Defragmenting care: testing an intervention to increase the effectiveness of interdisciplinary health care teams.
Few studies in the literature have examined the outcomes of health care interdisciplinary teams. Most existing studies have measured attributes of health care teams; however, none have implemented and examined outcomes of a team development intervention. This study was conducted to determine whether a development intervention used with an existing interdisciplinary team would reduce the length of stay for patients in an acute care setting. A quasi-experimental single-subject time series design was conducted with multiple measures of length of stay collected across baseline, intervention, and reversal phases of the study. Bronstein's Model for Interdisciplinary Collaboration provided the framework for this study. The components of this model were used to guide a team development intervention comprised of 4 consecutive weeks of classroom development sessions and 4 consecutive weeks of booster messaging. Length of stay (LOS) data were collected for each of the study phases to examine preintervention LOS and compare these data with LOS during the intervention and reversal phases. The results of this study revealed that the interdisciplinary team development intervention had no positive effect on the length of stay data. Baseline mean LOS across 12 baseline months was 4.83 days (SD=0.65) with monthly means ranging from 4.1 to 6.3 days. The mean LOS was 5.1 and 4.6 days for the intervention months of May and June and 6.0, 6.5, 5.7, and 5.4 days for the reversal months of July to October, respectively. All means in the intervention and reversal phases were higher than comparable months in the baseline phase. The pattern of the graphed trend was closely aligned with the seasonal variations seen during the baseline months. Although these results showed that the team development intervention provided for this interdisciplinary team had no positive effect on the LOS, there are many factors that may have influenced the results and may provide insights useful for future research. LOS may not be the outcome variable that reflects team effectiveness for this population. It is possible that the interdisciplinary team in this study had well-developed collaborative processes before the intervention. Physicians were not included in the team development intervention yet may be the discipline whose participation may have affected LOS.
Kilgore
Rachel V
RV
Transplant Surgical ICU, Rapid Response, Memorial Hermann TMC, Fannin 6411, Houston, TX 77030, USA. rvkilgore@comcast.net
Langford
Rae W
RW
D003142:Communication; D003266:Continuity of Patient Care / Q000458:organization & administration*; D003299:Cooperative Behavior; D003422:Critical Care / Q000458:organization & administration*; D006786:Hospitals, Urban; D006801:Humans; D007318:Inservice Training; D007400:Interprofessional Relations; D007902:Length of Stay / Q000706:statistics & numerical data*; D017146:Models, Organizational; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration*; D010564:Personnel, Hospital / Q000193:education / Q000600:supply & distribution; D024382:Professional Role; D015397:Program Evaluation; D012189:Retrospective Studies; D012621:Seasons; D013781:Texas