Nursing Teamwork in Health System Hospitals: A Multisite Longitudinal Study

Teamwork among nursing staff members—licensed and unlicensed—is essential to create a strong and dependable workplace. Relationship-Based Care (RBC), a care delivery model rooted in Jean Watson’s Model of Human Caring, was begun in 2006 in a Midwestern United States health care system’s hospitals as part of our nursing professional practice model.  RBC focuses on the relationships of caregivers with themselves, patients and family members, team members, and the community. Team members can be defined as two or more interdependent individuals who share skills and resources, working together to make decisions that achieve a common goal.  It is hypothesized that as relationships between team members grow, teamwork increases.  Teamwork, in turn, has been found to lead to productivity, job satisfaction, and promotion of optimal quality of care.  Over the past decade, teamwork has been described, measured, and studied by Kalisch and colleagues in surveys of nurses from multiple units in a variety of hospitals.  The significance of the longitudinal repeated measures study we are conducting is its aim to understand overall nursing teamwork and its facets over time, as perceived by nursing staff members who work in acute care inpatient units at diverse hospitals in a regional health system. 

A pilot study with nursing staff from two acute care units and 10 nurses who worked in the medical center’s resource pool was conducted in October 2014 to test the process for conducting and reporting the Nursing Teamwork Survey.  Based on the success of the pilot study, this multisite study is being launched to create a longitudinal description of nursing teamwork in a health system’s hospitals of various sizes and locations.  The purpose of this poster will be to share baseline results of nursing teamwork to describe the current workplace environment, document variations in perceived teamwork, and identify potential improvement strategies for units/areas, hospitals, and the health care system. 

Following IRB review, this descriptive, comparative, longitudinal study will collect data with an electronic survey that will be deployed every six months for three years.  Potential participants include approximately 4200 nursing employees from acute care inpatient units within our health system’s eleven hospital entities, some being Magnet®-designated.  The Nursing Teamwork Survey (NTS), developed by Kalisch and colleagues, contains 22 items that explore demographics, hours worked, nurse to patient ratio and churn in a recent shift, and satisfaction with teamwork, staffing, role, and position.  Another 33 items, scored as the percentage of time each occurs, comprise the overall teamwork measure and its five subscales:  trust, team orientation, backup, shared mental model, and team leadership.  A management leader and staff leader from each unit/area will collaborate to recruit nursing staff to participate in the semi-annual surveys.  Data will be managed and analyzed by the research team to create descriptive reports for each participating unit/area, hospital, and the health system.  Comparison statistics of survey responses by unit/area and hospital and hospital results by demographic characteristics will be generated.  The potential risk of survey participants being identified will be mitigated by not reporting demographic data at the unit level.  Identifying opportunities to foster improved teamwork is an anticipated benefit.  We will also share our experiences in designing, implementing, and reporting results of a multisite longitudinal study within a regional health system.