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Table 3 Outcomes for Identified Team-Building Interventions

From: A systematic review of team-building interventions in non-acute healthcare settings

Team-Building Intervention

Citation

Outcomes

“3-M” Team Training

Cooley, 1994 [39]

Trainee Evaluations: Average ratings for each of the three workshops ranged from 3.94 to 4.35 on a 1–5 Likert scale (standard deviations not reported). Participants found workshop sessions generally well-organized and useful, but would have appreciated more time to develop skills.

Team Functioning: Results for each conceptual domain targeted by the training (mapping, mirroring, and mining/refining) showed improvement that did not reach statistical significance.

CONNECT

Colón-Emeric, 2013 [40]

Team Functioning: Significantly improved communication and safety culture across intervention and control; trend-level findings of greater communication improvement for intervention than control (p = .06)

Patient Impact: Exploratory findings suggested a greater decrease in the number of falls in intervention nursing homes compared to control nursing homes (not statistically significant)

CREATE

Haycock-Stuart & Houston 2005 [41]

Trainee Evaluations: 69% thought CREATE was relevant; 80% said it met some of their educational needs (clinical staff appreciated it more than administrative staff); 68% wanted it to continue.

Team Functioning: Self-reports post-intervention suggested improved communication and the development of formalized meetings in at least one practice; additional analyses suggested statistically significant improvement in several self-reported teamwork variables (e.g. clear objectives, evaluating success in meeting practice objectives, meeting attendance, communication)

ELDER

Lange et al., 2011 [42]

Trainee Evaluations: Generally positive but not subjected to empirical testing

Mager et al., 2012 [36]

Trainee Evaluations: 97–100% of staff at each site rated the training positively

Teamwork Attitudes/Knowledge: Notes and checklists indicated good communication, respect, and collaboration during the simulations themselves (although not subjected to pre-post analysis)

Mager and Lange, 2014 [49]

Trainee Evaluations: Qualitatively, participants reported preferring innovative teaching methods (e.g. case-based discussion) over traditional lecture

Teamwork Attitudes/Knowledge: Participants did not show statistically significant improvement in knowledge of team concepts (based on a GITT instrument) or scores on an Interdisciplinary Teamwork IQ assessment

GITT

Clark et al., 2002 [56]

Team Functioning: No statistically significant changes for domains such as communication and cohesion (based on a team function assessment scale)

IMT

Nancarrow et al., 2012 [52]

Trainee Evaluations: Generally positive, but some participants expressed concerns about the amount of time required to attend workshops and complete associated assessments

Team Functioning: Workforce Dynamics Questionnaire [51] suggested improved team working score improved over time (p-value significant but not reported); no statistically significant change in several other teamwork domains; qualitative assessment (n = 15) suggested overall improved teamwork

Patient Impact: Changes in patient satisfaction pre- to post- intervention significant at some but not all sites

Nancarrow et al., 2015 [68]

Trainee Evaluations: This study expands on the findings from the trainee evaluations and qualitative findings reported in the Nancarrow et al. [52] (with results being generally but not universally positive)

Rehabilitation Team Training (no formal name provided)

Stevens et al., 2007 [70]

Trainee Evaluations: 100% of attendees agreed or strongly agreed that workshop met goals of emphasizing team functioning and its impact on patient outcomes; attendees less enthusiastic about written information summarizing survey responses related to team functioning

Strasser et al., 2008 [45]

Patient Impact: More patients treated by intervention teams gained above the median in motor function from Functional Independence Measure (FIM [71]); difference in increase: 13.6%; p = 0.03; no difference in length of stay or community discharge

TAP-ITP

Bain et al., 2014 [53]

Trainee Evaluations: W(e)Learn Program Evaluation Survey [48] indicated general satisfaction with the program

Team Functioning: Self-reports of collaboration, cohesion, communication, and conflict resolution improved post-intervention and at 1-year follow-up on the Bruyère Clinical Team Self-Assessment on Interprofessional Practice [72]

TeamSTEPPS

Stead et al., 2009 [35]

Trainee Evaluations: Evaluations were generally positive for participating staff, but specific results were neither reported nor subjected to statistical testing

