Qualitative evaluation of the implementation of the Interdisciplinary Management Tool: a reflective tool to enhance interdisciplinary teamwork using Structured, Facilitated Action Research for Implementation

Abstract

This document is the author deposited version. You are advised to consult the publisher's version if you wish to cite from it. Published versionNANCARROW, Susan, SMITH, Tony, ARISS, Steven and ENDERBY, Pamela M. (2015). Qualitative evaluation of the implementation of the interdisciplinary management tool: a reflective tool to enhance interdisciplinary teamwork using structured, facilitated action research for implementation. Health & Social Care In The Community, 23 (4), 437-448. Results: The IMT was implemented with 10 teams, including 253 staff from more than 10 different disciplines. Team challenges included lack of clear vision; communication issues; limited career progression opportunities; inefficient resources use; need for role clarity; and service development. The IMT successfully engaged staff in the change process, and resulted in teams developing creative strategies to address the issues above. Participants valued dedicated time to focus on the processes of team functioning, however some were uncomfortable with a focus on team work at the expense of delivering direct patient care. Copyright and re-use policyConclusion: The IMT is a relatively low-cost, structured, reflective approach to enhancing team function. It empowers individuals to understand and value their own, and others' roles and responsibilities within the team; identify barriers to effective team work, and develop and implement appropriate solutions to these. To be successful, teams need protected time to take the time for reflection and executive support to be able to broker changes that are beyond the scope of the team. What is already known on this topic Effective team work enhances patient outcomes, and ineffective team work detracts from patient outcomes.Reflective team practices can enhance team performance. What this paper addsTeam work is often perceived by teams as a by-product of service delivery, rather than a vital prerequisite to effectiveness.A structured facilitated process can effectively enhance interdisciplinary team work.Community based rehabilitation teams often lack several pre-requisites of effective team work such as accessible and effective meeting processes and internal communication structures.Teams that commit resources to reflecting on the processes of team work can enhance their team integration, processes of team working, and identify novel and contextually relevant solutions to improve team effectiveness.Individuals that participate in reflective processes to enhance team work recognise the value of the process personally and for their team.

A systematic review of team-building interventions in non-acute healthcare settings

“…Part 3 consists of assessment instruments to measure team functioning at the staff and patient levels. Two studies [ 52 , 68 ] conducted on same sample Triad for Optimal Patient Safety (TOPS) Sehgal et al, 2008 [ 43 ] TOPS involves development of a 4-hour teamwork training program for staff on an inpatient unit combining didactics, facilitated discussion of a safety trigger video, and small-group exercises to enhance communication skills and team behaviors. Three studies [ 37 , 38 , 43 ] conducted on same sample Geriatric Interdisciplinary Team Training (GITT) Siegler, 1998 [ 66 ] The GITT initiative was launched by the John A. Hartford Foundation in 1995, and has continued to inform team-building interventions into the twenty-first century.…”

“…clear objectives, evaluating success in meeting practice objectives, meeting attendance, communication) ELDER Lange et al, 2011 [ 42 ] Trainee Evaluations: Generally positive but not subjected to empirical testing Mager et al, 2012 [ 36 ] Trainee Evaluations: 97–100% of staff at each site rated the training positively Teamwork Attitudes/Knowledge: Notes and checklists indicated good communication, respect, and collaboration during the simulations themselves (although not subjected to pre-post analysis) Mager and Lange, 2014 [ 49 ] Trainee Evaluations: Qualitatively, participants reported preferring innovative teaching methods (e.g. case-based discussion) over traditional lecture Teamwork Attitudes/Knowledge: Participants did not show statistically significant improvement in knowledge of team concepts (based on a GITT instrument) or scores on an Interdisciplinary Teamwork IQ assessment GITT Clark et al, 2002 [ 56 ] Team Functioning: No statistically significant changes for domains such as communication and cohesion (based on a team function assessment scale) IMT Nancarrow et al, 2012 [ 52 ] Trainee Evaluations: Generally positive, but some participants expressed concerns about the amount of time required to attend workshops and complete associated assessments Team Functioning: Workforce Dynamics Questionnaire [ 51 ] suggested improved team working score improved over time ( p- value significant but not reported); no statistically significant change in several other teamwork domains; qualitative assessment ( n = 15) suggested overall improved teamwork Patient Impact: Changes in patient satisfaction pre- to post- intervention significant at some but not all sites Nancarrow et al, 2015 [ 68 ] Trainee Evaluations: This study expands on the findings from the trainee evaluations and qualitative findings reported in the Nancarrow et al [ 52 ] (with results being generally but not universally positive) Rehabilitation Team Training (no formal name provided) Stevens et al, 2007 [ 70 ] Trainee Evaluations: 100% of attendees agreed or strongly agreed that workshop met goals of emphasizing team functioning and its impact on patient outcomes; attendees less enthusiastic about written information summarizing survey responses related to team functioning Strasser et al, 2008 [ 45 ] Patient Impact: More patients treated by intervention teams gained above the ...…”

Creating effective academic research teams: Two tools borrowed from business practice

“…The NIH Field Guide on Collaboration and Team Science, 7 originally published by the National Cancer Institute in 2010 and updated in 2018, provides resources and tools for effective team operation. Other tools designed to enhance team effectiveness 8,9 and training curricula 10,11,12 have also been developed and evaluated.…”

Integrating Diverse Disciplines to Enhance Interprofessional Competency in Healthcare Delivery

“…The Association of American Medical Colleges (AAMC) requires participation as a member of an interprofessional team as an Entrustable Professional Activity (EPA) [7]; while the American Association of Colleges of Nursing (AACN) places a strategic focus on IPE to improve innovation within the discipline and within the field of healthcare [8]. Innovations are stimulated by diverse perspectives, academic backgrounds, and require strong skills in teamwork, leadership, and communication [9,10]. When students collaborate with others outside their area of expertise, creative thinking skills are enhanced as well as the students’ ability to generate solutions through teamwork [11].…”