Better Interprofessional Teamwork, Higher Level of Organized Care, and Lower Risk of Burnout in Acute Health Care Teams Using Care Pathways A Cluster Randomized Controlled Trial
Better Interprofessional Teamwork, Higher Level of Organized Care, and Lower Risk of Burnout in Acute Health Care Teams Using Care Pathways A Cluster Randomized Controlled Trial
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DOI：
10.1097/mlr.0b013e3182763312
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发表时间：
2013-01-01
期刊：
影响因子：
3
通讯作者：
Vanhaecht, Kris
中科院分区：
文献类型：
--
作者：
Deneckere, Svin;Euwema, Martin;Vanhaecht, Kris
背景资料：有效的跨专业团队合作是在日益复杂的医疗环境中提供高质量患者护理的重要组成部分。我们的目标是评估是否实施护理路径（CP），提高团队合作在急性hospital setting.Design和Measures：一个posttest-only集群随机对照试验在比利时急性医院进行。护理股骨近端骨折住院患者和慢性阻塞性肺疾病加重住院患者的团队被随机分为干预组和对照组。干预组实施CP。对照组给予常规护理。一组团队的投入，过程和产出指标被用来作为效果的措施。结果：30个团队共581名个人团队成员参与了调查。干预小组在冲突管理方面的得分明显更高[beta = 0.30（0.11）; 95%置信区间（CI），0.08至0.53];团队创新氛围[beta = 0.29（0.10）; 95% CI，0.09至0.49];和有组织护理水平[β = 5.56（2.05）; 95% CI，1.35至9.76]。他们还表现出较低的倦怠风险，因为他们在情绪疲惫方面得分显著较低[beta = -0.57（0.21）; 95%CI，-1.00 to -0.14]，而在能力水平方面得分较高（beta = 0.39; 95%CI，0.15 to 0.64）。关系coordination.Conclusions：CP是有效的干预措施，以提高团队合作，提高组织水平的护理流程，并降低风险的职业倦怠的医疗团队在急性医院环境。这样才能打造出高绩效的团队。
Background: 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.Design and Measures: 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.Results: Thirty teams and a total of 581 individual team members participated. The intervention teams scored significantly better in conflict management [beta = 0.30 (0.11); 95% confidence interval (CI), 0.08 to 0.53]; team climate for innovation [beta = 0.29 (0.10); 95% CI, 0.09 to 0.49]; and level of organized care [beta = 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 [beta = -0.57 (0.21); 95% CI, -1.00 to -0.14] and higher in the level of competence (beta = 0.39; 95% CI, 0.15 to 0.64). No significant effect was found on relational coordination.Conclusions: 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.