title: Innovation in healthcare team feedback.
abstract: Healthcare delivery is evolving from individual, autonomous practice to collaborative team practice. However, barriers such as professional autonomy, time constraints and the perception of error as failure preclude learning behaviours that can facilitate organizational learning and improvement. Although experimentation, engaging in questions and feedback, discussing errors and reflecting on results can facilitate learning and promote effective performance, the cultural barriers within healthcare can prevent or inhibit this type of behaviour among teams. At the University Health Network's Centre for Innovation in Complex Care, we realize the need for a tool that facilitates learning behaviour and is sensitive to the risk-averse nature of the clinical environment. The vehicle for the Team Feedback Tool is a web-based application called Rypple (www.rypple.com), which allows team members to provide anonymous, rapid-fire feedback on team processes and performance. Rypple facilitates communication, elicits feedback and provokes discussion. The process enables follow-up face-to-face team discussions and encourages teams to create actionable solutions for incremental changes to enhance team health and performance. The Team Feedback Tool was implemented and piloted in general internal medicine at the University Health Network's Toronto General Hospital from early May 2009 to July 2009 to address the issues of teamwork and learning behaviour in the clinical environment. This article explores the opportunities and barriers associated with the implementation of the Team Feedback Tool.
authors.affiliation: Centre for Innovation in Complex Care, University Health Network, in Toronto, Ontario, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Plaza
authors.forename: Leslie
authors.initials: L
authors.lastname: Beard
authors.forename: Anthony Di
authors.initials: AD
authors.lastname: Fonzo
authors.forename: Michael Di
authors.initials: MD
authors.lastname: Tommaso
authors.forename: Yaman
authors.initials: Y
authors.lastname: Mujawaz
authors.forename: Marcel
authors.initials: M
authors.lastname: Serra-Julia
authors.forename: Dante
authors.initials: D
authors.lastname: Morra
mesh_terms: D006126:Group Processes; D006801:Humans; D033183:Interdisciplinary Communication; D007858:Learning; D009936:Organizational Innovation; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration*