Achieving Strong Teamwork Practices in Hospital Labor and Delivery Units

Achieving Strong Teamwork Practices in Hospital Labor and Delivery Units

Donna O. Farley
Melony E. Sorbero
Susan L. Lovejoy
Mary Salisbury
Copyright Date: 2010
Published by: RAND Corporation
Pages: 148
https://www.jstor.org/stable/10.7249/tr842osd
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  • Book Info
    Achieving Strong Teamwork Practices in Hospital Labor and Delivery Units
    Book Description:

    To learn how hospital labor and delivery units can achieve effective and sustainable teamwork practices and how much such practices affect staff experiences and patient outcomes, RAND researchers studied five units as they implemented improvements in their teamwork practices over a one-year period. They identified some key factors required by any given strategy for teamwork improvement but no standard template for implementation.

    eISBN: 978-0-8330-5118-9
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. Preface
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-viii)
  4. Figures
    (pp. ix-x)
  5. Tables
    (pp. xi-xii)
  6. Summary
    (pp. xiii-xx)
  7. Acknowledgments
    (pp. xxi-xxii)
  8. Abbreviations
    (pp. xxiii-xxiv)
  9. CHAPTER ONE Introduction and Background
    (pp. 1-8)

    This study was designed to document and learn from the experiences and outcomes of five hospital labor and delivery (L&D) units as they implemented improvements in their teamwork practices over a one-year period. The study had the following objectives:

    Objective 1:Better understand the conditions and actions required for hospital L&D units to achieve effective and sustainable teamwork practices.

    Objective 2:Assess the extent to which successful adoption of teamwork practices may influence the experiences of staff working in the units and outcomes for patients.

    It is well documented in the quality-improvement (QI) literature that successful implementation of new or...

  10. CHAPTER TWO Study Design and Methods
    (pp. 9-28)

    In this section, we describe in detail the design and methods used for evaluating teamwork practice implementation by the five participating L&D units. There were two parts to this evaluation: (1) a process evaluation of the implementation process itself and (2) an outcome evaluation of the effects that improved use of team-based care had on staff perceptions and knowledge and on patient outcomes.

    We first present the conceptual model that guided our data collection and analysis for the evaluation, which is grounded in the principles of QI implementation processes. Then we give a brief overview of the evaluation design, derived...

  11. CHAPTER THREE Findings Regarding Teamwork Implementation
    (pp. 29-54)

    This section presents the results of our process evaluation, which examines the participating L&D units’ implementation of teamwork practices to achieve sustainable team-based care. These results address the first study objective—to better understand the conditions and actions required for hospital L&D units to achieve effective and sustainable teamwork practices—and its two associated research questions: What training and actions are required to achieve a high level of teamwork in the L&D process? And how strongly do self-reported experiences in implementing teamwork improvements correlate with actual levels of teamwork as measured by direct observation of the L&D process?

    The sources...

  12. CHAPTER FOUR Effects of Teamwork Improvement on Unit Staff and Patient Outcomes
    (pp. 55-70)

    This chapter presents the results of our outcome evaluation, which examined the effects that teamwork improvements made by the participating L&D units had on both the staff working in the units and the patients served by them. These results address the second study objective—to assess the extent to which successful adoption of teamwork practices may influence the experiences of staff working in the units and outcomes for patients—and its two associated research questions: How does achieving effective teamwork affect the patient-safety perceptions, experiences, and knowledge of staff working in L&D units? And what effects does effective teamwork have...

  13. CHAPTER FIVE Synthesis of Findings and Conclusions
    (pp. 71-76)

    The purpose of this study was to improve understanding of what is required to achieve effective and sustainable teamwork practices and improvements in related outcomes. The study results have given us a substantial portion of the answer to that question, although some uncertainties remain. From the process evaluation, we have learned that a diversity of approaches to implementing teamwork improvements can be successful but that any of these approaches should include several actions that appear to be keys to progress. The L&D units that successfully implemented the largest number of teamwork practices were those that provided comprehensive initial training to...

  14. APPENDIXES

    • APPENDIX A Tools and Strategies for Teamwork
      (pp. 77-84)
    • APPENDIX B Matrix of Questions and Stakeholders for Site Visits
      (pp. 85-94)
    • APPENDIX C Monthly Update Teleconference: Longitudinal Labor and Delivery Teamwork Study
      (pp. 95-98)
    • APPENDIX D Questions for Final Assessment: Longitudinal Labor and Delivery Teamwork Study
      (pp. 99-104)
    • APPENDIX E Team Performance Observation Tool
      (pp. 105-106)
    • APPENDIX F Staff Survey Questionnaire
      (pp. 107-114)
    • APPENDIX G Regression Results for Staff Perceptions and Knowledge
      (pp. 115-120)
  15. Bibliography
    (pp. 121-124)
  16. Back Matter
    (pp. None)