Terence Tang1, Christine Heidebrecht2, Andrea Coburn2, Elizabeth Mansfield3, Ellen Roberto2, Emanuel Lucez2, Morgan E Lim4, Robert Reid4, Sherman D Quan2. 1. Institute for Better Health and Program of Medicine, Trillium Health Partners, 100 Queensway West, Clinical Administrative Building, 6th floor, Mississauga, Ontario, L5B 1B8, Canada; Department of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: terence.tang@thp.ca. 2. Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada. 3. Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Department of Occupational Science and Occupational Therapy, University of Toronto, Canada. 4. Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada; Institute for Health Policy, Management, and Evaluation, University of Toronto, Canada.
Abstract
BACKGROUND: Teamwork and interprofessional communication are important in addressing the comprehensive care needs of complex hospitalized patients. The objective of this study is to evaluate the impact of an electronic interprofessional communication and collaboration platform on teamwork, communication, and adverse events in the hospital setting. MATERIALS AND METHODS: In this mixed methods study, we used a quasi-experimental design in the quantitative component and deployed the electronic tool in a staged fashion to 2 hospital wards 3 months apart. We measured teamwork, communication, and adverse events with Relational Coordination survey, video recordings of team rounds, and retrospective chart review. We conducted qualitative semi-structured interviews with clinicians to understand the perceived impacts of the electronic tool and other contextual factors. RESULTS: Teamwork sustainably improved (overall Relational Coordination score improved from 3.68 at baseline to 3.84 at three and six months after intervention, p = 0.03) on ward 1. A small change in face-to-face communication pattern during team rounds was observed (making plans increased from 22% to 24%, p = 0.004) at 3 months on ward 1 but was not sustained at 6 months. Teamwork and communication did not change after the intervention on ward 2. There was no meaningful change to adverse event rates on either ward. Clinicians reported generally positive views about the electronic tool's impact but described non-technology factors on each ward that affected teamwork and communication. CONCLUSION: The impact of using an electronic tool to improve teamwork and communication in the hospital setting appears mixed, but can be positive in some settings. Improving teamwork and communication likely require both appropriate technology and addressing non-technology factors.
BACKGROUND: Teamwork and interprofessional communication are important in addressing the comprehensive care needs of complex hospitalized patients. The objective of this study is to evaluate the impact of an electronic interprofessional communication and collaboration platform on teamwork, communication, and adverse events in the hospital setting. MATERIALS AND METHODS: In this mixed methods study, we used a quasi-experimental design in the quantitative component and deployed the electronic tool in a staged fashion to 2 hospital wards 3 months apart. We measured teamwork, communication, and adverse events with Relational Coordination survey, video recordings of team rounds, and retrospective chart review. We conducted qualitative semi-structured interviews with clinicians to understand the perceived impacts of the electronic tool and other contextual factors. RESULTS: Teamwork sustainably improved (overall Relational Coordination score improved from 3.68 at baseline to 3.84 at three and six months after intervention, p = 0.03) on ward 1. A small change in face-to-face communication pattern during team rounds was observed (making plans increased from 22% to 24%, p = 0.004) at 3 months on ward 1 but was not sustained at 6 months. Teamwork and communication did not change after the intervention on ward 2. There was no meaningful change to adverse event rates on either ward. Clinicians reported generally positive views about the electronic tool's impact but described non-technology factors on each ward that affected teamwork and communication. CONCLUSION: The impact of using an electronic tool to improve teamwork and communication in the hospital setting appears mixed, but can be positive in some settings. Improving teamwork and communication likely require both appropriate technology and addressing non-technology factors.
Authors: Rebecca T Leeb; Robyn A Cree; Laura Aird; Roberta L DeBiasi; Rita W Driggers; Elizabeth Garbarczyk; Lynne M Mofenson; Scott Needle; Jeannie Rodriguez; Christine Curry; Francisco García; Shana Godfred-Cato; Debra Hawks; Elizabeth Rosenblum; Eric Dziuban; Mark Hudak Journal: Am J Perinatol Date: 2020-05-21 Impact factor: 1.862
Authors: Carolyn Steele Gray; Terence Tang; Alana Armas; Mira Backo-Shannon; Sarah Harvey; Kerry Kuluski; Mayura Loganathan; Jason X Nie; John Petrie; Tim Ramsay; Robert Reid; Kednapa Thavorn; Ross Upshur; Walter P Wodchis; Michelle Nelson Journal: JMIR Res Protoc Date: 2020-11-25