects on the measures of three Teamwork subscales (i.e., trust, team orientation, and backup).
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train the trainer intervention to increase nursing Teamwork and decrease missed nursing care in acute care patient units
Nursing Research, 2013Co-Authors: Beatrice J. Kalisch, Boqin Xie, David L RonisAbstract:Background: Teamwork is essential for patient safety and results in less missed nursing care. Objectives: The aim of this study was to test the impact of a train-the-trainer intervention on the level of satisfaction with nursing Teamwork and the amount of missed nursing care. Methods: This study used a quasiexperimental design with repeated measures taken at pretest, posttest, and 2 months after completion of the intervention. The sample for this study was the nursing staff on three medical–surgical units in three separate acute care hospitals (one unit in each hospital). Three nurses from each unit underwent a training program and then taught the skills and knowledge they acquired to the staff members on their units in three-hour-long sessions. The training involved staff role-playing scenarios based on Teamwork problems that occur regularly on inpatient units in acute care hospitals followed by debriefing, which focused on Teamwork behaviors (e.g., leadership, team orientation, backup, performance monitoring) and missed nursing care. Four measures were used to test the efficacy of this intervention: The Nursing Teamwork Survey, the MISSCARE Survey, and questions about the knowledge of and satisfaction with Teamwork. Return rates for the surveys ranged from 73% to 84%. Follow-up tests individually comparing pretest, posttest, and delayed posttest were conducted within the mixed model and used the Bonferroni correction for multiple comparisons. Results: Teamwork increased (F = 6.91, df = 259.01, p = .001) and missed care decreased (F = 3.59, df = 251.29, p = .03) over time. Nursing staff also reported a higher level of satisfaction with Teamwork and an increase of Teamwork knowledge after the intervention. Discussion: The intervention tested in this study shows promise of being an effective and efficient approach to increase nursing Teamwork and decrease missed nursing care.
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the impact of Teamwork on missed nursing care
Nursing Outlook, 2010Co-Authors: Beatrice J. Kalisch, Kyung Hee LeeAbstract:Previous studies have shown that missed nursing care is a significant problem in acute care hospitals. Other studies have demonstrated that Teamwork is a critical element in assuring patient safety and quality of care. The purpose of this study was to determine if the level of nursing Teamwork impacts the extent and nature of missed nursing care. A sample of 2 216 nursing staff members on 50 acute care patient care units in 4 hospitals completed the Nursing Teamwork Survey and the MISSCARE Survey. The response rate was 59.7%. Controlling for occupation of staff members (eg, RN/LPN, NA) and staff characteristics (eg, education, shift worked, experience, etc), Teamwork alone accounted for about 11% of missed nursing care. The results of this study show that the level of nursing Teamwork impacts the nature and extent of missed nursing care. The study results point to a need to invest in methods of enhancing Teamwork in these settings.
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nursing Teamwork staff characteristics work schedules and staffing
Health Care Management Review, 2009Co-Authors: Beatrice J. KalischAbstract:Purpose This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of Teamwork in nursing staff on acute care hospital patient units. Design This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Findings Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher Teamwork scores. The higher Teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the Teamwork scores. Conclusions There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and Teamwork. Nursing staff want to work where Teamwork is high, and perceptions of good staffing lead to higher Teamwork. Higher Teamwork scores correlated with those who worked less overtime.
Nick Sevdalis - One of the best experts on this subject based on the ideXlab platform.
