EVALUATION OF A HOSPITAL STAFF TEAMWORK INTERVENTION
Background: Teamwork is widely considered to contribute to patient safety and patient and staff satisfaction. Conversely, lack of teamwork has been identified as a frequent contributor to adverse events in healthcare. Healthcare workers are trained as individuals in their respective disciplines, but are expected upon graduation to practice in teams made up of many disciplines. The TeamSTEPPS teamwork training program developed by the Department of Defense and Agency for Healthcare Research and Quality has five core skills: 1) communication, 2) leadership, 3) situation monitoring, 4) mutual support and 5) team structure. Hospital wide teamwork training is an important method to improve teamwork skills. Evaluation of TeamSTEPPStraining effect on staff perception of the five core teamwork skills is necessary to evaluate the effect of training however it is not often reported.
Methods: A pretest–posttest, quasi-experimental design from a convenience sample of hospital staff attending a teamwork-training program was conducted. Human subject approval was granted from the Hospital Institutional Review Board. All staff (nurses, physicians and support staff) was requested to voluntarily complete the TeamSTEPPS Team Perceptions Questionnaire (T-TPQ) immediately before and two to six month after the training program. The intervention was a four-hour teamwork-training program provided by certified TeamSTEPPS instructors. Training materials were obtained from the Agency for Healthcare Research and Quality. The training was customized for the hospital and focused on a culture of safety and improved communication. Statistical analysis was accomplished using the Statistical Package for Social Services (SPSS) for Mac version 21.0. A significance level of p = .05 was used to reduce the risk of Type I errors. Paired t-tests were used to measure the differences between pre and post survey scores.
Results: There were 495 completed pre-survey responses and 132 post-survey responses from the 512 trained participants. Only matched (n = 61) pre and post survey responses were used in data analysis. The 61 participants included in the analysis were: 48 nurses, 10 patient care technicians, 2 unit secretaries, and 1 physician. Statistically significant improvements were demonstrated in mutual support (t=2.33, p<0.023), and communication (t=2.53, p<0.014). Non-significant improvements were demonstrated in team structure (t=-7.03, p<0.09), leadership (t=1.83, p<.072), and situation monitoring (t=1.890, p<0.064).
Implications: Results from this study indicate that TeamSTEPPS was an effective teamwork-training program and resulted in improved perception of teamwork. Improved communication was an especially important finding because it is an integral component of teamwork behavior and supports leadership, situation monitoring and mutual support. Significant improvement in the perception of mutual support indicates a culture of trust and the promotion of patient safety. Future research approaches will include a longitudinal approach to survey six months and one-year changes in teamwork behaviors. Efforts to increase survey response and continuous evaluation of teamwork perceptions are needed. Training programs that improve teamwork perceptions are necessary to improve patient safety and patient and staff satisfaction.