Impact of teamwork improvement training on communication and teamwork climate in ambulatory reproductive health care.

BACKGROUND: While team training is associated with improved hospital-based team climate, less is known about effects in the ambulatory setting.

STUDY DESIGN: In 2014 and 2015, we enrolled 20 organizations, each operating various health centers, into this ongoing study. Evaluation tools include a communication behaviors assessment (CBA) and Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS® ) Teamwork Perceptions Questionnaire (T-TPQ), which staff completes at baseline, 6 months, and 1 year, and the Patients' Insights and Views of Teamwork (PIVOT) survey, which patients complete at baseline and 1 year. We also assessed patient satisfaction. We analyzed T-TPQs paired at the individual level and CBAs and PIVOTs paired at the health center level. We also conducted key informant interviews with the first cohort.

RESULTS: CBAs showed that TeamSTEPPS tools and strategies were utilized, with 50% or more of centers reporting increases in all behaviors at 1 year; key informant interviews confirmed this. T-TPQ findings indicated that TeamSTEPPS implementation was associated with improved staff perceptions of teamwork at 6 months; lesser improvements were seen at 1 year. The PIVOT survey demonstrated significant improvements in select patient ratings of teamwork. Patient satisfaction improved at 1 year.

CONCLUSIONS: TeamSTEPPS has positive effects in the ambulatory reproductive health care environment. Improvements persisted at 1 year.