Multidisciplinary in-hospital teams improve patient outcomes: A review

Background: The use of multidisciplinary in-hospital teams limits adverse events (AE), improves outcomes, and adds to patient and employee satisfaction. Methods: Acting like “well-oiled machines,” multidisciplinary in-hospital teams include “staff” from different levels of the treatment pyramid (e.g. staff including nurses’ aids, surgical technicians, nurses, anesthesiologists, attending physicians, and others). Their enhanced teamwork counters the “silo effect” by enhancing communication between the different levels of healthcare workers and thus reduces AE (e.g. morbidity/mortality) while improving patient and healthcare worker satisfaction. Results: Multiple articles across diverse disciplines incorporate a variety of concepts of “teamwork” for staff covering emergency rooms (ERs), hospital wards, intensive care units (ICUs), and most critically, operating rooms (ORs). Cohesive teamwork improved communication between different levels of healthcare workers, and limited adverse events, improved outcomes, decreased the length of stay (LOS), and yielded greater patient “staff” satisfaction. Conclusion: Within hospitals, delivering the best medical/surgical care is a “team sport.” The goals include: Maximizing patient safety (e.g. limiting AE) and satisfaction, decreasing the LOS, and increasing the quality of outcomes. Added benefits include optimizing healthcare workers’ performance, reducing hospital costs/complications, and increasing job satisfaction. This review should remind hospital administrators of the critical need to keep multidisciplinary teams together, so that they can continue to operate their “well-oiled machines” enhancing the quality/safety of patient care, while enabling “staff” to optimize their performance and enhance their job satisfaction.

[1]  Chih-Jen Yang,et al.  Outcomes of the patients in the respiratory care center are not associated with the seniority of the caring resident , 2013, The Kaohsiung journal of medical sciences.

[2]  C. Beattie,et al.  Successful strategies for improving operating room efficiency at academic institutions. , 1999, Anesthesia and analgesia.

[3]  E. Søfteland,et al.  A survey of surgical team members’ perceptions of near misses and attitudes towards Time Out protocols , 2013, BMC Surgery.

[4]  M. Guanci,et al.  Assessment of Satisfaction With Care Among Family Members of Survivors in a Neuroscience Intensive Care Unit , 2014, The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses.

[5]  J. Katajisto,et al.  Team climate and attitudes toward information and communication technology among nurses on acute psychiatric wards , 2015, Informatics for health & social care.

[6]  Hania Wehbe-Janek,et al.  Implementation of a surgical safety checklist: impact on surgical team perspectives. , 2013, The Ochsner journal.

[7]  M. Weigl,et al.  Identification and interference of intraoperative distractions and interruptions in operating rooms. , 2014, The Journal of surgical research.

[8]  C. Ball,et al.  Utility of simultaneous interventional radiology and operative surgery in a dedicated suite for seriously injured patients , 2013, Current opinion in critical care.

[9]  M. Estryn-behar,et al.  Shift Change Handovers and Subsequent Interruptions: Potential Impacts on Quality of Care , 2014, Journal of patient safety.

[10]  Sandra S Mangum,et al.  Increased efficiency through OR redesign and process simplification. , 2002, AORN journal.

[11]  P. Adobamen,et al.  Ear, Nose, Throat, Head and Neck Surgery Department Functioning as a Team in Nigeria: Any Benefit? , 2012, Indian Journal of Otolaryngology and Head & Neck Surgery.

[12]  G. B. Jacobs,et al.  Consequences and potential problems of operating room outbursts and temper tantrums by surgeons , 2012, Surgical neurology international.

[13]  M. Justić Does "ICU psychosis" really exist? , 2000, Critical care nurse.

[14]  A. Waylen,et al.  Centralization of Services for Children Born with Orofacial Clefts in the United Kingdom: A Cross-Sectional Survey , 2014, The Cleft palate-craniofacial journal : official publication of the American Cleft Palate-Craniofacial Association.

[15]  K. Reinhart,et al.  Effects of staff training on the care of mechanically ventilated patients: a prospective cohort study. , 2009, British journal of anaesthesia.

[16]  Qingzhao Yu,et al.  Getting a head start: high-fidelity, simulation-based operating room team training of interprofessional students. , 2014, Journal of the American College of Surgeons.

[17]  A. Talsma,et al.  Characterizing the Structure of Operating Room Staffing Using Social Network Analysis , 2011, Nursing research.

[18]  J. Ausman The business of surgery. Business principles applied to preoperative planning, operating room management, and surgical strategy. , 1999, Surgical neurology.

[19]  A. Darzi,et al.  Nontechnical skills performance and care processes in the management of the acute trauma patient. , 2014, Surgery.

[20]  Allison J Porter,et al.  Sustainable, effective implementation of a surgical preprocedural checklist: an "attestation" format for all operating team members. , 2014, Joint Commission journal on quality and patient safety.

[21]  Denise Gee,et al.  Pilot Testing of a Model for Insurer-Driven, Large-Scale Multicenter Simulation Training for Operating Room Teams , 2014, Annals of surgery.

[22]  Jean E. Cefalu,et al.  Interprofessional Teamwork Among Students in Simulated Codes: A Quasi‐Experimental Study , 2013, Nursing education perspectives.

[23]  N. Epstein,et al.  How to reduce hospital-acquired pressure ulcers on a neuroscience unit with a skin and wound assessment team , 2012, Surgical neurology international.

[24]  S. Rogers,et al.  In-hospital fellow coverage reduces communication errors in the surgical intensive care unit. , 2014, Journal of critical care.