title: Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
abstract: In a prior study involving 2 medical units, Structured Interdisciplinary Rounds (SIDRs) improved teamwork and reduced adverse events (AEs). SIDR was implemented on 5 additional units, and a pre- versus postintervention comparison was performed. SIDR combined a structured format for communication with daily interprofessional meetings. Teamwork was assessed using the Safety Attitudes Questionnaire (score range = 0-100), and AEs were identified using queries of information systems confirmed by 2 physician researchers. Paired analyses for 82 professionals completing surveys both pre and post implementation revealed improved teamwork (mean 76.8 ± 14.3 vs 80.5 ± 11.6; P = .02), which was driven mainly by nurses (76.4 ± 14.1 vs 80.8 ± 10.4; P = .009). The AE rate was similar across study periods (3.90 vs 4.07 per 100 patient days; adjusted IRR = 1.08; P = .60). SIDR improved teamwork yet did not reduce AEs. Higher baseline teamwork scores and lower AE rates than the prior study may reflect a positive cultural shift that began prior to the current study.
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL keoleary@nmh.org.
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: O'Leary
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Creden
authors.affiliation: Northwestern Memorial Hospital, Chicago, IL.
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Slade
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Landler
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Nita
authors.initials: N
authors.lastname: Kulkarni
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Jungwha
authors.initials: J
authors.lastname: Lee
authors.affiliation: University of Illinois College of Medicine at Peoria, IL.
authors.forename: John A
authors.initials: JA
authors.lastname: Vozenilek
authors.affiliation: Northwestern Memorial Hospital, Chicago, IL.
authors.forename: Pamela
authors.initials: P
authors.lastname: Pfeifer
authors.affiliation: Stanford School of Medicine, Stanford, CA.
authors.forename: Susan
authors.initials: S
authors.lastname: Eller
authors.affiliation: Northwestern University Feinberg School of Medicine, Chicago, IL.
authors.forename: Diane B
authors.initials: DB
authors.lastname: Wayne
authors.affiliation: University of Kentucky, Lexington, KY.
authors.forename: Mark V
authors.initials: MV
authors.lastname: Williams
mesh_terms: D000328:Adult; D002641:Chicago; D003299:Cooperative Behavior; D005260:Female; D006282:Health Personnel; D006784:Hospitals, Teaching; D006801:Humans; D007396:Internship and Residency; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D009726:Nurses; D010348:Patient Care Team; D010595:Pharmacists; D010820:Physicians; D000068217:Social Workers; D062606:Tertiary Care Centers
keywords: hospital medicine; interprofessional care; patient safety; teamwork