Better Interprofessional Teamwork, Higher Level of Organized Care, and Lower Risk of Burnout in Acute Health Care Teams Using Care Pathways

Adult Male Interprofessional Relations Emotions 610 Environment Pulmonary Disease, Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Belgium Hospital Administration 617 Humans Burnout, Professional Aged Quality of Health Care Patient Care Team Middle Aged Organizational Innovation 3. Good health Outcome and Process Assessment, Health Care Critical Pathways Female Clinical Competence Femoral Fractures
DOI: 10.1097/mlr.0b013e3182763312 Publication Date: 2012-11-09T07:11:23Z
ABSTRACT
Effective interprofessional teamwork is an essential component for the delivery of high-quality patient care in an increasingly complex medical environment. The objective is to evaluate whether the implementation of care pathways (CPs) improves teamwork in an acute hospital setting.A posttest-only cluster randomized controlled trial was performed in Belgian acute hospitals. Teams caring for patients hospitalized with a proximal femur fracture and those hospitalized with an exacerbation of chronic obstructive pulmonary disease, were randomized into intervention and control groups. The intervention group implemented a CP. The control group provided usual care. A set of team input, process, and output indicators were used as effect measures. To analyze the results, we performed multilevel statistical analysis.Thirty teams and a total of 581 individual team members participated. The intervention teams scored significantly better in conflict management [β=0.30 (0.11); 95% confidence interval (CI), 0.08 to 0.53]; team climate for innovation [β=0.29 (0.10); 95% CI, 0.09 to 0.49]; and level of organized care [β=5.56 (2.05); 95% CI, 1.35 to 9.76]. They also showed lower risk of burnout as they scored significantly lower in emotional exhaustion [β=-0.57 (0.21); 95% CI, -1.00 to -0.14] and higher in the level of competence (β=0.39; 95% CI, 0.15 to 0.64). No significant effect was found on relational coordination.CPs are effective interventions for improving teamwork, increasing the organizational level of care processes, and decreasing risk of burnout for health care teams in an acute hospital setting. Through this, high-performance teams can be built.
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