Team Functioning And Beliefs About Team Effectiveness In Inter-Professional Teams: Questionnaire Development And Validation

Figures & data

Figure 1 Flowchart of the Provider-PTE questionnaire development.

Table 1 Preliminary Items Related To Healthcare Team Processes And Outcomes

Items
PTE-Overall
Role Clarity	The roles of members of the healthcare team are well defined
	I am happy with the way work is divided among members of the healthcare team
Boundary Work	I trust other members of the healthcare team
Team Processes	My healthcare team is effective to provide patient care (BE)
Decision-making	Team members share relevant information to inform patient care decisions
Decision-making	My ideas, information or observations are used to solve patient care issues
Communication	The plan of care and patient care objectives are clearly outlined in the patient’s health record
Communication	The patient’s health record is updated as required
Communication	The flow of information between team members and patients and families is constrained
Coordination	The healthcare team adjusts treatments according to changes in the patient’s condition
Coordination	The care provided by the healthcare team is well organized
Cohesion	Team members work together to solve patient care issues
Problem-solving	Disagreements among team members are dealt with fairly by team members
Problem-solving	Differences of opinion among team members are respected
Patient–Family Focus	I have a role to play in the team
Patient–Family Focus	My contributions are valued by my healthcare team
Patient–Family Focus	Working with families to solve patient care issues is not part of the team’s mandate
Outcomes
	Patient care is delivered in a timely manner
	The healthcare team can easily access a provider who can order tests or medication
	Potential or actual patient complications are dealt with quickly by the team
	Patients return home with as many unanswered questions about their medication
	Patient transfers to other care facilities include all relevant patient information
	Patients return home with all their questions answered about their care
	Members of the healthcare team possess in-depth knowledge and the skills required to provide care

Table 2 Characteristics Of Respondents

	Variable		n	%	Mean	Standard Deviation	Min–Max
Respondent	Professional group	Intra-professional	217	84
		Inter-professional	31	12
		Management	9	4
	Language	English	42	15
		French	241	85
	Age (years)				39.2	9.1	23–67
	Gender	Male	42	16
		Female	216	84
	Job status	Full-time	205	80
		Part-time	31	12
		Temporary/contract position	7	3
		Leave	13	5
	Education	High school and below	8	3
		Above high school	250	97
	Length of time in current role (years)				7.25	7.8	0.08–45
		Below 2 years	46	19
		2–5 years	93	38
		>5 years	108	44
	Length with this team (years)				6.41	7	0.08–45
		Below 1 year	44	18
		1–5 years	106	42
		>5 years	100	40

Table 3 Characteristics Of The Healthcare Team

	Variable		n	%
Healthcare team	Province	Ontario	31	12
		Quebec	234	88
	Clinical setting	Primary care	132	56
		Medicine and surgery	39	16
		Oncology	38	16
		Emergency-critical care	28	12
	Location	Urban	229	82
		Non-urban	50	18
	Team size	Small	11	4
		Medium	76	27
		Large	193	69
	Nurse practitioner in team	Yes	167	60
		No/do not know	112	40

Table 4 Mean Scores For Boundary Work, Perceptions Of Team Effectiveness, Role Clarity, And Outcomes

Dimension	Variable	Number Of Items	Mean	Standard Deviation	Min–Max	Cronbach Alpha	Spearman’s Item-total Correlations With Team Processes
							rho Coefficient	p-Value
Boundary Work	Trust	1	5.2	0.84	1–6
Team Processes		14	4.7	0.6	1.5–6	0.881
	Belief about team effectiveness	1	5.2	0.8	1–6		0.584	<0.001
	Decision-making	2	4.9	0.8	1–6		0.807	<0.001
	Communication	3	4.4	0.7	2.3–6		0.688	<0.001
	Coordination	2	4.9	0.7	1–6		0.691	<0.001
	Cohesion	1	4.8	1.0	1–6		0.695	<0.001
	Problem-solving	2	4.4	1.1	1–6		0.698	<0.001
	Patient focus	3	4.9	0.8	1.7–6		0.752	<0.001
Role Clarity		2	4.7	1.0	1–6
PTE-Overall		17	4.8	0.6	1.4–6	0.909
Outcomes		7	4.8	0.6	2–6	0.724

