Impact of care pathway implementation on interprofessional teamwork: an international cluster randomized controlled trial
| Autor: | Massimiliano Panella, Deborah Seys, Svin Deneckere, Luk Bruyneel, Kris Vanhaecht, Cathy Lodewijckx, Walter Sermeus, Paulo Boto |
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| Rok vydání: | 2019 |
| Předmět: |
Teamwork
030504 nursing media_common.quotation_subject Control (management) education General Medicine Disease cluster Multilevel regression law.invention 03 medical and health sciences 0302 clinical medicine Nursing Randomized controlled trial law Care pathway Interprofessional teamwork 030212 general & internal medicine 0305 other medical science Psychology Competence (human resources) media_common |
| Popis: | This study evaluates whether the implementation of an in-hospital care pathway (CP) improves interprofessional teamwork across countries and tests whether improved communications ("relational coordination") is the mechanism of action. A hospital-based cluster randomized controlled trial in Ireland, Belgium, Italy, and Portugal was performed. Fifty-six interprofessional teams caring for patients admitted with an exacerbation of chronic obstructive pulmonary disease or for patients with a proximal femur fracture were included and randomly assigned to an intervention group (31 teams and 567 team members), where a CP was implemented, and a control group (25 teams and 417 team members) representing usual care. Multilevel regression and mediation analysis were applied. First, although no significant effect was found on our primary outcome relational coordination, our CP significantly improved several team inputs, team processes (team climate for innovation) and team output (the level of organized care, level of competence) indicators. Second, our team process indicator of team climate for innovation partially mediated the association between CP implementation and team output indicator of better level of organized care. In conclusion, a CP sets in motion various mechanisms that improve some but not all aspects of interprofessional teamwork. Relational coordination does not appear to be the mechanism by which team outputs are enhanced. ispartof: Journal of Interprofessional Care pages:1-9 ispartof: location:England status: Published online |
| Databáze: | OpenAIRE |
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