Sullivan Jennifer L, Weinburg Dana Beth, Gidmark Stefanie, Engle Ryann L, Parker Victoria A, Tyler Denise A
Center for Healthcare Organization and Implemenation Research, VA Boston Healthcare System, USA.
Boston University, USA.
Int J Care Coord. 2019 Jun 1;22(2):90-99. doi: 10.1177/2053434519858028.
Previous research in acute care settings has shown that collaborative capacity, defined as the way providers collaborate as equal team members, can be improved by the ways in which an organization supports its staff and teams. This observational cross-sectional study examines the association between collaborative capacity and supportive organizational context, supervisory support, and person-centered care in nursing homes to determine if similar relationships exist.
We adapted the Care Coordination Survey for nursing homes and administered it to clinical staff in 20 VA Community Living Centers. We used random effects models to examine the associations between supportive organizational context, supervisory support, and person-centered care with collaborative capacity outcomes including quality of staff interactions, task independence, and collaborative influence.
A total of 723 Community Living Center clinical staff participated in the Care Coordination Survey resulting in a response rate of 29%. We found that teamwork and collaboration-measured as task interdependence, quality of interactions and collaborative influence-did not differ significantly between Community Living Centers but did differ significantly across occupational groups. Moreover, staff members' experiences of teamwork and collaboration were positively associated with supportive organizational context and person-centered care.
Our findings suggest that elements of organizational context are important to facilitating collaborative capacity. Additionally, investing in staffing, rewards, and person-centered care may improve teamwork.
以往在急性护理环境中的研究表明，协作能力（定义为提供者作为平等团队成员进行协作的方式）可以通过组织支持其员工和团队的方式得到提升。这项观察性横断面研究考察了养老院中协作能力与支持性组织环境、监督支持以及以人为主的护理之间的关联，以确定是否存在类似关系。
我们对养老院护理协调调查问卷进行了改编，并将其施用于20家退伍军人事务部社区生活中心的临床工作人员。我们使用随机效应模型来考察支持性组织环境、监督支持以及以人为主的护理与协作能力结果（包括员工互动质量、任务独立性和协作影响力）之间的关联。
共有723名社区生活中心临床工作人员参与了护理协调调查，回复率为29%。我们发现，以任务相互依存性、互动质量和协作影响力衡量的团队合作和协作在各社区生活中心之间没有显著差异，但在不同职业群体之间存在显著差异。此外，工作人员的团队合作和协作体验与支持性组织环境和以人为主的护理呈正相关。
我们的研究结果表明，组织环境因素对于促进协作能力很重要。此外，在人员配备、奖励和以人为主的护理方面进行投入可能会改善团队合作。
