title: The relationship between patients' perceptions of team effectiveness and their care experience in the emergency department.
abstract: BACKGROUND
  Effective teamwork is important in the fast-paced Emergency Department (ED) setting. Most of the teamwork literature addresses the provider's perspective of teamwork rather than the patient's perspective.
  
  
  OBJECTIVE
  Examine the relationship between patients' perceptions of teamwork and care experience in the ED.
  
  
  METHODS
  We conducted a cross-sectional survey study of adult patients seen at the University of Pennsylvania ED during the fall of 2011. Patients rated overall satisfaction, pain management, trust, and confidence in the team and likelihood of treatment compliance (outcomes) and four components of team effectiveness (role clarity, shared goals, relationships, and job satisfaction) on a Likert scale. We examined the relationship between patients' perception of teamwork and the outcomes using multivariate analysis, controlling for sociodemographic factors.
  
  
  RESULTS
  We collected 1010 surveys. Patients rated the individual components of teamwork equally, with about 70% rating teamwork as "Very High." Most patients who rated teamwork highly also rated their confidence and trust in their providers highly (80-90%) compared to 20% of those who rated teamwork lower. The relative risk ratios between high and low teamwork were 4.1 (95% confidence interval [CI] 2.8-5.9) for overall satisfaction, 3.9 (95% CI 2.7-5.8) for satisfaction with pain treatment, 5.3 (95% CI 3.6-7.8) for confidence in providers, and 1.9 (95% CI 1.5-2.5) for likelihood to follow-up treatment recommendations.
  
  
  CONCLUSIONS
  Patient satisfaction and willingness to adhere to treatment recommendations are highly correlated with patients' perceptions of ED teamwork.
authors.affiliation: University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania.
authors.forename: Amira
authors.initials: A
authors.lastname: Kipnis
authors.forename: Karin V
authors.initials: KV
authors.lastname: Rhodes
authors.forename: Christian N
authors.initials: CN
authors.lastname: Burchill
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Datner
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000592:standards*; D005260:Female; D006126:Group Processes; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D059408:Pain Management; D010348:Patient Care Team; D010349:Patient Compliance / Q000523:psychology; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D035502:Trust
keywords: adherence; emergency medicine teamwork; patient centeredness; patient perceptions; patient satisfaction; team effectiveness; treatment follow-up