Implementation of unit-based interventions to improve teamwork and patient safety on a medical service

Am J Med Qual. Sep-Oct 2015;30(5):409-16. doi: 10.1177/1062860614538093. Epub 2014 Jun 11.

Abstract

In a prior study involving 2 medical units, Structured Interdisciplinary Rounds (SIDRs) improved teamwork and reduced adverse events (AEs). SIDR was implemented on 5 additional units, and a pre- versus postintervention comparison was performed. SIDR combined a structured format for communication with daily interprofessional meetings. Teamwork was assessed using the Safety Attitudes Questionnaire (score range = 0-100), and AEs were identified using queries of information systems confirmed by 2 physician researchers. Paired analyses for 82 professionals completing surveys both pre and post implementation revealed improved teamwork (mean 76.8 ± 14.3 vs 80.5 ± 11.6; P = .02), which was driven mainly by nurses (76.4 ± 14.1 vs 80.8 ± 10.4; P = .009). The AE rate was similar across study periods (3.90 vs 4.07 per 100 patient days; adjusted IRR = 1.08; P = .60). SIDR improved teamwork yet did not reduce AEs. Higher baseline teamwork scores and lower AE rates than the prior study may reflect a positive cultural shift that began prior to the current study.

Keywords: hospital medicine; interprofessional care; patient safety; teamwork.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Chicago
  • Cooperative Behavior
  • Female
  • Health Personnel*
  • Hospitals, Teaching
  • Humans
  • Internship and Residency
  • Interpersonal Relations
  • Male
  • Middle Aged
  • Nurses
  • Patient Care Team*
  • Pharmacists
  • Physicians
  • Social Workers
  • Tertiary Care Centers