title: Team-building and change management in respiratory care: description of a process and outcomes.
abstract: BACKGROUND
  Teamwork promotes enhanced outcomes in various business sectors but can be hampered when there are organizational "silos." This study describes an intervention that fostered teamwork among 4 separate respiratory therapy (RT) departments within a single hospital.
  
  
  METHODS
  An initial retreat of leaders of the 4 RT groups indicated a common goal of developing a scorecard by which RT outcomes could be followed and improved. Developing this scorecard involved a business review process that comprised 7 facilitated meetings, in which the 4 RT groups developed metrics and targets for RT outcomes in 4 categories: quality/innovation; service; productivity; and employee engagement.
  
  
  RESULTS
  The process of developing the scorecard prompted improvements in the quality of RT care (eg, enhanced cross-staffing, low respiratory therapist turnover). A welcome impact of the business review process was enhanced collaboration and teamwork among the 4 RT groups, as manifested by sharing of educational resources, developing a cross-departmental float pool, and forming a process and group to standardize RT care across all groups.
  
  
  CONCLUSIONS
  The results of this business review process show that teamwork among 4 separate RT departments improved and that enhanced outcomes were achieved. Based on this experience, we recommend consideration of this business review process as a team-building activity that can confer demonstrable clinical benefits.
authors.affiliation: Department of Pulmonary, Allergy, and Critical Care Medicine, Respiratory Institute, A90, the Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA. stollej@ccf.org
authors.forename: James K
authors.initials: JK
authors.lastname: Stoller
authors.forename: Madhu
authors.initials: M
authors.lastname: Sasidhar
authors.forename: David M
authors.initials: DM
authors.lastname: Wheeler
authors.forename: Robert L
authors.initials: RL
authors.lastname: Chatburn
authors.forename: Roy T
authors.initials: RT
authors.lastname: Bivens
authors.forename: Dave
authors.initials: D
authors.lastname: Priganc
authors.forename: Douglas K
authors.initials: DK
authors.lastname: Orens
mesh_terms: D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D006801:Humans; D019982:Organizational Case Studies; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010557:Personnel Administration, Hospital / Q000379:methods* / Q000592:standards; D010561:Personnel Staffing and Scheduling; D012138:Respiratory Therapy