Daily practice teams in nursing homes: evidence from New York state.
OBJECTIVE
Most health care organizations, including nursing homes, report having teams. However, little is known about everyday practice teams among staff providing direct resident care. We assess the prevalence of such teams in nursing homes as reported by direct care staff and administrators, and examine characteristics of facilities that foster these teams.


METHODS
The analytical model is based on 149 nursing homes. Data sources include surveys of administrators (n = 292) and direct care staff (n = 6,867), and Online Survey Certification and Reporting System. Linear regression with robust standard errors and sampling probability weights is used to examine the relationship between daily practice teams and facility characteristics.


RESULTS
On average, 16% of workers per facility report practicing in formal multidisciplinary teams providing daily resident care. Team prevalence is 3.3% higher when managers view teams as very important for clinical care quality, 2.6% higher when the directors of nursing report formally organized teams, 2.5% higher for each 10% increase in workers' involvement in teams other than the daily practice teams, and 1.95% higher for each 1-hr increase in nursing hours.


CONCLUSIONS
Our study shows that multidisciplinary daily practice teams can be found in most facilities in our large sample, but their penetration within nursing homes is far from pervasive; in 72% of facilities, staff report team prevalence of less than 25%. Given that the majority of managers report teamwork as very important to their facilities' operations, we discuss why only a relatively small proportion of daily care is provided in this fashion.
Department of Community and Preventive Medicine, University of Rochester School of Medicine, Rochester, NY 14642, USA. helena_temkin-greener@urmc.rochester.edu
Helena
H
Temkin-Greener
Shubing
S
Cai
Paul
P
Katz
Hongwei
H
Zhao
Dana B
DB
Mukamel
D019538:Health Care Surveys; D009518:New York; D009735:Nursing Homes / Q000458:organization & administration*; D010348:Patient Care Team / Q000706:statistics & numerical data*