The moderating role of team resources in translating nursing teams' accountability into learning and performance: a cross-sectional study.
OBJECTIVE
The aim of this study was to test the moderated-mediation model suggesting that nursing teams' accountability affects team effectiveness by enhancing team learning when relevant resources are available to the team.


BACKGROUND
Disappointing evidence regarding improvement in nurses' safe and quality care elevate the need in broadening our knowledge regarding the factors that enhance constant learning in nursing teams. Accountability is considered as crucial for team learning and quality of care but empirical findings have shown mixed evidence.


METHODS
A cross-sectional design.


METHODS
Forty-four nursing teams participated in the study. Data were collected in 2013-2014: Head nurses completed validated questionnaires, regarding team resources for learning (time availability, team autonomy and team performance feedback), and nursing teams' effectiveness; and nurses answered questionnaires regarding teams' accountability and learning (answers were aggregated to the team level). The model was tested using a moderated-mediation analysis with resources as moderating variables, and team learning as the mediator in the team accountability-team effectiveness link.


RESULTS
The results of a mixed linear regression show that, as expected, nursing teams' accountability was positively linked to nursing teams' learning, when time availability, and team autonomy were high rather than low, and team performance feedback was low rather than high.


CONCLUSIONS
Nurturing team accountability is not enough for achieving team learning and subsequent team effectiveness. Rather there is a need to provide nursing teams with adequate time, autonomy, and be cautious with performance feedback, as the latter may motivate nurses to repeat routine work strategies rather than explore improved ones.
The Department of Health Systems Management, Max Stern Yezreel Valley Academic College, Israel.
Sarit
http://orcid.org/0000-0001-8038-7425
S
Rashkovits
The Department of Nursing, University of Haifa, Israel.
Anat
http://orcid.org/0000-0003-4319-9008
A
Drach-Zahavy
D000328:Adult; D002983:Clinical Competence / Q000592:standards*; D003430:Cross-Sectional Studies; D005246:Feedback; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009746:Nursing, Team / Q000592:standards*; D057184:Practice Patterns, Nurses' / Q000592:standards*; D017009:Professional Autonomy; D012941:Social Responsibility; D013192:Staff Development
accountability; autonomy; availability; feedback; learning; nursing team; performance