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observational Teamwork assessment for surgery content validation and tool refinement
Journal of The American College of Surgeons, 2011Co-Authors: Louise Hull, Sonal Arora, Eva Kassab, Roger Kneebone, Nick SevdalisAbstract:Background Effective Teamwork is crucial for safe surgery. Failures in nontechnical and Teamwork skills are frequently implicated in adverse events. The Observational Teamwork Assessment for Surgery (OTAS) tool assesses Teamwork of the entire team in the operating room. Empirical testing of OTAS has yet to explore the content validity of the tool. Study Design This was a cross-sectional observational study. Data were collected in 30 procedures by 2 trained researchers. Five Teamwork behaviors were scored (ie, communication, leadership, cooperation, coordination, and monitoring) and behavior exemplar completion was recorded (phase 1). Expert operating room personnel (5 surgeons, 5 anesthesiologists, and 5 scrub nurses) assessed the content validity of the OTAS exemplar behaviors. Finally, a panel of operating room patient-safety experts refined the exemplars (phase 2). Results In total, the observability (presence/absence) of 130 exemplars was assessed by 2 blinded observers in 30 general surgical cases. Observer agreement was high (Cohen's κ ≥ 0.41) for 83.85% (109 of 130) of exemplar behaviors; 60.77% (79 of 130) of exemplar behaviors were observed frequently with high observer agreement. The majority of the exemplars were rated by expert operating room practitioners and an expert panel as substantial contributors to Teamwork and patient safety. Based on expert consensus, 21 behavior exemplars were removed from OTAS and an additional 23 were modified. Conclusions The exemplars of OTAS demonstrated very good content validity. Taken together with recent evidence on the construct validity of the tool, these findings demonstrate that OTAS is psychometrically robust for capturing Teamwork in the operating room.
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observational Teamwork assessment for surgery otas refinement and application in urological surgery
World Journal of Surgery, 2007Co-Authors: Shabnam Undre, Nick Sevdalis, Andrew N Healey, Ara Darzi, Charles VincentAbstract:Background Teamwork in surgical teams is at the forefront of good practice guidelines and empirical research as an important aspect of safe surgery. We have developed a comprehensive assessment for Teamwork in surgery—the Observational Teamwork Assessment for Surgery (OTAS)—and we have tested it for general surgical procedures. The aim of the research reported here was to extend the assessment to urology procedures.
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observational Teamwork assessment for surgery otas refinement and application in urological surgery
World Journal of Surgery, 2007Co-Authors: Shabnam Undre, Nick Sevdalis, Andrew N Healey, Ara Darzi, Charles VincentAbstract:Teamwork in surgical teams is at the forefront of good practice guidelines and empirical research as an important aspect of safe surgery. We have developed a comprehensive assessment for Teamwork in surgery—the Observational Teamwork Assessment for Surgery (OTAS)—and we have tested it for general surgical procedures. The aim of the research reported here was to extend the assessment to urology procedures. After refining the original assessment, we used it to observe 50 urology procedures. The OTAS comprises a procedural task checklist that assesses patient, equipment/provisions, and communication tasks as well as ratings on five team behavior constructs (communication, cooperation, coordination, leadership, and monitoring). Teamwork was assessed separately in the surgical, anesthesia, and nursing subteams in the operating theater. We also assessed the reliability of the behavioral scoring. Regarding task completion, a number of communication and equipment/provisions tasks were not routinely performed during the operations we observed. Regarding Teamwork-related behaviors, adequate reliability was obtained in the scoring of behaviors. Anesthetists and nurses obtained their lowest scores on communication. Surgeons’ scores revealed a more complex pattern. In addition to low scores on communication, surgeons’ Teamwork behaviors appeared to deteriorate as the procedures were finishing. Our findings suggest that OTAS is applicable to various branches of surgery. Separate assessment of the subteams in the operating theater provides useful information that can be used to build targeted Teamwork training aiming to improve surgical patients’ safety and outcomes.
Mark W Friedberg - One of the best experts on this subject based on the ideXlab platform.
