Toward spanning the quality chasm: an examination of team functioning measures

Dale C Strasser; Andrea Backscheider Burridge; Judith A Falconer; Jay M Uomoto; Jeph Herrin

doi:10.1016/j.apmr.2014.06.013

Toward spanning the quality chasm: an examination of team functioning measures

Arch Phys Med Rehabil. 2014 Nov;95(11):2220-3. doi: 10.1016/j.apmr.2014.06.013. Epub 2014 Jul 4.

Authors

Dale C Strasser¹, Andrea Backscheider Burridge², Judith A Falconer³, Jay M Uomoto⁴, Jeph Herrin⁵

Affiliations

¹ Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: dstrass@emory.edu.
² Department of Educational Psychology, University of Houston, Houston, TX.
³ Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
⁴ Neuropsychology Postdoctoral Residency Program, VA Northern California Health Care System, Martinez, CA.
⁵ Division of Cardiology, Yale University School of Medicine, Yale University, New Haven, CT; Health Research and Educational Trust, Chicago, IL.

PMID: 25007707
DOI: 10.1016/j.apmr.2014.06.013

Abstract

Objective: To examine the effect of 5 measures of team functioning on patient outcomes.

Design: Observational, exploratory, measurement. Team functioning surveys and patient outcomes collected 1 year apart in a clinical trial were analyzed. The findings are discussed in context of the domains of team functioning, team effectiveness, and quality improvement.

Setting: 27 Veterans Affairs medical centers.

Participants: Staff (t1: N=356; t2: N=273) on inpatient teams and patients (t1: N=4266; t2: N=3213) treated by the teams.

Interventions: Not applicable.

Main outcome measures: Five measures of team functioning (Physician Engagement, Shared Leadership, Supervisor Team Support, Teamness, and Team Effectiveness scales) and 3 measures of patient outcomes (functional improvement, discharge destination, and length of stay) were assessed at 2 time points with hierarchical generalized linear models to evaluate the association between team functioning measures and changes in patient outcomes.

Results: Associations (P<.05) between team functioning measures and patient outcomes were found for 3 of the 15 analyses over the study period. Higher Physician Engagement scale score was associated with lower length of stay (P=.017), and increased scores on Teamness and Team Effectiveness scales correlated with higher rates of community discharge (P=.044 and .049, respectively).

Conclusions: This exploratory analysis revealed trends that team functioning corresponds with patient outcomes in clinically relevant patterns. An increase in community discharge and a decrease in length of stay were associated with higher scores of team functioning. Here, we find evidence that modifiable attributes of team functioning have a measurable effect on patient outcomes. Such findings are promising and support the need for further research on team effectiveness.

Trial registration: ClinicalTrials.gov NCT00237757.

Keywords: Patient care team; Process assessment (Health Care); Quality of health care; Rehabilitation.

Publication types

Observational Study
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Female
Humans
Leadership
Length of Stay
Male
Middle Aged
Patient Care Team / organization & administration
Patient Care Team / standards*
Patient Discharge
Patient Outcome Assessment*
Practice Patterns, Physicians' / standards
Quality Improvement
Recovery of Function
Rehabilitation / organization & administration
Rehabilitation / standards*

Associated data

ClinicalTrials.gov/NCT00237757