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