Interventions to improve team effectiveness within health care: a systematic review of the past decade

Abstract

Background: A high variety of team interventions aims to improve team performance outcomes. In 2008, we conducted a systematic review to provide an overview of the scientific studies focused on these interventions. However, over the past decade, the literature on team interventions has rapidly evolved. An updated overview is therefore required, and it will focus on all possible team interventions without restrictions to a type of intervention, setting, or research design. Objectives: To review the literature from the past decade on interventions with the goal of improving team effectiveness within healthcare organizations and identify the "evidence base" levels of the research. Methods: Seven major databases were systematically searched for relevant articles published between 2008 and July 2018. Of the original search yield of 6025 studies, 297 studies met the inclusion criteria according to three independent authors and were subsequently included for analysis. The Grading of Recommendations, Assessment, Development, and Evaluation Scale was used to assess the level of empirical evidence. Results: Three types of interventions were distinguished: (1) Training, which is subdivided into training that is based on predefined principles (i.e. CRM: crew resource management and TeamSTEPPS: Team Strategies and Tools to Enhance Performance and Patient Safety), on a specific method (i.e. simulation), or on general team training. (2) Tools covers tools that structure (i.e. SBAR: Situation, Background, Assessment, and Recommendation, (de)briefing checklists, and rounds), facilitate (through communication technology), or trigger (through monitoring and feedback) teamwork. (3) Organizational (re)design is about (re)designing structures to stimulate team processes and team functioning. (4) A programme is a combination of the previous types. The majority of studies evaluated a training focused on the (acute) hospital care setting. Most of the evaluated interventions focused on improving non-technical skills and provided evidence of improvements. Conclusion: Over the last decade, the number of studies on team interventions has increased exponentially. At the same time, research tends to focus on certain interventions, settings, and/or outcomes. Principle-based training (i.e. CRM and TeamSTEPPS) and simulation-based training seem to provide the greatest opportunities for reaching the improvement goals in team functioning.

Evaluation of the Patient Safety Culture Status and its Related Factors From the Perspective of Operating Room Personnel

“…Functional results of teamwork include reducing the duration of hospitalization, decreasing the likelihood of patient readmission, increasing the power of communication and collaboration between physicians and other personnel, and also reducing the incidence of medical errors. Achieving patient safety depends on teamwork (Buljac-Samardzic et al, 2020). In the present study, "non-punitive response to error" was introduced as the main weakness of safety culture in operating room wards.…”

Development and psychometric assessment of the triage nurses’ professional capability questionnaire in the emergency department

“…In such circumstances, if triage nurses are not skilled at teamwork, they cannot manage and organize matters properly and, due to anxiety and hastiness, may commit clinical errors. According to Buljac-Samardzic, et al (2020), teamwork skills as an important component of emergency nurses' clinical competency [29]. The instruments used in other studies mostly measure triage nurses' knowledge and the important index of teamwork skills is ignored.…”

Social distancing: implications for the operating room in the face of COVID-19

“…This OR communication has been studied qualitatively and quantitatively and was shown to improve overall team function. [12][13][14][15] Optimizing OR communication is especially complex as these teams often change, not only from day to day but also from case to case, thus limiting their adaptive capacity. The literature indicates that several factors are integral to success, including: 1) shared knowledge and understanding, 2) shared goals, and 3) mutual respect.…”