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Improving teamwork, one physician at a time: The Teamwork Effectiveness Assessment Module (TEAM).

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Chesluk B, Reddy S, Lynn LA, Bernabeo E, Odhner T. — American Board of Internal Medicine

Hess BJ. — Hess Consulting

Presented: AcademyHealth Annual Research Meeting, June 2014

Objective: Teamwork continues to be recognized as a vital component of safe, timely, effective patient care, as well as important to sustainable, rewarding working relationships among care providers. The American Board of Internal Medicine (ABIM) introduced the TEAM (Teamwork Effectiveness Assessment Module) in October 2012 to provide practicing hospital physicians feedback on their teamwork behaviors and skills from their interprofessional team. This study evaluated the initial launch of the module to understand whether and how physicians were able to use the module to improve their teamwork.

Study Design: The TEAM was launched in October 2012 to participants in ABIM’s Focused Practice in Hospital Medicine certification program. Data were collected on the number of physicians ordering and completing the module, time to completion, evaluation by users and their raters via survey questions within the module. Two rounds of follow-up interviews were conducted with module registrants and completers (one round of interviews shortly after using the module, and one round six months or more after completing the module) to obtain more in-depth and nuanced information. These data were then analyzed to understand how physicians used the TEAM and its value to their clinical work.

Population Studied: Hospitalist physicians who used the TEAM and the members of their interprofessional teams.

Principal Findings: After one year, 156 physicians had ordered the TEAM and 83 had completed the module. They worked in a diversity of hospital types and practice models. Completers reported that the TEAM provided meaningful, actionable feedback that they would not have otherwise received. Team members who rated physicians reported that the module asked about the meaningful aspects of how they worked with physicians; most felt the module adequately protected their anonymity in giving feedback. The interviews with 21 physicians six months after they had completed the TEAM indicated that, to varying degrees, many module users had been able to make changes in how they engaged with their team members, both personally and professionally, and some others had incorporated their feedback into their participation in hospital-wide initiatives around teamwork. These interviews also pointed out challenges module users faced in acting on their feedback, including the need to engage peers who had not completed the module and the difficulty of adding a new obligation (“improving teamwork”) to the already-demanding work of practicing hospital medicine.

Conclusion and Implications for Policy or Practice: Findings from this research point to both the potential of an individual assessment activity for practicing physicians to improve interprofessional teamwork in the hospital, as well as some of the limitations of using this approach. Most early users of the TEAM found the module to produce worthwhile, actionable feedback on their teamwork; many were able to use the feedback to the module to improve how they work with their teams to care for patients, yet faced challenges in implementing changes based on their feedback as well. Improving teamwork in health care remains a complex task that will require multiple interventions aimed at health care providers from all professions, at all stages of learning, as individuals and as teams.

For more information about this presentation, please contact Research@abim.org.