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physician nurse practitioner Teamwork in primary care practices in new york a cross sectional survey
Journal of General Internal Medicine, 2020Co-Authors: Lusine Poghosyan, Affan Ghaffari, Jianfang Liu, Mark W FriedbergAbstract:Primary care practices increasingly rely on the growing workforce of nurse practitioners (NPs) to meet primary care demand. Understanding Teamwork between NPs and physicians in primary care practices is critically important. We assessed Teamwork between NPs and physicians practicing within the same primary care practice and determined how Teamwork affects their job satisfaction, intent to leave their current job, and quality of care. A cross-sectional survey design was used to collect data from both NPs and physicians in New York State in 2017. 584 participants (398 NPs and 186 physicians) from 476 primary care practices completed the survey yielding a 27% response rate for NPs and 12% for physicians. The survey tool contained validated measures of Teamwork and three outcomes: job satisfaction, intent to leave, and perceived quality of care. Simple and multi-level multivariable regression models were built. Most participants (76%) were either moderately satisfied or very satisfied with their job (NP sample: 75%; physician sample: 77%) and about 10% intended to leave their current job (NP sample: 11%; physician sample: 9%). The average perceived quality of care was the same across NP and physician samples with a mean of 8.5 on a 11 point scale. After controlling for confounders, a higher organizational-level Teamwork score was associated with higher job satisfaction (cumulative OR: 3.00; 95% CI: 1.85-4.88), lower odds of intent to leave (OR: 0.25; 95% CI: 0.09-0.74), and higher perceived quality of care (b=1.00; 95% CI: 0.77-1.23). This study produced evidence about NP-physician Teamwork in primary care practices. We found the vast majority of NPs and physicians reported favorable Teamwork, and that Teamwork affects clinician job satisfaction and intent to leave as well as perceived quality of care in their practices.
Mirjam Korner - One of the best experts on this subject based on the ideXlab platform.
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inter professional Teamwork and its association with patient safety in german hospitals a cross sectional study
PLOS ONE, 2020Co-Authors: Julia Dinius, Rebecca Philipp, Nicole Ernstmann, Lina Heier, Anja S Goritz, Stefanie Pfistererheise, Judith Hammerschmidt, Corinna Bergelt, Antje Hammer, Mirjam KornerAbstract:Background Inter-professional Teamwork is a prominent factor in quality of care and may lead to improved patient safety. Although team members’ points of view are highly relevant when trying to improve inpatient procedures, there is a lack of systematic assessment of their perceptions. Therefore, study aims were to explore inter-professional Teamwork, safety-related behavior, and patient safety in German hospitals from team members’ point of view. Furthermore, we wanted to examine the association between inter-professional Teamwork and safety-related behavior as well as the association between inter-professional Teamwork and patient safety. Methods We used cross-sectional pre-intervention data of a multicenter longitudinal study (German KOMPAS project). We gathered descriptive statistics for sample characteristics and to describe the current state of inter-professional Teamwork, safety-related behavior, and patient safety. We used one-way variance analyses to assess differences between groups, and linear regression analyses to examine the association between inter-professional Teamwork and the outcomes safety-related behavior, and patient safety. Results 326 inpatient care team members participated in the study. Participants perceived a moderate to high level of inter-professional Teamwork, and a moderate level of patient safety. Moreover, they reached rather high values in safety-related behavior. Professional group, work experience, and period of employment had an impact on the perceptions of inter-professional Teamwork, and patient safety. Higher inter-professional Teamwork was associated with better patient safety. We did not find an association between inter-professional Teamwork and safety-related behavior. Conclusions Based on the association between inter-professional Teamwork and patient safety, we recommend the implementation of team interventions. Because professional group, period of employment, and work experience had an impact on the perceptions of inter-professional Teamwork and patient safety, we suggest future qualitative research to explore reasons for caregivers’ critical evaluation. Moreover, we recommend longitudinal studies to reveal causal relationships, and subsequently to determine areas of improvement for a safer health care.
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A patient-centred team-coaching concept for medical rehabilitation.
Journal of interprofessional care, 2017Co-Authors: Mirjam Korner, Sonja Becker, Julia Dinius, Christian Müller, L. Zimmermann, M. RundelAbstract:Team coaching enhances Teamwork and subsequently improves patient-centredness in medical rehabilitation clinics. Even though interprofessional Teamwork is regarded as a crucial factor in medical re...
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interprofessional Teamwork and team interventions in chronic care a systematic review
Journal of Interprofessional Care, 2016Co-Authors: Mirjam Korner, Sonja Becker, L. Zimmermann, Sarah Butof, C Muller, Jurgen BengelAbstract:ABSTRACTTo identify key features of Teamwork and interventions for enhancing interprofessional Teamwork (IPT) in chronic care and to develop a framework for further research, we conducted a systema...
