Research Catalog

Title

Achieving strong teamwork practices in hospital labor and delivery units.

Author

Farley, Donna.

Publication

Santa Monica : Rand Corporation, 2010

Items in the Library & Off-site

Holdings

Details

Additional Authors

Center for Military Health Policy Research.

Description

xxiv, 124 p.; 28 cm.

Summary

A RAND study of teamwork-improvement initiatives in hospital labor and delivery (L&D) units was designed to document and learn from the experiences and outcomes of five L&D units as they implemented improvements in their teamwork practices over a one-year period. The study had two objectives: (1) better understand the conditions and actions required for hospital L&D units to achieve effective and sustainable teamwork practices, and (2) assess the extent to which successful adoption of teamwork practices may influence the experiences of L&D staff and patient outcomes. Substantial progress is possible in one year of implementing teamwork practices, which can improve proximal outcomes, such as staff knowledge and perceptions. More than a year of implementation effort is required to achieve a high level of performance on teamwork practices. Two dynamics might be involved in later years of implementation: (1) momentum from the first year might continue into later years, such that subsequent implementation might reinforce continued improvement, and (2) it might not be possible to sustain high intensity in implementation beyond the first year. The study results reinforce the importance of developing and implementing a well-crafted strategy by training staff in the L&D units, working consistently with staff to introduce practices, and providing coaching on effective use of practices. The study identified some key factors required by any given strategy for teamwork improvement, but it did not point to a standard template for implementation. This result implies that there may not be one fixed "intervention" that could be tested in comparative-control studies to develop further evidence for teamwork practices.

Series Statement

Technical report ; TR-842-OSD

Uniform Title

Technical report (Rand Corporation) ; TR-842-OSD.

Subject

• Patient Care Team
• Delivery Rooms > standards
• Cooperative Behavior
• Birthing Centers > organization & administration
• Medical Staff, Hospital > psychology
• Hospitals > Employees
• Delivery, Obstetric
• Personnel, Hospital

Bibliography (note)

• Includes bibliographical references (p. 121-124).

Processing Action (note)

• committed to retain

Contents

Introduction and background -- Study design and methods -- Findings regarding teamwork implementation -- Effects of teamwork improvement on unit staff and patient outcomes -- Synthesis of findings and conclusions -- Appendix A: Tools and strategies for teamwork -- Appendix B: Matrix of questions and stakeholders for site visits -- Appendix C: Monthly update teleconference: longitudinal labor and delivery teamwork study -- Appendix D: Questions for final assessment: longitudinal labor and delivery teamwork study -- Appendix E: Team performance observation tool -- Appendix F: Staff survey questionnaire -- Appendix G: Regression results for staff perceptions and knowledge

ISBN

• 0833050559
• 9780833050557

OCLC

671531658

Owning Institutions

Harvard Library