Indicators for Follow-Up of Multidisciplinary Teamwork in Care Processes

Abstract

In order to study the impact of interventions on multidisciplinary teamwork in care processes, relevant indicators need to be defined. In the present study, the authors performed a Delphi survey of a purposively selected expert panel consisting of scientific researchers and hospital managers. Thirty-six experts from 13 countries participated. Each participant rated a list of team indicators on a scale of 1-6. Consensus was sought in two consecutive rounds. The content validity index (CVI) varied from 8% to 92%. A final list of 19 indicators was generated: 5 on team context/structure, 8 on team process, and 6 on team outcomes. Most relevant team indicators were as follows: "team relations," "quality of team leadership," "culture/climate for teamwork," "team perceived coordination of the care process," and "team vision." Scientific researchers and hospital managers that want to study and improve multidisciplinary teamwork in care processes should primarily focus on these team indicators.

Better organized care via care pathways: A multicenter study

“…Care pathway implementation is a well-established strategy to standardize care. It reduces unnecessary complexity and the variation of care processes in and between organizations [9–11]. The European Pathway Association (E-P-A) defines a care pathway as “a complex intervention for the mutual decision making and organization of care for a well-defined group of patients during a well-defined period” [12].…”

“…It has also been found that the hospitalization costs were significantly lower when care pathways had been introduced [16]. Second, there are multiple positive effects on teams, including: better team communication, better documentation between professionals, better team relations and lower risk of burnout and task orientation [11, 13, 15, 17, 18]. When a care pathway is introduced, staff feel an urge to collaborate within the hospital and with primary care, which lead to better organized care processes [19].…”

Recommended content of referral letters from general practitioners to specialised mental health care: a qualitative multi-perspective study

“…Those assessed as replaceable by only one or two participants were not excluded. Finally, we used a predefined cut-off limit of 75% or more of the participants scoring the themes at 4 or 5, as did Deneckere and colleagues [22]. Only the themes rated as most important or second most important by 75% or more of the participants were included.…”

The European quality of care pathways (EQCP) study on the impact of care pathways on interprofessional teamwork in an acute hospital setting: study protocol: for a cluster randomised controlled trial and evaluation of implementation processes

“…The concept of relational coordination (RC) describes a mutually reinforcing process of communicating and relating for the purpose of task integration [31]. The following criteria justify our choice: RC describes communication and relations within the type of teams we are focusing on; an international panel of scientific experts and hospital managers identified team communication and relations as highly relevant for follow-up as team indicators (Content Validity Indexes of 89% and 86%, respectively) [32], and both are dimensions measured with the concept of RC; Gittell et al showed that there is a clear mediating relationship between RC and the performance effects of care pathways [10]; and systematic literature review showed a positive relation between care pathways and both team communication and relations [12]. …”