From words to action: visibility of management in supporting interdisciplinary team working in an acute rehabilitative geriatric hospital.

PURPOSE The following case study aims to explore management's, health professionals' and patients' experiences on the extent to which there is visibility of management support in achieving effective interdisciplinary team working, which is explicitly declared in the mission statement of a 60-bed acute rehabilitative geriatric hospital in Malta. DESIGN/METHODOLOGY/APPROACH A total of 21 semi-structured interviews were conducted with the above-mentioned key stakeholders. FINDINGS Three main distinct yet interdependent themes emerged as a result of thematic analysis: "managing a team-friendly hospital", "interdisciplinary team components", and "interdisciplinary team processes". The findings show that visibility of management support and its alignment with the process and content levels of interdisciplinary teamwork are key to integrated care for acute rehabilitative geriatric patients. RESEARCH LIMITATIONS/IMPLICATIONS The emerging phenomena may not be reproducible in a different context; although many of the emerging themes could be comfortably matched with the existing literature. PRACTICAL IMPLICATIONS The implications are geared towards raising the consciousness and conscientiousness of good practice in interdisciplinary teamwork in hospitals, as well as in emphasizing organizational and management support as crucial factors for team-based organizations. SOCIAL IMPLICATIONS Interdisciplinary teamwork in acute rehabilitative geriatrics provides optimal quality and integrated health care delivery with the aim that the older persons are successfully discharged back to the community. ORIGINALITY/VALUE The authors draw on solid theoretical frameworks--the complexity theory, team effectiveness model and the social identity theory--to support their major finding, namely the alignment of organizational and management support with intra-team factors at the process and content level.

[1]  B. Tuckman,et al.  Stages of Small-Group Development Revisited , 1977 .

[2]  P. Burnard.  A method of analysing interview transcripts in qualitative research. , 1991, Nurse education today.

[3]  R. McDaniel,et al.  Case Study Research: The View From Complexity Science , 2005, Qualitative health research.

[4]  R. Reznick,et al.  Uptake of a team briefing in the operating theatre: a Burkean dramatistic analysis. , 2009, Social science & medicine.

[5]  Sydney Morss Dy,et al.  A Systematic Review of Satisfaction with Care at the End of Life , 2008, Journal of the American Geriatrics Society.

[6]  G. Voerman,et al.  Review Article: Effectiveness of Patient Care Teams and the Role of Clinical Expertise and Coordination , 2009, Medical care research and review : MCRR.

[7]  Yvonna S. Lincoln,et al.  The landscape of qualitative research: theories and issues Sage The landscape of qualitative research: theories and issues 480 £24.95 0761926941 0761926941 [Formula: see text]. , 2004, Nurse researcher.

[8]  J. Weller,et al.  Are doctors team players, and do they need to be? , 2010, The New Zealand medical journal.

[9]  Christiane Herre,et al.  Promoting team effectiveness , 2010 .

[10]  Eduardo Salas,et al.  Managing team performance in complex settings: Research-based best practices. , 2009 .

[11]  M. Polanyi.  Chapter 7 – The Tacit Dimension , 1997 .

[12]  L. Festinger.  A Theory of Social Comparison Processes , 1954 .

[13]  J. Conway,et al.  The relative importance of task, citizenship and counterproductive performance to job performance ratings: Do rater source and team‐based culture matter? , 2008 .

[14]  Joy V Goldsmith,et al.  Interdisciplinary Geriatric and Palliative Care Team Narratives: Collaboration Practices and Barriers , 2010, Qualitative health research.

[15]  O. Warren,et al.  Medical leadership: why it's important, what is required, and how we develop it , 2010, Postgraduate Medical Journal.

[16]  S. Brumfitt,et al.  Benefits and losses: a qualitative study exploring healthcare staff perceptions of teamworking , 2008, Quality & Safety in Health Care.

[17]  Joan R. Rentsch,et al.  The Role of Cognition in Managing Conflict to Maximize Team Effectiveness: A Team Member Schema Similarity Approach , 2008 .

[18]  L. Cohen,et al.  Research Methods in Education , 1980 .

[19]  M. Patton,et al.  Qualitative evaluation and research methods , 1992 .

[20]  E. Salas,et al.  Promoting health care safety through training high reliability teams , 2005, Quality and Safety in Health Care.

