title: Factors influencing teamwork and collaboration within a tertiary medical center.
abstract: OBJECTIVE
  To understand how work climate and related factors influence teamwork and collaboration in a large medical center.
  
  
  METHODS
  A survey of 3462 employees was conducted to generate responses to Sexton's Safety Attitudes Questionnaire (SAQ) to assess perceptions of work environment via a series of five-point, Likert-scaled questions. Path analysis was performed, using teamwork (TW) and collaboration (CO) as endogenous variables. The exogenous variables are effective communication (EC), safety culture (SC), job satisfaction (JS), work pressure (PR), and work climate (WC). The measurement instruments for the variables or summated subscales are presented. Reliability of each sub-scale are calculated. Alpha Cronbach coefficients are relatively strong: TW (0.81), CO (0.76), EC (0.70), SC (0.83), JS (0.91), WP (0.85), and WC (0.78). Confirmatory factor analysis was performed for each of these constructs.
  
  
  RESULTS
  Path analysis enables to identify statistically significant predictors of two endogenous variables, teamwork and intra-organizational collaboration. Significant amounts of variance in perceived teamwork (R(2) = 0.59) and in collaboration (R(2) = 0.75) are accounted for by the predictor variables. In the initial model, safety culture is the most important predictor of perceived teamwork, with a β weight of 0.51, and work climate is the most significant predictor of collaboration, with a β weight of 0.84. After eliminating statistically insignificant causal paths and allowing correlated predictors1, the revised model shows that work climate is the only predictor positively influencing both teamwork (β = 0.26) and collaboration (β = 0.88). A relatively weak positive (β = 0.14) but statistically significant relationship exists between teamwork and collaboration when the effects of other predictors are simultaneously controlled.
  
  
  CONCLUSIONS
  Hospital executives who are interested in improving collaboration should assess the work climate to ensure that employees are operating in a setting conducive to intra-organizational collaboration.
authors.affiliation: Shu Feng Chien, Technician of Medical Research and Education Department, Veterans General Hospital-Taipei, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, China.
authors.forename: Shu Feng
authors.initials: SF
authors.lastname: Chien
authors.affiliation: Shu Feng Chien, Technician of Medical Research and Education Department, Veterans General Hospital-Taipei, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, China.
authors.forename: Thomas Th
authors.initials: TT
authors.lastname: Wan
authors.affiliation: Shu Feng Chien, Technician of Medical Research and Education Department, Veterans General Hospital-Taipei, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, China.
authors.forename: Yu-Chih
authors.initials: YC
authors.lastname: Chen
keywords: Intra-organizational collaboration; Safety culture; Teamwork; Work climate in a hospital