BACKGROUND: Improving communication between caregivers is an important approach to improving safety. OBJECTIVE: To implement teamwork and communication interventions and evaluate their impact on patient outcomes. DESIGN: A prospective, interrupted time series of a three-phase INTERVENTION: a run-in period (phase 1), during which a training programme was given to providers and staff on each unit; phase 2, which focused on unit-based safety teams to identify and address care problems using skills from phase 1; and phase 3, which focused on engaging patients in communication efforts. SETTING: General medical inpatient units at three northern California hospitals. PATIENTS: Administrative data were collected from all adults admitted to the target units, and a convenience sample of patients interviewed during and after hospitalisation. MEASUREMENTS: Readmission, length of stay and patient reports of teamwork, problems with care, and overall satisfaction. RESULTS: 10 977 patients were admitted; 581 patients (5.3% of total sample) were interviewed in hospital, and 313 (2.9% overall, 53.8% of interviewed patients) completed 1-month surveys. No phase of the study was associated with adjusted differences in readmission or length of stay. The phase 2 intervention appeared to be associated with improvement in reports of whether physicians treated them with respect, whether nurses treated them with respect or understood their needs (p<0.05 for all). Interestingly, patients were more likely to perceive that an error took place with their care and agreed less that their caregivers worked well together as a team. No phase had a consistent impact on patient reports of care processes or overall satisfaction. Limitations The study lacks direct measures of patient safety. CONCLUSIONS: Efforts to simultaneously improve caregivers' ability to troubleshoot care and enhance communication may improve patients' perception of team functions, but may also increase patients' perception of safety gaps.
BACKGROUND: Improving communication between caregivers is an important approach to improving safety. OBJECTIVE: To implement teamwork and communication interventions and evaluate their impact on patient outcomes. DESIGN: A prospective, interrupted time series of a three-phase INTERVENTION: a run-in period (phase 1), during which a training programme was given to providers and staff on each unit; phase 2, which focused on unit-based safety teams to identify and address care problems using skills from phase 1; and phase 3, which focused on engaging patients in communication efforts. SETTING: General medical inpatient units at three northern California hospitals. PATIENTS: Administrative data were collected from all adults admitted to the target units, and a convenience sample of patients interviewed during and after hospitalisation. MEASUREMENTS: Readmission, length of stay and patient reports of teamwork, problems with care, and overall satisfaction. RESULTS: 10 977 patients were admitted; 581 patients (5.3% of total sample) were interviewed in hospital, and 313 (2.9% overall, 53.8% of interviewed patients) completed 1-month surveys. No phase of the study was associated with adjusted differences in readmission or length of stay. The phase 2 intervention appeared to be associated with improvement in reports of whether physicians treated them with respect, whether nurses treated them with respect or understood their needs (p<0.05 for all). Interestingly, patients were more likely to perceive that an error took place with their care and agreed less that their caregivers worked well together as a team. No phase had a consistent impact on patient reports of care processes or overall satisfaction. Limitations The study lacks direct measures of patient safety. CONCLUSIONS: Efforts to simultaneously improve caregivers' ability to troubleshoot care and enhance communication may improve patients' perception of team functions, but may also increase patients' perception of safety gaps.
Authors: Beverly W Henry; Danielle M McCarthy; Anna P Nannicelli; Nicholas P Seivert; John A Vozenilek Journal: Health Expect Date: 2013-10-07 Impact factor: 3.377
Authors: Ann Ding; Temple A Ratcliffe; Alanna Diamond; Erika O Bowen; Lauren S Penney; Meghan A Crabtree; Kanapa Kornsawad; Christopher J Moreland; Sean E Garcia; Luci K Leykum Journal: BMC Med Educ Date: 2020-03-23 Impact factor: 2.463
Authors: Elena Parmelli; Gerd Flodgren; Scott G Fraser; Nicola Williams; Gregory Rubin; Martin P Eccles Journal: Cochrane Database Syst Rev Date: 2012-08-15
Authors: Rachel D A Havyer; Majken T Wingo; Nneka I Comfere; Darlene R Nelson; Andrew J Halvorsen; Furman S McDonald; Darcy A Reed Journal: J Gen Intern Med Date: 2013-12-11 Impact factor: 5.128
Authors: Leslie A Curry; Erika L Linnander; Amanda L Brewster; Henry Ting; Harlan M Krumholz; Elizabeth H Bradley Journal: Implement Sci Date: 2015-03-07 Impact factor: 7.327
Authors: Karl Swedberg; Desmond Cawley; Inger Ekman; Heather L Rogers; Darijana Antonic; Daiga Behmane; Ida Björkman; Nicky Britten; Sandra C Buttigieg; Vivienne Byers; Mats Börjesson; Kirsten Corazzini; Andreas Fors; Bradi Granger; Boban Joksimoski; Roman Lewandowski; Virgilijus Sakalauskas; Einav Srulovici; Jan Törnell; Sara Wallström; Axel Wolf; Helen M Lloyd Journal: Health Sci Rep Date: 2021-06-06