Teamwork in hospital: a human factors approach

Effective teamwork and sufficient communication are critical components essential to patient safety in today’s specialized and complex healthcare services. Team training is important for an improved efficiency in inter-professional teamwork within hospitals.

Published 30. Jun. 2021. Updated on 27. Feb. 2024

Facts

Project manager

Randi Ballangrud, NTNU Gjøvik & SHARE

Project period

2016 - 2021

Funding

NTNU Gjøvik, University of Stavanger & Sykehuset Innlandet HF, Norwegian Nurses Association

Photo: Shutterstock

The research project Teamwork in hospital aims to validate questionnaires measuring teamwork in healthcare, and to explore the impact of a longitudinal interprofessional TeamSTEPPS® teamwork intervention in a surgical ward. To address the aim of the project, a descriptive, an explorative design and a quasi-experimental interventional design was applied. The study was carried out in five different hospitals (A-E) in three hospital trusts in Norway, and included two different parts. Frontline healthcare personnel in Hospitals A and B, from both acute and non-acute departments, were invited to respond to three Norwegian translated teamwork questionnaires, which were tested for psychometric properties (Part 1).

An inter-professional teamwork interventio, in line with the TeamSTEPPS® recommend Model of Change, which is built upon John Kotter’s change model with eight steps for organizational change, was implemented in a surgical ward (intervention ward) at Hospital C. TeamSTEPPS®, which is the abbreviation for "Team Strategies and Tools to Enhance Performance and Patient Safety”, aims to improve patient safety by raising the competence in teamwork by focusing on team structure and the four team skills communication, leadership, situation monitoring and mutual support. The four team skills with associated tools and strategies were implemented over a period of 12 months, including training courses and refresher courses for all health professionals. All physicians, registered nurses and assistant nurses in the intervention ward and two control wards (Hospitals D and E) were invited to survey their perception of teamwork, team decision making, safety culture and attitude towards teamwork before intervention and after six and 12 months. Adult patients admitted to the intervention surgical unit were invited to survey their perception of quality of care during their hospital stay before intervention and after six and 12 months. Moreover, anonymous patient registry data from local registers and data from patients’ medical records were collected (Part 2).

Published articles:

Ballangrud, R., Husebø, S. E., Aase, K., Aaberg, O. R., Vifladt, A., Berg, G. V., & Hall-Lord, M. L. (2017). “Teamwork in hospitals”: a quasi-experimental study protocol applying a human factors approach. BMC Nursing, 16(1), 34.

Ballangrud, R., Husebø, S. E., & Hall-Lord, M. L. (2017). Cross-cultural validation and psychometric testing of the Norwegian version of the TeamSTEPPS® teamwork perceptions questionnaire. BMC Health Services Research, 17(1), 799.

Ballangrud, R., Husebø, S. E., & Hall-Lord, M. L. (2019). Cross-cultural validation and psychometric testing of the Norwegian version of TeamSTEPPS teamwork attitude questionnaire. Journal of Interprofessional Care.

Aaberg, O. R., Hall‐Lord, M. L., Husebø, S. I. E., & Ballangrud, R. (2019). Collaboration and Satisfaction About Care Decisions in Team questionnaire—Psychometric testing of the Norwegian version, and hospital healthcare personnel perceptions across hospital units. Nursing Open, 6(2), 642-650

Aaberg, O. R., Hall-Lord, M. L., Husebø, S. E., & Ballangrud, R. (2019). A complex teamwork intervention in a surgical ward in Norway. BMC Research Note, 12(1), 582

Aaberg, O. R., Ballangrud, R., Husebø, S. I. E., & Hall-Lord, M. L. (2019). An interprofessional team training intervention with an implementation phase in a surgical ward: A controlled quasi-experimental study. Journal of Interprofessional Care.

Ballangrud, R., Aase, K., & Vifladt, A. (2020). Longitudinal team training programme in a Norwegian surgical ward: a qualitative study of nurses' and physicians' experiences with teamwork skills. BMJ open, 10.

Aaberg, O. R., Hall-Lord, M. L., Husebø, S. I. E., & Ballangrud, R. (2021). A Human Factors Intervention in Hospital-Evaluating Outcome of a TeamSTEPPS Program in a Surgical Ward. BMC Health Services Research, 21(114).

_{Under publication:}

Ballangrud, R., Aase, K., & Vifladt, A. (2021). Longitudinal team training program in a Norwegian surgical ward: A qualitative study of nurses' and physicians' experiences with implementation.

Hall-Lord, M.L; Ballangrud, R. (2021) Patients’ perceptions of quality of care: A teamwork intervention study in a surgical ward.

Vifladt, A., Moger,T., Ballangrud, R. Berg, G. V. (2021). Changes in adverse events during and after implementation of a team training program in a surgical ward. A retrospective review of adverse events.