[21]  Phillip G. Clark,et al.  Health Care Teamwork: Interdisciplinary Practice and Teaching , 2000 .

[22]  J. Firth‐Cozens,et al.  Multidisciplinary teamwork: the good, bad, and everything in between , 2001, Quality in health care : QHC.

[23]  C. Rutte.  Social loafing in teams , 2008 .

[24]  Michael A. West,et al.  Managing people and performance: an evidence based framework applied to health service organizations , 2004 .

[25]  D. Buchanan.  Case Studies in Organizational Research , 2012 .

[26]  F. Zollman,et al.  Rehabilitation Team Disagreement: Guidelines for Resolution , 2009, PM & R : the journal of injury, function, and rehabilitation.

[27]  J. Hackman,et al.  The design of work teams , 1987 .

[28]  T Packwood,et al.  Qualitative Research: Case study evaluation , 1995, BMJ.

[29]  J. Dawson,et al.  Reducing patient mortality in hospitals: the role of human resource management , 2006 .

[30]  H. Tajfel.  Differentiation between social groups: Studies in the social psychology of intergroup relations. , 1978 .

[31]  M. Knapp,et al.  Home treatment for mental health problems: a systematic review. , 2001, Health technology assessment.

[32]  Daan van Knippenberg,et al.  Intergroup Relations in Organizations , 2008 .

[33]  Barbara Wisse,et al.  The Formation of Group Affect and Team Effectiveness: The Moderating Role of Identification , 2009 .

[34]  M O Roland,et al.  Identifying predictors of high quality care in English general practice: observational study , 2001, BMJ : British Medical Journal.

[35]  H. McKenna,et al.  Establishing the credibility of qualitative research findings: the plot thickens. , 1999, Journal of advanced nursing.

[36]  Michael A. West,et al.  Developing Effective Teams , 2008 .

[37]  Tom Wengraf,et al.  Qualitative Research Interviewing , 2001 .

[38]  J. Mathieu,et al.  The influence of shared mental models on team process and performance. , 2000, The Journal of applied psychology.

[39]  E. Salas,et al.  How to turn a team of experts into an expert medical team: guidance from the aviation and military communities , 2004, Quality and Safety in Health Care.

[40]  E. Grill,et al.  ICF Core Sets development for the acute hospital and early post-acute rehabilitation facilities , 2005, Disability and rehabilitation.

[41]  Frank Ostroff,et al.  The horizontal organization , 1999 .

[42]  Thomas W. Lee,et al.  Using Qualitative Methods in Organizational Research , 1998 .

[43]  N. Denzin,et al.  The Landscape of Qualitative Research , 2012 .

[44]  M. West,et al.  Team working and effectiveness in health care , 2000 .

[45]  M. Hammersley.  Using qualitative methods , 1981 .

[46]  Bernard C. K. Choi,et al.  Multidisciplinarity, interdisciplinarity, and transdisciplinarity in health research, services, education and policy: 2. Promotors, barriers, and strategies of enhancement. , 2007, Clinical and investigative medicine. Medecine clinique et experimentale.

[47]  Martin J. Eppler,et al.  Managing team knowledge: core processes, tools and enabling factors , 2000 .

[48]  M. Patton.  Qualitative evaluation and research methods, 2nd ed. , 1990 .

[49]  Dean Tjosvold,et al.  Team Organization: An Enduring Competitive Advantage , 1991 .

[50]  G. Dunn,et al.  The Lambeth Early Onset (LEO) Team: randomised controlled trial of the effectiveness of specialised care for early psychosis , 2004, BMJ : British Medical Journal.

[51]  I. Nonaka,et al.  The Knowledge Creating Company , 2008 .

[52]  J. Dawson,et al.  Leadership clarity and team innovation in health care , 2003 .

[53]  Denise Polit-O'Hara,et al.  Nursing Research: Principles and Methods , 1978 .

[54]  Christopher J. Bamber,et al.  Factors affecting successful implementation of high performance teams , 2001 .

[55]  L. Nichols,et al.  Interdisciplinary Geriatric Primary Care Evaluation and Management: Two‐Year Outcomes , 2000, Journal of the American Geriatrics Society.

[56]  J. Barker.  Tightening the Iron Cage: Concertive Control in Self-Managing Teams , 1993 .

[57]  Michael M. Beyerlein,et al.  Team‐Based Organization Creating an Environment for Team Success , 2008 .