Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 18 (1), 146

A Systematic Review of Team-Building Interventions in Non-Acute Healthcare Settings


A Systematic Review of Team-Building Interventions in Non-Acute Healthcare Settings

Christopher J Miller et al. BMC Health Serv Res.


Background: Healthcare is increasingly delivered in a team-based format emphasizing interdisciplinary coordination. While recent reviews have investigated team-building interventions primarily in acute healthcare settings (e.g. emergency or surgery departments), we aimed to systematically review the evidence base for team-building interventions in non-acute settings (e.g. primary care or rehabilitation clinics).

Methods: We conducted a systematic review in PubMed and Embase to identify team-building interventions, and conducted follow-up literature searches to identify articles describing empirical studies of those interventions. This process identified 14 team-building interventions for non-acute healthcare settings, and 25 manuscripts describing empirical studies of these interventions. We evaluated outcomes in four domains: trainee evaluations, teamwork attitudes/knowledge, team functioning, and patient impact.

Results: Trainee evaluations for team-building interventions were generally positive, but only one study associated team-building with statistically significant improvement in teamwork attitudes/knowledge. Similarly mixed results emerged for team functioning and patient impact.

Conclusions: The evidence base for healthcare team-building interventions in non-acute healthcare settings is much less developed than the parallel literature for short-term team function in acute care settings. Only one intervention we identified has been tested in multiple non-acute settings by distinct research teams. Positive findings regarding the utility of team-building interventions are tempered by a lack of control conditions, inconsistency in outcome measures, and high probability of bias. Considering these results alongside the well-recognized costs of poor healthcare teamwork suggests that additional research is sorely needed to develop the evidence base for team-building in non-acute settings.

Keywords: Non-acute; Team training; Team-building intervention; Teamwork.

Conflict of interest statement

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.


Fig. 1
Fig. 1
Team Effectiveness Pyramid (a conceptual model for non-acute healthcare team-building)
Figure 2
Figure 2
PRISMA Diagram (Modified)

Similar articles

See all similar articles

Cited by 2 PubMed Central articles


    1. Mitchell P, Wynia M, Golden R, McNellis B, Okun S, Webb CE, Rohrbach V, Von Kohorn I. Core principles & values of effective team-based health care. Washington, DC: Institute of Medicine; 2012.
    1. Mickan SM. Evaluating the effectiveness of health care teams. Aust Health Rev. 2005;29(2):211–217. doi: 10.1071/AH050211. - DOI - PubMed
    1. Helfrich CD, Dolan ED, Simonetti J, Reid RJ, Joos S, Wakefield BJ, Schectman G, Stark R, Fihn SD, Harvey HB. Elements of team-based care in a patient-centered medical home are associated with lower burnout among VA primary care employees. J Gen Intern Med. 2014;29(2):659–666. doi: 10.1007/s11606-013-2702-z. - DOI - PMC - PubMed
    1. Gittell JH, Fairfield KM, Bierbaum B, Head W, Jackson R, Kelly M, Laskin R, Lipson S, Siliski J, Thornhill T. Impact of relational coordination on quality of care, postoperative pain and functioning, and length of stay: a nine-hospital study of surgical patients. Med Care. 2000;38(8):807–819. doi: 10.1097/00005650-200008000-00005. - DOI - PubMed
    1. Lemieux-Charles L, McGuire WL. What do we know about health care team effectiveness? A review of the literature. Med Care Res Rev. 2006;63(3):263–300. doi: 10.1177/1077558706287003. - DOI - PubMed

Publication types

MeSH terms

LinkOut - more resources