Australian Institute of Health Service Management, University of Tasmania, Sydney, Australia.
Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Int J Health Care Qual Assur. 2020 Jul 14;33(4-5):373-387. doi: 10.1108/IJHCQA-10-2019-0178.
This paper aims to explore if health professionals share understanding of teamwork that supports collaborative ward rounds.
DESIGN/METHODOLOGY/APPROACH: A purpose-designed survey was conducted in two acute medical and two rehabilitation wards from a metropolitan teaching hospital. Medical officers, nurses and allied health professionals participated. To understand characteristics that support collaborative ward rounds, questions developed from literature and industry experience asked: what are the enablers and challenges to teamwork; and what are clinicians' experiences of positive teamwork? Descriptive and thematic analyses were applied to the dimensions of effective teamwork as a framework for deductive coding.
Seventy-seven clinicians participated (93% response rate). Findings aligned with dimensions of teamwork framework. There was no meaningful difference between clinicians or specialty. Enablers to teamwork were: effective communication, shared understanding of patient goals, and colleague's roles. Challenges were ineffective communication, individual personalities, lack of understanding about roles and responsibilities, and organisational structure. Additional challenges included: time; uncoordinated treatment planning; and leadership. Positive teamwork was influenced by leadership and team dynamics.
Ward rounds benefit from a foundation of collaborative teamwork. Different dimensions of teamwork present during ward rounds support clinicians' shared understanding of roles, expectations and communication.
ORIGINALITY/VALUE: Rounds such as structured rounding, aim to improve teamwork. Inverting this concept to first develop effective collaboration will support team adaptability and resilience. This enables teams to transition between the multiple rounding processes undertaken in a single ward. The emphasis becomes high-quality teamwork rather than a single rounding process.
本文旨在探讨卫生专业人员是否对支持协作病房查房的团队合作有共同的理解。
设计/方法/途径：在一家大都市教学医院的两个急性内科病房和两个康复病房进行了一项专门设计的调查。医疗官员、护士和联合卫生专业人员参与了调查。为了了解支持协作病房查房的特点，从文献和行业经验中开发的问题询问了：团队合作的促进因素和挑战是什么；临床医生对积极的团队合作有什么经验？对有效团队合作的维度进行了描述性和主题性分析，作为演绎编码的框架。
77 名临床医生参与了调查（93%的回应率）。调查结果与团队合作框架的维度一致。临床医生或专业之间没有明显差异。团队合作的促进因素是：有效的沟通、对患者目标的共同理解以及同事的角色。挑战包括沟通效果不佳、个人个性、对角色和责任的理解不足以及组织结构。其他挑战包括：时间、治疗计划不协调以及领导力。积极的团队合作受到领导力和团队动态的影响。
病房查房受益于协作团队合作的基础。病房查房过程中存在的不同团队合作维度支持临床医生对角色、期望和沟通的共同理解。
原创性/价值：像结构化查房这样的查房旨在改善团队合作。反转这一概念，首先发展有效的协作关系将支持团队的适应性和弹性。这使团队能够在单个病房中进行的多种查房过程之间进行过渡。重点是高质量的团队合作，而不是单一的查房过程。
