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N815 IBD Team Climate Inventory: finding solutions to team challenges

Burke M., Keogh A.

Galway University Hospital, Gastroenterology, Galway, Ireland

Background

Effective teamwork is associated with a range of positive outcomes such as a reduction in medical errors, increased patient safety, reducing work-related stress for staff and improving local team relationships [1]. It is suggested that the best care for IBD patients is provided by a multidisciplinary team, offering an effective model for long-term care of patients and reflect the need to be adaptable and responsive to patients with changeable and progressive disease who have both complex medical and psychosocial care needs [2], The IBD Team Climate Inventory (TCI) measures team function and can help to “diagnose where teams need help to be more effective” [3]. The aim of this project was to assess team function using the TCI to identify any challenging teamwork factors and implement change to progress team function and enhance supportive working environments for IBD team members to improve the effectiveness of the team in terms of care delivery and staff working experience.

Methods

A postal questionnaire was sent to the IBD team (n=29). TCI was first measured across the team in April 2016 and re-assessed in a sub group (nursing)in October 2016 after a Consultant-led Virtual Biologic Clinic was in place 4 months. Team characteristics were collected using both closed and open ended questions.

Results

Overall the TCI team score was 3.5. There was no statistically significant difference in scores by professional group within three of the subscales. However there was a statistically significant difference in the participatory safety PS)sub scale scores across the professional groups F(3,19)=7.5, p=0.001, size effect was moderate (0.6). Posthoc analysis indicated that the mean score in the nursing group was significantly difference from the other groups (Nursing, M=2.78, SD=0.455). While the mean PS team score was 3.5, the nursing group mean score was significantly lower (2.8) with the infusion unit nursing staff reporting an even lower score average of 2.4. Open ended questions revealed that the nursing staff in the infusion unit reported a level of isolation from the other IBD team members. Communication with and access to the medical profession was perceived to be limited in terms of managing patients, which was seen as a barrier to teamworking and building working relationships. This qualitative data is reflective of the participatory safety scores reported.

Conclusion

This research suggests that the TCI can be used to identify challenges for the multidisciplinary IBD team. The consultant led Virtual Biologic Clinic model employed enhanced levels of access to and communication between team members, contributed positively to patient management and created a more supportive working environments for staff.

References:

[1] West & Lyubovnikova, (2013), Illusions of teamworking in healthcare, Journal of Health Organization and Management

[2] Pane, J., O Connor, M., Peyrin-Biroulet, L., Petersson, J. & Colombel, J., (2014), Improving quality of care in inflammatory bowel disease:what changes can be made today? Journal of Crohns & Colitis

[3] Beaulieu, M., Dragieva, N., Del Grande, C. et al. (2014), The team climate inventory as a measure of primary care team processes: validation of the team climate inventory. Healthcare Policy