Implementation of Unit-Based Interventions to Improve Teamwork and Patient Safety on a Medical Service. (September 2015)

• Record Type: Journal Article
• Authors: O'Leary, Kevin J.; Creden, Amanda J.; Slade, Maureen E.; Landler, Matthew P.; Kulkarni, Nita; Lee, Jungwha; Vozenilek, John A.; Pfeifer, Pamela; Eller, Susan; Wayne, Diane B.; Williams, Mark V.
• Is Part Of: American journal of medical quality. Volume 30:Number 5(2015:Sep./Oct.)
• Page Start: 409
• Page End: 416
• Publication Date: 2015-09
• Subjects: patient safety -- teamwork -- interprofessional care -- hospital medicine; Medical care -- Quality control -- Periodicals; Medical care -- Evaluation -- Periodicals; Medical care -- Utilization review -- Periodicals; Medical care -- United States -- Periodicals; 362.1
• DOI: 10.1177/1062860614538093
• Languages: English
• ISSNs: 1062-8606

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.