Toward Spanning the Quality Chasm: An Examination of Team Functioning Measures |
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Authors: | Dale C. Strasser Andrea Backscheider Burridge Judith A. Falconer Jay M. Uomoto Jeph Herrin |
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Affiliation: | 1. Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA;2. Department of Educational Psychology, University of Houston, Houston, TX;3. Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL;4. Neuropsychology Postdoctoral Residency Program, VA Northern California Health Care System, Martinez, CA;5. Division of Cardiology, Yale University School of Medicine, Yale University, New Haven, CT;6. Health Research and Educational Trust, Chicago, IL |
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Abstract: | ObjectiveTo examine the effect of 5 measures of team functioning on patient outcomes.DesignObservational, exploratory, measurement. Team functioning surveys and patient outcomes collected 1 year apart in a clinical trial were analyzed. The findings are discussed in context of the domains of team functioning, team effectiveness, and quality improvement.Setting27 Veterans Affairs medical centers.ParticipantsStaff (t1: N=356; t2: N=273) on inpatient teams and patients (t1: N=4266; t2: N=3213) treated by the teams.InterventionsNot applicable.Main Outcome MeasuresFive measures of team functioning (Physician Engagement, Shared Leadership, Supervisor Team Support, Teamness, and Team Effectiveness scales) and 3 measures of patient outcomes (functional improvement, discharge destination, and length of stay) were assessed at 2 time points with hierarchical generalized linear models to evaluate the association between team functioning measures and changes in patient outcomes.ResultsAssociations (P<.05) between team functioning measures and patient outcomes were found for 3 of the 15 analyses over the study period. Higher Physician Engagement scale score was associated with lower length of stay (P=.017), and increased scores on Teamness and Team Effectiveness scales correlated with higher rates of community discharge (P=.044 and .049, respectively).ConclusionsThis exploratory analysis revealed trends that team functioning corresponds with patient outcomes in clinically relevant patterns. An increase in community discharge and a decrease in length of stay were associated with higher scores of team functioning. Here, we find evidence that modifiable attributes of team functioning have a measurable effect on patient outcomes. Such findings are promising and support the need for further research on team effectiveness. |
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Keywords: | Patient care team Process assessment (Health Care) Quality of health care Rehabilitation |
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