Background:
Studies demonstrate discrepant attitudes about teamwork among nurses and physicians in operating rooms and intensive care units. Little is known about teamwork attitudes on general medical services. Our objective was to assess ratings of teamwork by providers on inpatient medical units and barriers to collaboration.
Methods:
During a 1‐month study period, all nurses, primary service physicians (teaching and hospitalist service), medical subspecialty consultants, social workers, and case managers on 4 general medical units were surveyed. Providers were asked to rate the quality of communication and collaboration experienced with their own and other disciplines on a 5‐point Likert scale (from 1 = very low to 5 = very high). Providers also rated potential barriers to collaboration on a 4‐point Likert scale (from 1 = not at all a barrier to 4 = major barrier). Using ANOVA, we tested for differences in ratings of collaboration that provider types gave to each other.
Results:
Of 238 eligible providers, 166 (70%) completed the survey. Teamwork ratings of nurses, social workers, and case managers were similarly high across provider types (mean overall ratings were 4.05, 3.86, and 3.84; P ≥ .3 for each). Ratings of physicians differed considerably by provider type (P < .001 for each). The vast majority of teaching service, hospitalist, and subspecialty physicians rated the quality of collaboration with nurses as high or very high (72%, 70%, and 70%, respectively). Far fewer nurses rated the quality of collaboration with physicians as high or very high (35%, 42%, and 16% for teaching service, hospitalist, and subspecialty physicians, respectively). Medical subspecialty consultants received the lowest overall rating of collaboration (mean = 3.13). Nurses reported that negative attitudes toward the importance of communication on the part of some providers and not having a way for patients to get updated information on names and roles of their providers were barriers to collaboration (mean ratings = 3.19 and 3.23, respectively). Physicians rated not having physicians and nurses on a single telecommunication system as the biggest barrier (mean rating = 3.23).
Conclusions:
In a general medical inpatient setting, discrepancies among nurses and physicians existed in the ratings of communication and collaboration. While physicians rated the quality of teamwork with nurses favorably, nurses perceived teamwork as subopti‐mal. Perceptions of barriers to communication also differed based on provider type.
Author Disclosure:
K. O'Leary, none; C. Ritter, none; H. Wheeler, none; M. Szekendi, none; M. Williams, none.