title: Can staff attitudes to team working in stroke care be improved?
abstract: BACKGROUND
  Teamwork is regarded as the cornerstone of rehabilitation. It is recognized that the skills of a multiprofessional team are required to provide the care and interventions necessary to maximize the patient's potential to recover from his/her stroke.
  
  
  METHODS
  Critical evaluation of team working is lacking in the literature. Indeed, there is no consensus on a precise definition of teamwork or on the best way of implementing it, beyond a general exhortation to members to work to the same therapeutic plan in a cohesive manner. The literature has highlighted many problems in team working, including petty jealousies, ignorance and a perceived loss of autonomy and threat to professional status.
  
  
  OBJECTIVE
  To determine if the use of team co-ordinated approaches to stroke care and rehabilitation would improve staff attitudes to team working.
  
  
  METHODS
  A pre-post design was adopted using 'The Team Climate Inventory' to explore attitudes to team working before and after introducing the interventions. Local Research Ethics Committee approval was obtained.
  
  
  RESULTS
  Improvements in attitudes towards team working suggest that the introduction of team co-ordinated approaches (integrated care pathways and team notes) did not result in greater team working.
  
  
  CONCLUSIONS
  The introduction of an integrated care pathway and team notes is based on an assumption that they would enhance team working.
  
  
  CONCLUSIONS
  The results suggest that the introduction of team co-ordinated approaches (team notes and care pathways) do not improve attitudes to team working, teams appear to take a long time to establish cohesion and develop shared values.
authors.affiliation: Department of Nursing, University of Central Lancashire, Preston, UK. bgibbon@uclan.ac.uk
authors.forename: Bernard
authors.initials: B
authors.lastname: Gibbon
authors.forename: Caroline
authors.initials: C
authors.lastname: Watkins
authors.forename: David
authors.initials: D
authors.lastname: Barer
authors.forename: Karen
authors.initials: K
authors.lastname: Waters
authors.forename: Steve
authors.initials: S
authors.lastname: Davies
authors.forename: Liz
authors.initials: L
authors.lastname: Lightbody
authors.forename: Michael
authors.initials: M
authors.lastname: Leathley
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards; D003299:Cooperative Behavior; D019091:Critical Pathways / Q000592:standards; D006757:Hospital Units / Q000458:organization & administration; D006801:Humans; D007400:Interprofessional Relations; D008499:Medical Records / Q000592:standards; D009737:Nursing Records / Q000592:standards; D015279:Organizational Culture; D010348:Patient Care Team / Q000592:standards*; D010564:Personnel, Hospital / Q000193:education / Q000523:psychology*; D011209:Power, Psychological; D017009:Professional Autonomy; D011361:Professional Competence / Q000592:standards; D015397:Program Evaluation; D000071939:Stroke Rehabilitation; D017749:Total Quality Management / Q000458:organization & administration*