Teamwork Attitudes/Knowledge: Some improvements were reported in teamwork-related knowledge, skills, and attitudes, but overall change scores were not statistically significant

Team Functioning: Statistically significant improvement in communication (p < .05) from pre- to post-intervention

Patient Impact: Reduced seclusion rates (p < .001) from pre- to post-intervention

Mahoney et al., 2012 [33]

Team Functioning: Significant increases in Teamwork Attitudes Questionnaire [73] from pre-intervention to 1-year follow-up (p < .01 for five of seven subdomains)

TeamSTEPPS (continued)

Spiva et al., 2014 [34]

Teamwork Attitudes/Knowledge: Compared to the control group, the intervention group did not experience statistically greater improvement on TeamSTEPPS Teamwork Attitudes measure

Team Functioning: Compared to the control group, the intervention group did not experience statistically greater improvement on the Hospital Survey on Patient Safety Culture (HSOPSC [74]) subdomains; similarly, no statistically greater improvement on TeamSTEPPS Team Members’ Perceptions of Team Effectiveness

Patient Impact: Intervention group fall rates reduced by 62% and injury rates by 71% (compared to increased rates for control group)

Treadwell et al., 2015 [46]

Team Functioning: Intervention group had significantly higher ratings of team collaboration post-intervention than did the comparison group (p < .001)

Gaston et al., 2016 [54]

Trainee Evaluations: Training rated as “good” to “excellent” by 96–100% of participants

Team Functioning: Teamwork Perceptions Questionnaire [75] and HSOPSC [74] subscale scores showed statistically significant improvement from pre- to post-intervention (p < .001)

Roman et al., 2016 [55, 63]

Teamwork Attitudes/Knowledge: Participants endorsed increased awareness of the need for open communication (not subjected to statistical testing)

Team Functioning: Statistically significant improvement from pre- to post-intervention in all five teamwork-related subscales assessed (all p < .01 from custom measure)

Team Training (no formal name provided

Cashman et al., 2004 [44]

Team Functioning: Post-intervention SYMLOG (Systematic Multiple Level Observation of Groups [76]) showed significant improvements in task orientation (i.e. feeling sense of shared goals/tasks), friendliness, and dominance (i.e. comfortable being assertive in working toward shared goals), but findings were not evaluated via statistical testing. One-year follow-up showed regression for some of these measures (apparently based on frustration at slow rate of change and bureaucratic restrictions)

Team Training Programme (no formal title provided)

Bunnell et al., 2013 [31]

Team Functioning: Staff consistently reported post-intervention improvements in team-related clinical care processes, although this was not subject to statistical testing; missing orders for unlinked visits dropped significantly post-intervention (30 to 2%, p < .001); no statistically significant change in uncommunicated order changes pre- to post-intervention

TIPS

Bajnok et al., 2012 [47]

Trainee Evaluations: Generally positive, especially related to setting shared team goals, but results were not subject to statistical tests

Teamwork Attitudes/Knowledge: Quantitative pre-post surveys showed statistically significant improvements in W(e)Learn [48] constructs of content, service, and outcomes

Team Functioning: Surveys suggested improved team functioning but not subjected to statistical tests

Patient Impact: Provider surveys suggested improved clinical outcomes but not subjected to statistical tests

TOPS

Sehgal et al., 2008 [43]

Trainee Evaluations: Almost universally positive, with 99% of attendees reporting that they would recommend the training to their peers; mean overall rating of the training was 4.5 (sd = 0.79) on 1–5 Likert scale (but not subjected to statistical tests)

Blegen et al., 2009 [38]

Team Functioning: Within-unit teamwork HSOPSC [74] showed no statistically significant change from pre- to post-intervention (statistically significant findings emerged only when one site was dropped from the analyses)

Auerbach et al., 2011 [37]

Team Functioning: Patients were significantly more likely to report good team functioning on the part of their clinicians post-intervention

Patient Impact: No statistically significant effects on readmission or length of stay; patients were more likely post-intervention (at the trend level) to indicate that their providers had made a mistake that affected their care

Toronto Framework

Pilon et al., 2015 [20]

Team Functioning: No change in TDM [50] scores over 2 years