Enhancing patient-engaged teamwork in healthcare: an observational case study

Abstract

The purpose of this study was to describe how teamwork that effectively engaged patients and families, manifested itself in an acute rural care setting in order to inform the development of teamwork skills. One hundred and forty participants were included in the study representing providers, patients, family, hospital and clinical support personnel, education specialists and students. Using a modified grounded theory approach, and informed by activity theory, observational field notes and interview transcripts were analyzed. Through the analysis of 343 events of providers interacting with, or exchanging information about, patients, three patterns of teamwork emerged that facilitated patient-engaged care: uniprofessional, multiprofessional and interprofessional. The data indicated that providers navigated between these patterns, as well as others, throughout their workday. Providers should be skilled in applying the construct of situation awareness in order to adopt a pattern of teamwork that best facilitates patient-engaged care. Interventions that can enhance teamwork should focus on: valuing the perspectives of others; developing relational competence and resilience; employing reflective learning and shared decision-making skills; and incorporating principles of change theory for both individuals and systems.

• Case study
• interprofessional care
• patient-centered practice
• team-based practice
• team effectiveness
• teamwork

Acknowledgements

The authors wish to thank Tracy Gierman, Anne Brasset-Latulippe and Dana Cross of the Academic Health Council Champlain Region for their assistance and support throughout the project. Thanks to Enkenyelesh Bekele and Marc Bergeron for their assistance with the graphic design. Thanks to all the staff, physicians, administrators, students, patients and families at the study site for their partnership and participation in this study.

Declaration of interest

The authors report no declarations of interest. The authors are responsible for the writing and content of this paper.

This study was funded by HealthForceOntario.

Note

Notes

¹Illustrations of these patterns can be viewed in English at http://www.ahc-cas.ca/wp-content/uploads/2013/05/Patterns-of-Teamwork_-Hall-et-al-_2013_EN_Acc.pdf or in French at http://www.ahc-cas.ca/wp-content/uploads/2013/05/Patterns-of-Teamwork_-Hall-et-al-_2013_FR_Acc.pdf. These images are located on the Academic Health Council, Champlain region website http://www.ahc-cas.ca. Quotes from observations have been selected to illustrate typical examples of the patterns.