Better Interprofessional Teamwork, Higher Level of Organized Care, and Lower Risk of Burnout in Acute Health Care Teams Using Care Pathways
- 1 January 2013
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Medical Care
- Vol. 51 (1), 99-107
- https://doi.org/10.1097/mlr.0b013e3182763312
Abstract
Effective interprofessional teamwork is an essential component for the delivery of high-quality patient care in an increasingly complex medical environment. The objective is to evaluate whether the implementation of care pathways (CPs) improves teamwork in an acute hospital setting. A posttest-only cluster randomized controlled trial was performed in Belgian acute hospitals. Teams caring for patients hospitalized with a proximal femur fracture and those hospitalized with an exacerbation of chronic obstructive pulmonary disease, were randomized into intervention and control groups. The intervention group implemented a CP. The control group provided usual care. A set of team input, process, and output indicators were used as effect measures. To analyze the results, we performed multilevel statistical analysis. Thirty teams and a total of 581 individual team members participated. The intervention teams scored significantly better in conflict management [β=0.30 (0.11); 95% confidence interval (CI), 0.08 to 0.53]; team climate for innovation [β=0.29 (0.10); 95% CI, 0.09 to 0.49]; and level of organized care [β=5.56 (2.05); 95% CI, 1.35 to 9.76]. They also showed lower risk of burnout as they scored significantly lower in emotional exhaustion [β=-0.57 (0.21); 95% CI, -1.00 to -0.14] and higher in the level of competence (β=0.39; 95% CI, 0.15 to 0.64). No significant effect was found on relational coordination. CPs are effective interventions for improving teamwork, increasing the organizational level of care processes, and decreasing risk of burnout for health care teams in an acute hospital setting. Through this, high-performance teams can be built.Keywords
This publication has 38 references indexed in Scilit:
- Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United StatesBMJ, 2012
- ‘Global Trigger Tool’ Shows That Adverse Events In Hospitals May Be Ten Times Greater Than Previously MeasuredHealth Affairs, 2011
- Burnout in health-care professionals during reorganizations and downsizing. A cohort study in nursesBMC Nursing, 2010
- What is a clinical pathway? Development of a definition to inform the debateBMC Medicine, 2010
- Interventions to improve team effectiveness: A systematic reviewHealth Policy, 2010
- Global priorities for patient safety researchBMJ, 2009
- Does Team Training Improve Team Performance? A Meta-AnalysisHuman Factors: The Journal of the Human Factors and Ergonomics Society, 2008
- Impact of recurrent changes in the work environment on nurses’ psychological well‐being and sickness absenceJournal of Advanced Nursing, 2006
- Making it safe: the effects of leader inclusiveness and professional status on psychological safety and improvement efforts in health care teamsJournal of Organizational Behavior, 2006
- The link between the management of employees and patient mortality in acute hospitalsThe International Journal of Human Resource Management, 2002