Effects of implementation of a team model on physician and staff perceptions of a clinic's organizational and learning environments.
OBJECTIVE
Although teamwork is widely promoted by the Institute of Medicine, the American Academy of Family Physicians, and the Future of Family Medicine project, the health care literature does not provide clear direction on how to create or maintain high-functioning teams in ambulatory residency education. In 2004, we reorganized the clinical operation of our family medicine residency clinic into teams, each consisting of faculty, residents, and nursing and administrative staff. We hypothesized that operating within teams would have a positive effect on employees' job satisfaction and perceptions of our clinic's organizational and learning environments.


METHODS
We administered a confidential survey to faculty, residents, and staff annually over 5 years (2002-2006). Using questionnaire data from 2002-2003 as a baseline and data from 2004-2006 as a post-intervention measurement, we performed Mann-Whitney tests to assess the effect of the implementation of teams on employees' ratings of job satisfaction, individual autonomy, organizational commitment, goal attainment, physical characteristics and personnel arrangements within the clinic, learning opportunities for residents, teaching behaviors of faculty, roles of staff, and learning organization characteristics.


RESULTS
After the implementation of teams, there was an improvement in ratings of learning opportunities and quality of teaching, job satisfaction, employee autonomy, staff roles, and staff attitudes toward residents.


CONCLUSIONS
Implementing a team approach in a residency clinic can improve measures of physician and staff satisfaction and organizational function.
Roth
Linda M
LM
Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, MI 48201, USA. lroth@med.wayne.edu
Markova
Tsveti
T
Monsur
Joseph C
JC
Severson
Richard K
RK
D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000193:education; D006801:Humans; D007396:Internship and Residency; D007588:Job Satisfaction; D008824:Michigan; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration*; D017009:Professional Autonomy; D012380:Role; D011795:Surveys and Questionnaires