title: Toward spanning the quality chasm: an examination of team functioning measures.
abstract: OBJECTIVE
  To examine the effect of 5 measures of team functioning on patient outcomes.
  
  
  METHODS
  Observational, exploratory, measurement. Team functioning surveys and patient outcomes collected 1 year apart in a clinical trial were analyzed. The findings are discussed in context of the domains of team functioning, team effectiveness, and quality improvement.
  
  
  METHODS
  27 Veterans Affairs medical centers.
  
  
  METHODS
  Staff (t1: N=356; t2: N=273) on inpatient teams and patients (t1: N=4266; t2: N=3213) treated by the teams.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Five measures of team functioning (Physician Engagement, Shared Leadership, Supervisor Team Support, Teamness, and Team Effectiveness scales) and 3 measures of patient outcomes (functional improvement, discharge destination, and length of stay) were assessed at 2 time points with hierarchical generalized linear models to evaluate the association between team functioning measures and changes in patient outcomes.
  
  
  RESULTS
  Associations (P<.05) between team functioning measures and patient outcomes were found for 3 of the 15 analyses over the study period. Higher Physician Engagement scale score was associated with lower length of stay (P=.017), and increased scores on Teamness and Team Effectiveness scales correlated with higher rates of community discharge (P=.044 and .049, respectively).
  
  
  CONCLUSIONS
  This exploratory analysis revealed trends that team functioning corresponds with patient outcomes in clinically relevant patterns. An increase in community discharge and a decrease in length of stay were associated with higher scores of team functioning. Here, we find evidence that modifiable attributes of team functioning have a measurable effect on patient outcomes. Such findings are promising and support the need for further research on team effectiveness.
authors.affiliation: Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA. Electronic address: dstrass@emory.edu.
authors.forename: Dale C
authors.initials: DC
authors.lastname: Strasser
authors.affiliation: Department of Educational Psychology, University of Houston, Houston, TX.
authors.forename: Andrea Backscheider
authors.initials: AB
authors.lastname: Burridge
authors.affiliation: Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
authors.forename: Judith A
authors.initials: JA
authors.lastname: Falconer
authors.affiliation: Neuropsychology Postdoctoral Residency Program, VA Northern California Health Care System, Martinez, CA.
authors.forename: Jay M
authors.initials: JM
authors.lastname: Uomoto
authors.affiliation: Division of Cardiology, Yale University School of Medicine, Yale University, New Haven, CT; Health Research and Educational Trust, Chicago, IL.
authors.forename: Jeph
authors.initials: J
authors.lastname: Herrin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007857:Leadership; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration / Q000592:standards*; D010351:Patient Discharge; D063868:Patient Outcome Assessment; D010818:Practice Patterns, Physicians' / Q000592:standards; D058996:Quality Improvement; D020127:Recovery of Function; D012046:Rehabilitation / Q000458:organization & administration / Q000592:standards*
keywords: Patient care team; Process assessment (Health Care); Quality of health care; Rehabilitation