A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

Abstract

PurposeAlthough the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness.MethodA multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis.ResultsIn order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010–.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions.ConclusionThe TCC improved dimensions that were addressed directly by the approach and were linked to the clinics’ needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and processes regarding the implementation of the intervention.

An Exploratory Mixed Methods Study of Experiences of Interprofessional Teams Who Received Coaching to Simultaneously Redesign Primary Care Education and Clinical Practice

“…Qualitative findings also revealed the benefits of coaching included feedback, support, help with conflict management, and staying on task. These findings are consistent with those found in the study by Korner et al, 12 which revealed that team coaching improved team meetings and information exchange by improving willingness to accept responsibility derived from real-time feedback sessions. We similarly learned that feedback was important to the teams, which other studies have shown fosters reflective abilities.…”

“…The second paper involved a cluster-randomized controlled study designed to evaluate team coaching for improving teamwork and patient-centeredness among members of rehabilitation teams. 12 This study found that team coaching improved structured team meetings, information exchange and willingness to accept responsibility during feedback sessions that occurred in real-time. 12 Weaknesses in this paper include that the setting was limited to rehabilitation clinics and the study was conducted in Germany and is not generalizable to the United States.…”

Person-Centered Rehabilitation Model: Framing the Concept and Practice of Person-Centered Adult Physical Rehabilitation Based on a Scoping Review and Thematic Analysis of the Literature

“…153,154 Articulated through a PCR team Rehabilitation is often delivered by professionals from multiple disciplines; therefore, PCR approaches (and how the person experiences them) emerge from interactions with rehabilitation teams, not single professionals. 120,146,155 As such, PCR is contingent on individual professionals working within person-centered teams and is activated through team members systematically working together to address the persons' needs. 20 Optimally, all professionals who deliver interventions to the person demonstrate a shared commitment to PCR, 23,65,111 listen to the person, 82 and work toward common or articulated rehabilitation goals (beyond disciplinary-based agendas).…”

Multiteam systems in an agile environment: a realist systematic review

“…The PO is better able to monitor and facilitate, as a team coach, teamwork capabilities. Team coaching concentrates on “working processes, team organization, distribution of roles and responsibilities and optimization of communication” (Korner et al , 2017, p. 4). This requires the PO to step away from the role as a team member to assess and optimize teamwork.…”