Implementation of Unit-Based Interventions to Improve Teamwork and Patient Safety on a Medical Service.
O'Leary, Kevin J. MD, MS 1; Creden, Amanda J. BS 1; Slade, Maureen E. MS, RN, CS 2; Landler, Matthew P. MD 1; Kulkarni, Nita MD 1; Lee, Jungwha PhD, MPH 1; Vozenilek, John A. MD 3; Pfeifer, Pamela RN 2; Eller, Susan RN, MSN 4; Wayne, Diane B. MD 1; Williams, Mark V. MD 5
[Article] American Journal of Medical Quality. 30(5):409-416, September 2015.

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: In a prior study involving 2 medical units, Structured Interdisciplinary Rounds (SIDRs) improved teamwork and reduced adverse events (AEs). SIDR was implemented on 5 additional units, and a pre- versus postintervention comparison was performed. SIDR combined a structured format for communication with daily interprofessional meetings. Teamwork was assessed using the Safety Attitudes Questionnaire (score range = 0-100), and AEs were identified using queries of information systems confirmed by 2 physician researchers. Paired analyses for 82 professionals completing surveys both pre and post implementation revealed improved teamwork (mean 76.8 /- 14.3 vs 80.5 /- 11.6; P = .02), which was driven mainly by nurses (76.4 /- 14.1 vs 80.8 /- 10.4; P = .009). The AE rate was similar across study periods (3.90 vs 4.07 per 100 patient days; adjusted IRR = 1.08; P = .60). SIDR improved teamwork yet did not reduce AEs. Higher baseline teamwork scores and lower AE rates than the prior study may reflect a positive cultural shift that began prior to the current study.

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