Table 5 Responses Related To Face Validity

		n	%
The time it took to complete the questionnaire was	Appropriate	81	96
	Too long	3	4
	Too short	–	–
Overall, the instructions contained in the consent were	Clear	83	99
	Not clear	1	1
Are there any questions NOT included in this questionnaire that you feel would be important to include to better understand how teams function effectively?	No	63	76
	Yes	20	24
Are there questions you feel are unimportant, irrelevant, or redundant and could be eliminated from the questionnaire without jeopardizing completeness of the study results?	No	74	87
	Yes	11	13
The format of the questionnaire was:	Easy to read	81	100
	Difficult to read	–	–
The font size made the questionnaire:	Easy to read	81	100
	Difficult to read	–	–
The questions were ordered in a logical manner that was easy to follow:	Agree	79	96
	Disagree	3	4

Table 6 Differences In Team Processes And Outcomes By Known Group Comparisons

Dimension	Professional Groups	NP In Team	Length of Time In Team (Less Than Or More Than 2 Years)	Full vs Part Time
Boundary Work		0.027
Team Processes		0.034
Role Clarity	0.017*		0.025
PTE Overall		0.035
Outcomes		0.014		0.017

Notes: *Mann–Whitney U post hoc test £ Bonferroni correction significance α/3 (p<0.017); empty cells=not statistically significant.

Table 7 Differences In Processes And Outcomes In High And Low Functioning Teams

Dimension	Belief About Team Effectiveness	n	Mean	Standard Deviation	Mann-Whitney-U test
					Median	p Value
Boundary Work	Low (scores 1–4)	29	3.86	1.217	4	<0.001
	High (scores 5–6)	234	5.38	0.608	5	<0.001
Team Processes	Low (scores 1–4)	29	3.92	0.84	4.1	<0.001
	High (scores 5–6)	235	4.83	0.52	4.88	<0.001
Outcomes	Low (scores 1–4)	29	4.2	0.755	4.29	<0.001
	High (scores 5–6)	227	4.83	0.53	4.93	<0.001
Role Clarity	Low (scores 1–4)	29	3.5	1.35	3.5	<0.001
	High (scores 5–6)	235	4.83	0.844	5	<0.001

Table 8 Revised Items Related To Healthcare Team Processes And Outcomes*

Items
PTE-Overall
Role Clarity	The roles of members of the healthcare team are well defined
	I am happy with the way work is divided among members of the healthcare team
Boundary Work	I trust other members of the healthcare team
Team Meeting	The healthcare team meets as needed to address complex care issues that arise
	Regular inter-professional team meetings are scheduled to plan patient care
Team Processes	My healthcare team is effective to provide patient care (BE)
Decision-making	Team members share relevant information to inform patient care decisions
Decision-making	My ideas, information or observations are used to solve patient care issues
Communication	Healthcare team members know the goals of patients’ plans of care
Communication	The patient’s health record is updated as required
Communication	The flow of information between team members and patients and families is constrained
Coordination	The healthcare team adjusts treatments according to changes in the patient’s condition
Coordination	The care provided by the healthcare team is well organized
Cohesion	Team members work together to solve patient care issues
Problem-solving	Disagreements among team members are dealt with fairly by team members
Problem-solving	Differences of opinion among team members are respected
Patient–Family Focus	I have a role to play in the team
Patient–Family Focus	My contributions are valued by my healthcare team
Patient–Family Focus	Working with families to solve patient care issues is not part of the team’s mandate
Outcomes
	Patient care is delivered in a timely manner
	The healthcare team can easily access a provider who can order tests or medication
	Potential or actual patient complications are dealt with quickly by the team
	Patients return home with as many unanswered questions about their medication
	Patient transfers to other care facilities include all relevant patient information
	Patients return home with all their questions answered about their care
	Members of the healthcare team possess in-depth knowledge and the skills required to provide care

Note: *Negative wording bolded.

Availability Of Data

The dataset analysed in the current study is available from the corresponding author on reasonable request.