Qualitative and Quantitative Assessment of Teamwork on Hospital Medicine Units Indicates Weaknesses in Cohesiveness, Communication, Role Clarity, and Goal Clarity

1Emory University School of Medicine, Atlanta, GA
2Emory University Healthcare, Atlanta, GA
3Emory University School of Medicine, Atlanta, GA
4Emory University School of Medicine, Atlanta, GA

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 67

Background:

Highly functional teams require cohesiveness, communication, role clarity, and goal clarity. Although in patient physicians and nurses may ideologically agree on the importance of teamwork, weaknesses in these domains may still exist. To understand domains of teamwork weakness in our hospital medicine units and to plan targeted interventions to build more highly functional teams, we performed a formal team needs assessment.

Methods:

Two 24‐bed medical units in a 550‐bed tertiary‐care, academic medical center were included in our evaluation. Both units have approximately 55 unit‐based nurses, patient care technicians, and clerical support staff; 10 ancillary staff, such as social work and therapists; 22 hospitalists; and 4 nonphysician provider who rotate throughout the units. In 1 of the 2 unite, small group discussions were conducted by the physician and nurse unit leaders to investigate the staffs perceptions of current best practices for patient care and employee engagement as well as areas requiring improvement. These conversations were followed by an anonymous 44‐question Web survey to assess cohesiveness, communication, role clarity, and goal clarity.

Results:

Greater than 95% of unit‐based nursing and support staff attended small group discussions and identified opportunities for improvement predominantly in the following areas: nurse work processes, staff behavior and interactions, physician‐related concerns, unit processes and patient flow, and patient satisfaction. Web surveys were completed by 76.7% of nursing, ancillary, and provider staff and consistently identified weaknesses across all attributes of highly functional teams (Table 1). Perceptions were also generally consistent regardless of health care role.

Conclusions:

The multidisciplinary staff on 2 medical units in our tertiary‐care, academic medical center appears to have less cohesiveness, communication, role clarity, and goal clarity than is desired among multidisciplinary, frontline hospital staff. Identifying areas of weakness is first step in facilitating targeted interventions to develop more functional teams better able to deliver high‐quality patient care.

Author Disclosure:

J. Hollberg, none; J. Stein, Emory University, entitled to royalties under patent‐licensing arrangement through Emory University; B. Castle, none; D. Tong, none

To cite this abstract:

Hollberg J, Castle B, Tong D, Stein J. Qualitative and Quantitative Assessment of Teamwork on Hospital Medicine Units Indicates Weaknesses in Cohesiveness, Communication, Role Clarity, and Goal Clarity. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 67. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/qualitative-and-quantitative-assessment-of-teamwork-on-hospital-medicine-units-indicates-weaknesses-in-cohesiveness-communication-role-clarity-and-goal-clarity/. Accessed May 26, 2019.

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