Dixon Nancy, Wellsteed Lorna
Strategic Services, Healthcare Quality Quest, Romsey, UK.
Wellsteed Associates, Mortimer, UK.
BMJ Open Qual. 2019 Apr 24;8(2):e000500. doi: 10.1136/bmjoq-2018-000500. eCollection 2019.
To determine the effects of a structured team-based learning approach to quality improvement (QI) on the performance 12 months later of two teams caring for patients with dementia.
Before and after prospective study.
Staff working in two inpatient services in National Health Service Trusts in England, one providing orthopaedic surgery (Team A) and one caring for elderly people with mental health conditions, including dementia (Team B). Team A consisted of nurses; Team B included doctors, nurses, therapists, mental health support workers and administrators.
QI training and support, assessment of the performance of teams and team coaching were provided to the two teams. QI training integrated tools for teamworking and a structured approach to QI. Team members completed the Aston Team Performance Inventory, a validated tool for assessing team performance, at the start of the QI work (time 1) and 1 year later (time 2).
A year after the QI training and team QI project, Team A members perceived themselves as a high-performing team, reflected in improvement in 24 of 52 components measured in the Inventory; Team B was initially a poorly performing team and had improvements in 42 of 52 components a year later.
This study demonstrates that a structured team-based learning approach to QI has effects a year later on the performance of teams in clinical settings, as measured by a validated team performance tool.
确定一种基于团队的结构化质量改进方法对两个照顾痴呆患者的团队在12个月后的绩效的影响。
前瞻性前后对照研究。
在英国国民健康服务信托基金的两个住院服务部门工作的员工,一个提供骨科手术(A组),另一个照顾患有精神健康疾病(包括痴呆)的老年人(B组)。A组由护士组成;B组包括医生、护士、治疗师、精神健康支持人员和管理人员。
为两个团队提供质量改进培训和支持、团队绩效评估及团队指导。质量改进培训整合了团队合作工具和一种结构化的质量改进方法。团队成员在质量改进工作开始时(时间1)和1年后(时间2)完成阿斯顿团队绩效量表,这是一种经过验证的评估团队绩效的工具。
在质量改进培训和团队质量改进项目开展一年后,A组成员认为自己是一个高绩效团队,这体现在量表所测量的52个项目中有24个项目得到了改善;B组最初是一个绩效较差的团队,一年后52个项目中有42个项目得到了改善。
本研究表明,一种基于团队的结构化质量改进方法在一年后会对临床环境中团队的绩效产生影响,这是通过一种经过验证的团队绩效工具来衡量的。