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Narrative review
Team-training in healthcare: a narrative synthesis of the literature
  1. Sallie J Weaver1,
  2. Sydney M Dy2,
  3. Michael A Rosen1
  1. 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Armstrong Institute for Patient Safety & Quality, Baltimore, Maryland, USA
  2. 2Department of Health Policy & Management, Oncology, and Medicine, Johns Hopkins University, Baltimore, Maryland, USA
  1. Correspondence to Sallie J Weaver, Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Armstrong Institute for Patient Safety & Quality, 750 E. Pratt St., 15th Floor, #1544, Baltimore, MD 21202, USA; sjweaver{at}jhu.edu

Abstract

Background Patients are safer and receive higher quality care when providers work as a highly effective team. Investment in optimising healthcare teamwork has swelled in the last 10 years. Consequently, evidence regarding the effectiveness for these interventions has also grown rapidly. We provide an updated review concerning the current state of team-training science and practice in acute care settings.

Methods A PubMed search for review articles examining team-training interventions in acute care settings published between 2000 and 2012 was conducted. Following identification of relevant reviews with searches terminating in 2008 and 2010, PubMed and PSNet were searched for additional primary studies published in 2011 and 2012. Primary outcomes included patient outcomes and quality indices. Secondary outcomes included teamwork behaviours, knowledge and attitudes.

Results Both simulation and classroom-based team-training interventions can improve teamwork processes (eg, communication, coordination and cooperation), and implementation has been associated with improvements in patient safety outcomes. Thirteen studies published between 2011 and 2012 reported statistically significant changes in teamwork behaviours, processes or emergent states and 10 reported significant improvement in clinical care processes or patient outcomes, including mortality and morbidity. Effects were reported across a range of clinical contexts. Larger effect sizes were reported for bundled team-training interventions that included tools and organisational changes to support sustainment and transfer of teamwork competencies into daily practice.

Conclusions Overall, moderate-to-high-quality evidence suggests team-training can positively impact healthcare team processes and patient outcomes. Additionally, toolkits are available to support intervention development and implementation. Evidence suggests bundled team-training interventions and implementation strategies that embed effective teamwork as a foundation for other improvement efforts may offer greatest impact on patient outcomes.

  • Team training
  • Teamwork
  • Patient safety

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 3.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/3.0/

https://doi.org/10.1136/bmjqs-2013-001848

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