Table 3.
Outcomes for Identified Team-Building Interventions
| 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 |