Teamwork on inpatient medical units: assessing attitudes and barriers

Abstract

Background: Discrepant attitudes about teamwork among nurses and physicians exist in operating rooms and intensive care units. Little is known about teamwork attitudes on general medical services.

Objective: To assess ratings of teamwork by providers on inpatient medical units and barriers to collaboration.

Design and participants: Nurses, primary hospital physicians and medical subspeciality consultants on four general medical units were surveyed.

Measurements: Providers rated the quality of communication and collaboration experienced with their own and other disciplines. Providers also rated potential barriers to collaboration. Differences between providers in ratings of collaboration and barriers were tested using analysis of variance.

Results: Of 230 eligible providers, 159 (69%) completed the survey. Teamwork ratings of nurses were similarly high across provider types. Ratings of physicians differed considerably by provider type (p<or=0.001). Whereas the vast majority of physicians rated the quality of collaboration with nurses as high or very high, a minority of nurses rated collaboration with physicians as high or very high. Nurses perceived the biggest barriers to interdisciplinary communication to be difficulty identifying patients' providers and their roles. Primary hospital physicians rated not having physicians and nurses on a single telecommunication system as the biggest barrier.

Conclusions: In a general medical inpatient setting, discrepancies among nurses and physicians existed in ratings of collaboration and barriers to teamwork. Whereas physicians rated the quality of teamwork with nurses favourably, nurses perceived teamwork as suboptimal.