Interdisciplinary health care teams: Organizational context, team performance, team development, and team goals

By 2030 over 9 million Americans will be age 85 years or older and have one or more chronic illnesses. The current United States health care system must prepare for the aging population and the accompanying increase in chronic illnesses. The system lacks the structure to care for the complex needs of the chronically ill. Many experts believe that interdisciplinary health care teams (IHCT) are necessary to coordinate and deliver care to patients with complex conditions Furthermore, experts assert that such health care teams can promote patient care and initiate health care quality improvement (QI) programs (Bodenheimer, Wagner, & Grumbach, 2002; P. J. Drinka & Clark, 2000; Lynn & Adamson, 2003; Reuben et al., 2004).; As the approach to patient care using IHCTs grows, more evidence is needed to understand the relationship between team characteristics, the workings within the team, and their influence on team goals. Organizational theories suggest that individual characteristics, organizational context, team characteristic and team performance impact team effectiveness (Hackman, 1987; Sundstrom, De Meuse, & Futrell, 1990; Swezey & Salas, 1992).; The purpose of this study is to describe the organizational context, team performance, stage of team development and the relationships between these variables to the IHCTs achievement of a QI goal. The research questions proposed are: (1) Is there a relationship between organizational context and the achievement of the IHCTs QI goal? (2) Is there a relationship between team performance and the achievement of the IHCTs QI goal? (3) Is there a relationship between the team's stage of development and the achievement of the IHCTs QI goal? (4) Can organizational context, team performance and the stage of team development predict the achievement of the IHCTs QI goal?; This study was conducted between November 2004 to July 2005 with 18 teams participating in the New York Palliative Care Collaborative (PCQuIC). The intervention used was the application of the rapid cycle quality improvement method. Teams designed a QI goal, implemented a change and measured the achievement of this goal over time. Three instruments were used: the Organizational Context Survey (OCS), the Team Performance Measure (TPM) and the PeaceHealth Team Development (PTD) measure. Biographic data were collected in or around the final learning session of the Collaborative (July 2005). Correlation and regression models assessed relationship between organizational context, team performance and stage of team development to the achievement of the IHCT's QI goal.; Data were used from 11 IHCTs of the 18 teams in the sample frame. Surveys were completed by 45 participants for an overall response rate of 62 percent. Achievement of the IHCT's QI goal was positively associated with organizational context, team performance and stage of team development. (Abstract shortened by UMI.)...